The Human Papillomavirus (HPV) Vaccine

The New York State Department of Health endorses the National Human Papillomavirus (HPV) Vaccination Roundtable's "Start at 9" campaign to urge vaccination with HPV vaccine begin at age 9 years as routine practice. When the HPV vaccine is administered between the ages of 9 and 14 years, only two doses, given at least 6 months apart are needed to complete the series. If the HPV vaccine series is started at age 15 years or older or is planned for those 9 to 26 years of age with a weakened immune system, then 3 doses are needed for full protection. If 3 doses are needed, the second dose should be given 1 to 2 months after the first dose and the third dose should be given at least 6 months after dose 1 (minimal interval between dose 2 to dose 3 is 12 weeks, and minimal interval between dose 1 and dose 3 is 5 months). Catch-up vaccination through age 26 years is recommended for all persons not adequately vaccinated. Catch-up vaccination is not recommended for most adults over the age of 26 years. Shared clinical decision-making is recommended for some adults ages 27 through 45 years. The vaccine is not licensed for adults over the age of 45 years.

The HPV vaccine protects preteens, teens, and young adults from human papillomavirus (HPV). Research shows that when boys and girls are vaccinated early – prior to 9 to 14 years – they are better protected from serious health problems that HPV can cause, including certain cancers and genital warts.

HPV is a very common infection. It is estimated that one (1) in every four (4) Americans is infected with the virus. Most of them are in their late teens and 20s. Many will never know they have the virus, since HPV usually causes no symptoms. Even so, they can pass the disease to others during sex. For most people, HPV will eventually clear up on its own. But for others, the untreated infection could cause genital warts and certain kinds of cancer. About 31,000 HPV-related cancers are diagnosed each year. Most could be prevented with HPV vaccine.

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Who should get HPV vaccine?

Two (2) doses of HPV vaccine given at least six (6) months apart are recommended for those 9- to 14-year-olds to protect them from HPV cancers and genital warts. If the vaccine series is started at the routine 9-year-old doctor visit, this offers more opportunities to complete the 2 dose series.

Older teens and young adults can still benefit from the HPV vaccine - even if they are sexually active. The vaccine will protect them from the most common types of HPV. There are about 40 different types. Young adults can get the vaccine through age 26. Teens who are 15 years and older, and young adults, will need three (3) doses of HPV vaccine. People 27-45 years old can also receive HPV vaccine if they and their health care provider feel they would benefit from receiving the vaccine. The vaccine is not licensed for adults over age 45 years.

Individuals with weak immune systems (including people living with HIV/AIDS) ages nine (9) through 26, should get the three (3) dose vaccine series at 1, 1-2, and 6 months. A three (3) dose series is also recommended for person who receive their first valid dose on or after their 15th birthday.

Why is HPV vaccine recommended at age 9 to 12 years?

The HPV vaccine is recommended for preteen boys and girls aged 9 to 12 years so they are protected before ever being exposed to the virus.

Studies show the vaccine produces a stronger immune response in preteen and young teens compared to older teens and young adults. In fact, two (2) shots given at least six (6) months apart for preteens and teens younger than 15 years provides the same protection as three (3) shots for those older than 15 years. It is not recommended that an individual waits to be vaccinated until they reach puberty or start having sex. Preteens should receive all recommended doses of the HPV vaccine series long before they begin any type of sexual activity. Beginning the vaccine series at the routine 9-year-old doctor visit also provides more opportunities to complete the 2-dose series on time by the age of 13.

Who recommends the HPV vaccine?

The HPV vaccine is recommended by the Advisory Committee on Immunization Practices (ACIP), which is a group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States.

The HPV vaccine is also recommended by the Centers for Disease Control and Prevention (CDC), the American Cancer Society, the American Academy of Pediatrics (AAP), the American Academy of Family Physicians, the Society for Adolescent Health and Medicine and leading U.S. cancer centers (PDF) (

Why is the HPV vaccine recommended?

The HPV vaccine is a safe and effective way to protect against the serious health problems that HPV can cause. HPV is the main cause of genital warts in people. It can also cause cancers of the cervix, vagina, and vulva in women; cancer of the penis in men; and cancers of the anus and the mouth or throat in both women and men. Most of these diseases could be prevented with the HPV vaccine.

How is the HPV vaccine given?

The vaccine is given as a series of two (2) or three (3) shots, depending on when it is started.

Boys and girls who start the HPV vaccine series before they turn 15 will only need two (2) shots at least six (6) months apart. Teens and young adults who start the series later, between ages 15 and 26, and anyone who has a weakened immune system (age 9 through 26), will need three (3) doses of HPV vaccine for full protection.

If your child has started, but not completed the HPV vaccine series, talk with your doctor about completing the series so he or she will have full protection.

The shots can be given at the same time as other recommended vaccines for preteens and teens, including:

  • Tdap (which prevents tetanus, diphtheria, and pertussis, or whooping cough)
  • Meningococcal vaccine (which prevents meningitis)
  • Flu vaccine

Is the HPV vaccine safe?

Yes. The HPV vaccine has been administered since 2006 in the United States and even longer in other countries. Studies have shown that it is very safe. More than 57 million people have been given the vaccine, and there have been no serious safety concerns.

The CDC and the Food and Drug Administration (FDA) continue to monitor the vaccine's safety very carefully. These studies continue to show that HPV vaccines are safe. An overview of these studies can be found at HPV Vaccine Safety and Effectiveness Data (

The vaccine series should be delayed until after completion of pregnancy.

What are the side effects of the HPV vaccine?

Common, mild side effects include redness and pain at the injection site, low-grade fever, dizziness, and nausea. Some preteens and teens might faint after getting the vaccine, which is not uncommon when young people get shots. It is recommended that adolescents sit or lie down for 15 minutes after getting the shot. Serious side effects are rare.

Who should not be vaccinated?

Anyone who has ever had a life-threatening allergic reaction to any component of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine. Tell your doctor about any severe allergies, including an allergy to latex or yeast.

HPV vaccine is not recommended for pregnant women. Women who are breastfeeding may get the vaccine.

People who are mildly ill when a dose of HPV vaccine is planned can still be vaccinated.

How can I pay for the HPV vaccine?

All private insurance plans regulated by New York State are required to cover the cost of all ACIP-recommended vaccines, including HPV vaccine, for patients through the age of 18. All other private insurance plans should be contacted individually to determine their coverage of HPV vaccination.

A federal program called the Vaccines for Children (VFC) Program can help pay for your child's vaccines if he or she is 18 years if age or younger and is not insured, underinsured, eligible for Medicaid, an American Indian or an Alaska Native. For more information, visit New York State Vaccines for Children (VFC) Program.

What if someone is uninsured or underinsured and older than 18?

Merck, the pharmaceutical company, has a patient assistance program which offers help for individuals 19-26 years of age who cannot afford HPV vaccination. You can reach the Merck Vaccine Patient Assistance Program by calling (toll-free) 1-800-293-3881.

How can I learn more about the HPV vaccine?

Talk to your child's doctor and review the additional resources listed below.

Additional Resources for Parents

Additional Resources for Providers