HPV vaccination is routinely recommended at 11-12 years of age but may start at 9.
Vaccination is indicated up to the age of 26 years, with catch-up vaccination if inadequately vaccinated. The usual protocol is 2 doses given 6-12 months apart. A third dose can be given if the first dose is after 15 years or if the patient has an immunocompromising condition.
After the age of 26 years the vaccine has limited benefit. The vaccine is not licensed for adults > 45 years.
Some adults 27 to 45 years of age may benefit from vaccination if not adequately vaccinated and if at risk for new HPV infection. A new sex partner is a risk factor for acquiring a new HPV infection. A person in a long-term, mutually monogamous sexual relationship is unlikely to acquire a new HPV infection.
HPV vaccination should be delayed until after pregnancy in a pregnant female but can be given if breastfeeding.
Vaccine effectiveness may be low in:
(1) an adult with multiple lifetime sex partners
(2) likely previous infection with vaccine-type HPV
(3) certain immunocompromising conditions
HPV vaccination is prophylactic. It does not prevent progression of HPV-related disease or increase clearance.
