HPV Vaccine

What is the HPV vaccine?

The HPV vaccine is a series of shots that can protect you from an HPV (human papillomavirus) infection. HPV is a common sexually transmitted infection (STI) that spreads through skin-to-skin contact. There are about 40 types (strains) of HPV that can spread through sex. It’s so common that 80% of sexually active people will have an HPV infection at some point. Often, healthy immune systems can fight off the virus.

But some HPV infections don’t go away. Some progress to cancer. For example, most cervical cancer and cancers affecting your genitals are associated with an HPV infection. HPV infections are also responsible for genital warts.

This is why getting the HPV vaccine is so important. It’s a safe and effective way to prevent infections if you’re ever exposed.

What is the HPV vaccine for?

The HPV vaccine prevents HPV infections that can progress to cancer or genital warts. This part’s important: The vaccine prevents infections, but it isn’t a treatment. If you’ve already been exposed to a particular strain of HPV, the vaccine can’t heal the infection.

The HPV vaccine can protect you from strains you haven’t encountered before. These include high-risk types and low-risk types. High-risk HPV strains can progress to cancer. Low-risk types don’t increase your cancer risk, but they can cause nuisance conditions like genital warts.

The HPV vaccine prevents infections that can lead to:

• Cervical cancer.
• Vaginal cancer.
• Vulvar cancer.
• Penile cancer.
• Anal cancer.
• Cancer of the back of the throat (oropharyngeal cancer).
• Genital warts.

But, not all HPV vaccines provide the same protection. There are three different vaccines. Each protects against different strains of HPV.

Two of the vaccines are no longer available in the U.S. but are available in other countries. Still, many people in the U.S. received these earlier vaccines. It’s important to understand what protection you have based on the vaccine you received.

Gardasil-9

Since 2017, Gardasil-9 has been the only HPV vaccine available in the United States. It provides the most comprehensive protection of any HPV vaccine. Gardasil-9 protects against infections associated with:

• HPV-16 & HPV-18. These are the two most common high-risk strains of HPV. These strains cause 70% of cervical cancers, 90% of anal cancers and many cancers that can affect your throat and genitals.
• HPV-31, 33, 45, 52 & 58. Together, these strains cause an additional 20% of cervical cancers.
• HPV-6 & HPV-11. These strains cause 90% of genital warts. They’re considered low risk since they don’t cause cancer. Still, genital warts are a nuisance — and contagious. The vaccine can prevent you from ever having to deal with them yourself or having to tell a partner that you exposed them.

Gardasil

Gardasil was the first FDA-approved HPV vaccine. It became available in 2006. Gardasil protects against infections associated with:

• HPV-16 & HPV-18 (associated with 70% of cervical cancers, 90% of anal cancers and many cancers that can affect your throat and genitals).
• HPV-6 & HPV-11 (associated with 90% of genital warts).

Unlike Gardasil-9, the original Gardasil doesn’t protect against the additional HPV strains that cause 20% of cervical cancers. So, while Gardasil-9 reduces your risk of cervical cancer by 90%, the original Gardasil reduces your risk by 70%.

Cervarix

The FDA approved Cervarix in 2009. Cervarix only protects against high-risk strains of HPV associated with cancer. It doesn’t protect you from the strains that cause genital warts. Cervarix protects against infections associated with:

• HPV-16.
• HPV-18.

Who should get the HPV vaccine?

Everyone, regardless of sex or gender, should get vaccinated before they’re exposed to HPV through sexual activity. Remember — the HPV vaccine can only protect you from strains of HPV you haven’t already been exposed to via an infected partner.

The age recommendations from the Centers for Disease Control (CDC) for getting the vaccine reflect this rationale.

• Children between ages 11 & 12. The HPV vaccine is part of the vaccination schedule for children between 11 and 12, but children as young as 9 years old can safely receive it. The goal is to vaccinate children before they become sexually active and risk exposure.
• Adults up to and including age 26. The vaccine is also recommended for adults up to age 26. This includes people who started the series as a child, teen or young adult but didn’t finish it.
• Some adults up to and including age 45: In 2018, the Federal Drug Administration (FDA) expanded the age range from 26 to 45. The recommendation was based on research that showed the vaccine prevented HPV infections among adults in this age range, too.

The age limit for getting vaccinated (first 26 and now 45) is based on the thinking that most people have had sex (and potentially been exposed to multiple strains of HPV) by adulthood. If you’ve already been exposed, the vaccine won’t provide much benefit. Related, not all insurance companies cover the costs of the vaccine past ages 26 or 45.

But this doesn’t mean you can’t personally benefit from the vaccine if you’re a middle-aged adult. For example, if you’ve had few or no previous partners, getting vaccinated can potentially protect you from HPV if you’re about to start a sexual relationship.

Everyone’s situation is different. Your healthcare provider can advise you based on your sexual history.

Who shouldn’t get the HPV vaccine?

You shouldn’t get the HPV vaccine if you:

• Are pregnant. There isn’t a lot of research about the vaccine’s safety during pregnancy, so it’s best to get it after having your baby. But if you learn you’re pregnant after getting a shot, don’t worry. The HPV vaccine isn’t associated with pregnancy complications.
• Had a reaction to a previous dose. Tell your healthcare provider if you had a reaction to a previous HPV shot or to the ingredients in it. Inform them of any severe allergies you have, including yeast or latex allergies, which may increase your risk of an allergic reaction.
• Have moderate to severe illness. You may need to wait to get the vaccine until you’re healthy. Ask your provider when it’s safe to get the shot.

How does the HPV vaccine work?

The vaccine contains a simulation of the virus — not the actual live virus. The vaccine stimulates your immune system to produce antibodies that fight HPV. If you’re exposed to the actual virus, these antibodies prevent it from causing an infection.

What is the HPV vaccination schedule?

You’ll get the vaccine as a series of shots. The number of shots depends on the age at the first dose.

• From age 9 to 15: You’ll need two shots to be fully protected. You should get the second shot six to 12 months after getting the first shot. At this age, your immune system is especially strong. Vaccination at a young age provides the strongest immune response and the best protection against HPV infection.
• Ages 15 and up: You’ll need three shots to be fully protected. You should get the second shot one to two months after your first shot. You should get the third shot six months after your first shot.

People of any age with a condition that causes them to have a weakened immune system (immunocompromised) should follow the HPV vaccine schedule that requires three shots, not two.

What are the benefits of getting the HPV vaccine?

The HPV vaccine can reduce the risk of HPV-related cancers and genital warts in any person who is (or will one day be) sexually active.

The HPV vaccine became widely available to people assigned female at birth (AFAB) in 2006 to prevent cervical cancer. Rates of cervical cancer have been going down since. HPV infections related to cancer and genital warts have dropped by over 80%.

The FDA didn’t approve HPV vaccines in people assigned male at birth (AMAB) until 2011. Unfortunately, HPV vaccination rates among people AMAB remain low. This is especially concerning, given the rise of HPV-related throat cancers in this group. The vaccine can prevent these cancers as well as anal and penile cancers.

If you’re AMAB, getting vaccinated can also protect your sexual partners. Although you can’t develop cervical cancer, you can infect an unvaccinated sexual partner with a cervix with HPV strains that put them at serious risk of cervical cancer — unless you’re vaccinated.

The best defense against the virus is for everyone — regardless of sex — to get vaccinated before becoming sexually active.

How many years is the HPV vaccine good for?

Many people who’ve been vaccinated for several years wonder if they need a booster shot. The short answer is no. The vaccines continue to provide protection against HPV years after people complete the series. Currently, we know that:

• Gardasil (available since 2006) remains effective 10+ years after vaccination.
• Cervarix (available since 2009) remains effective 10+ years after vaccination.
• Gardasil-9 (available since 2014) remains effective at least 6 years after vaccination.

Scientists will continue to monitor the vaccine’s effectiveness over time.

What are the side effects of getting the HPV vaccine?

The HPV vaccine is safe. Still, as with any vaccination, you may notice mild side effects briefly after getting the shot. Your provider will monitor you to ensure you’re OK before going home.

Some of the most common side effects include:

• Soreness, swelling or redness at the injection site.
• Headache or feeling tired.
• Muscle or joint pain.
• Dizziness.
• Fever.
• Nausea.
• Severe allergic reactions (rare).

There aren’t any long-term side effects.

What questions should I ask my healthcare provider?

Contact your healthcare provider with any concerns or questions about getting the vaccine. This includes making sure you understand the vaccination schedule for your child. If you’re an adult age up to and including age 45 and haven’t been vaccinated, ask your provider if you could benefit from getting the HPV vaccine.

Should I get the HPV vaccine if I’ve already had HPV?

It depends. Much depends on your sexual history. Although the vaccine can’t protect you from the current strain causing the infection, it can protect you from strains you haven’t encountered. But, if you’ve already likely been exposed to various strains of HPV, the vaccine may not benefit you.

Weigh potential benefits with your provider.

Can you get the HPV vaccine at any age?

The current recommendations advise getting vaccinated up until age 45, depending on your sexual history. It’s best to get vaccinated around 11 or 12, before becoming sexually active and when your immune response to the vaccine is strongest. People as young as 9 can safely receive the vaccine.

Do I still need Pap tests if I’ve gotten the HPV vaccine?

Absolutely. You’ll still need regular Pap tests and HPV tests regardless of your vaccination status. The vaccines provide excellent protection from most HPV-related infections. But none of the vaccines protect against all high-risk HPV strains. Anyone with a cervix still needs routine screening to catch (and treat) cervical cancer in the early stages when it’s curable.

Should I get the new HPV vaccine if I had an old one?

Many people who received the earlier vaccines (Gardasil and Cervarix) wonder if they need Gardasil-9, which protects against more HPV strains. The CDC doesn’t currently recommend additional vaccinations because the earlier versions protect against the most high-risk strains of HPV. Alongside regular Pap and HPV tests, these vaccines provide excellent protection against cervical cancer.

If you have a question about potential benefits based on your vaccination and sexual history, talk to your provider.

Why do people opt out of the HPV vaccine?

Some people opt out of the vaccine because they’re allergic to the ingredients. You shouldn’t get the vaccine if it poses a potential risk to your health. For most people, however, the vaccine is both effective and safe.

Unfortunately, other people opt out of the HPV vaccine because of misinformation.

For example, many people AMAB think the vaccine only protects against cervical cancer. But this is false. It also prevents cancers affecting your throat, penis and anus. It prevents genital warts.

Some parents or caregivers choose not to vaccinate their children because they worry it’ll encourage them to have sex prematurely. Choosing not to vaccinate comes from a place of love and concern for their child’s sexual development. But the decision to become sexually active is much more complex than a single vaccine. Also, no research supports the view that the vaccine prompts people to start having sex.

However, research does show that the vaccine can protect your child in the future when they’re mature enough to engage in healthy adult sexual relationships. It can save their life.

A note from Cleveland Clinic

The HPV vaccine is one of our most powerful weapons against cervical cancer and other HPV-related cancers. If you’re a parent or caregiver, talk to your provider about vaccinating your child. If you’re an adult 45 years old or younger who’s never been vaccinated (or who didn’t complete the vaccine), ask your provider if the HPV vaccine could benefit you.