HPV Vaccine Recommendations for Girls, Boys, Women, and Men

The human papillomaviruses (HPVs) are a group of over 100 types viruses that infect humans. Over 40 HPV types infect the genital tract and anus of men and women. They may sometimes cause genital warts, but a subgroup of the HPVs that infect the genital tract can lead to precancerous changes in the uterine cervix and cervical cancer. HPV infection is also associated with the development of other cancers like anal and penile cancer in men, as well as a subgroup of head and neck cancers in both women and men.

A vaccine designed to prevent cervical cancer and other diseases caused by infection with HPVs was approved for use in the U.S. in June 2006. This was the first vaccine to be developed against a known risk factor for the development of a cancer. An additional vaccine also was approved, but was withdrawn from the market in 2016, and the original vaccine has also been modified to target more HPV types (see next sections).

There are three HPV vaccine which have been used in the US.

Gardasil

• Gardasil, developed by Merck & Co., has been shown to be safe and 100% effective in preventing infection by four common HPV types (6, 11, 16, 18) in young people who have not been previously infected with HPV. Its effectiveness is lessened for those who have already been exposed to the viruses.
• Both types of the Gardasil vaccine are effective against diseases caused by HPV-16 and HPV-18 and can prevent cervical pre-cancers in women as well as cancers of the cervix, vulva, vagina, penis, anus, and oropharynx.
• Gardasil has been tested and shown to prevent pre-cancers of the vulva, vagina, and anus.
• Gardasil protects against HPV-6 and HPV-11, the virus types that commonly cause genital warts.

Gardasil 9

• Gardasil 9 is a newer version of the Gardasil vaccine, and was approved in December 2014. It confers immunity to 9 HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58).

Cervarix

• Cervarix is another HPV vaccine that prevents infection from HPV types 16 and 18 that are the two HPV types most commonly associated with cervical cancer. Cervarix is manufactured by GlaxoSmithKline and is the second HPV vaccine to be developed. Cervarix was withdrawn from the US market in 2016.

Both types of the Gardasil and the Cervarix vaccine are effective against diseases caused by HPV-16 and HPV-18 and can prevent cervical pre-cancers in women as well as cancers of the cervix, vulva, vagina, penis, anus, and oropharynx. Only Gardasil protects against HPV-6 and HPV-11, the virus types that commonly cause genital warts.

HPV vaccine age recommendations for girls and women

Ideally, vaccination should occur before youth become sexually active, since those who have not yet been infected with any HPV types will get the full benefit of the vaccine. Therefore, the CDC recommends that 11- to 12-year-old girls should receive three doses of HPV vaccine, and young women ages 13 through 26 should get the vaccine if they did not receive any or all doses when they were younger.

HPV vaccine age recommendations for boys and men

Gardasil is also approved for use in males aged 9 to 26. The CDC recommends Gardasil for all boys aged 11 or 12 years, and for males aged 13 through 21 years who did not receive the full three vaccination series. Men up to age 26 may receive the vaccine. The HPV vaccine is recommended for any men who have sex with men or men with compromised immune function, up through 26 years of age.

Research is ongoing to determine whether the vaccine has any beneficial effects in older women. Its safety for use in pregnant women has not yet been determined. It is also not known if the vaccine confers lifelong immunity, since long-term study results are not yet available.

• Gardasil only targets the four major types of HPV that infect the genital tract. It does not protect against all causes of HPV.
• HPV types 16 and 18 are the cause about 70% of all cervical cancers, and HPV types 6 and 11 cause about 90% of genital warts.
• Gardasil 9 protects against additional HPV types 31, 33, 45, 52, and 58.
• All women, including those who have received the vaccine, should still undergo regular cervical cancer screenings.

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