One of the most controversial topics in medicine recently has been the HPV vaccine. It can save lives by helping prevent cervical cancer, but it works best when given at an early age.
What is HPV? Genital human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. More than half of sexually active men and women are infected with HPV at some time in their lives.
About 20 million Americans are currently infected, and about 6 million more are infected each year. HPV is usually spread through sexual contact.
Most HPV infections cause no symptoms and go away on their own. HPV can cause cervical cancer in women. Cervical cancer is the second leading cause of cancer deaths among women worldwide. In the United States, about 12,000 women develop cervical cancer every year, and about 4,000 are expected to die from it.
HPV is also associated with several less common cancers: vaginal and vulvar cancers in women, and anal and oropharyngeal cancers, which involve the back of the throat including the base of the tongue and the tonsils, in both men and women. HPV can also cause genital warts and warts in the throat.
There is no cure for HPV infection, but some of the problems it causes can be treated.
HPV vaccine: why get vaccinated? The HPV vaccine can be given to both males and females. It prevents most cases of cervical cancer in females if given before exposure to the virus. It can also prevent vaginal and vulvar cancer in females, and genital warts and anal cancer in both males and females. Protection is expected to be long-lasting. Vaccination is not a substitute for cervical cancer screening, and women should still have regular Pap tests.
Who should get the HPV vaccine and when? As of 2013, the vaccine was given as a 3-dose series: the first dose, the second one to two months later, and the third six months after the first. Booster doses were not recommended. The vaccine was recommended for girls and boys at 11 or 12 years of age, and could be started at age 9.
Why is HPV vaccine recommended at 11 or 12 years of age? HPV infection is easily acquired, even with only one sexual partner. That is why the vaccine should be given before any sexual contact takes place. Response to the vaccine is also better at this age than at older ages.
Catch-up vaccination: In 2013 the vaccine was recommended for females aged 13 to 26 who had not completed the series, and for males aged 13 to 21. It could be given to men aged 22 through 26 who had not completed the series, and was recommended through age 26 for men who have sex with men or whose immune systems are weakened by HIV infection, illness, or medication. It may be given at the same time as other vaccines.
Update, 2026: The schedule and age range have both changed since this post was written. The series is now 2 doses when started between ages 9 and 14, with the second dose 6 to 12 months after the first, and 3 doses when started at age 15 or older or for people who are immunocompromised. Catch-up vaccination is recommended through age 26 for everyone. For adults aged 27 through 45, vaccination is a shared decision between patient and clinician rather than a routine recommendation. The vaccine is not licensed beyond age 45. Check current CDC guidance at https://www.cdc.gov/vaccines-children/schedules/index.html and talk to your provider about what applies to you.
Some people should not get HPV vaccine or should wait: Anyone who has had a life-threatening allergic reaction to any component of the vaccine, or to a previous dose, should not receive it. Tell your doctor if the patient has any severe allergies, including an allergy to yeast. The vaccine is not recommended during pregnancy, though receiving it while pregnant is not a reason to consider terminating the pregnancy. Women who are breastfeeding may receive it.
What are the risks from this vaccine? As of 2013 the HPV vaccine had been used in the U.S. and around the world for about six years with a strong safety record. Any medication can cause a serious problem or severe allergic reaction, though the risk of a vaccine causing serious injury or death is very small. Life-threatening allergic reactions are very rare, and when they occur it is within minutes to hours of vaccination. Several mild to moderate problems are known to occur. These do not last long and resolve on their own:
- Reactions in the arm where the shot was given
- Pain around the injection site
- Redness or swelling around the injection site
- Mild fever up to 100 degrees F
- Moderate fever up to 102 degrees F
- Headache
- Fainting during the procedure, usually from nervousness
What should I look for in a moderate or severe reaction? Any unusual condition, such as a high fever or a change in behavior in the person who was vaccinated. Signs of a serious allergic reaction include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart rate, or dizziness. If any of these occur, call a medical provider or 911 immediately.
Board Certified in Obesity Medicine and Family Medicine
This blog is for educational purposes only and does not constitute individual medical advice. Always consult your own physician before making changes to your health, medications, or treatment plan.
This information comes from the U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC).
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Thanks Dr. Rennie. This is truly informative. i am an ardent reader of your blog and love the objectiveness with which you tackle each topic. keep it up.