Can Adults Get the HPV Vaccine?

The vaccine is recommended for everyone up to 26 years old—but what if you're older?

The human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. While nine out of 10 cases of HPV resolve on their own without causing health problems, others can linger, resulting in conditions like genital warts or certain types of cancer—including cervical cancer and anal cancer.

The good news: There's a highly effective vaccine to prevent HPV and its associated cancers. A study published in 2021 demonstrated this.

Researchers in the U.K. found that the first-generation HPV vaccine led to a "substantial reduction" in cervical cancer rates and incidences of precancerous findings when given to girls and young women, specifically 12–13-year-olds. According to the study authors, "the HPV [immunization program] has successfully almost eliminated cervical cancer in women born since [September] 1, 1995."

Squamous epithelial cells of human cervix under the microscope view. Pap smear test is a procedure to test for cervical cancer in women
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These findings may leave many adults wondering about their vaccination status—if they never received the HPV vaccine as a child, are they still eligible to get vaccinated now? And would the vaccine provide any real protection? Here, we break down the current HPV recommendations and what experts say about getting the HPV vaccine as an adult.

Human papillomavirus, or HPV, is a group of related viruses with more than 200 types. These germs are incredibly common and can cause everything from warts on your hands and feet to cervical cancer and sexually transmitted genital warts. Some types have no symptoms at all. 

What Is the HPV Vaccine?

As of 2023, the HPV vaccine available in the U.S. is Gardasil 9, which helps protect against nine HPV types, or strains. It's a two-to-three-dose vaccine regimen approved for use in all children of all genders that protects against HPV infection and HPV-related conditions. Those conditions include:

  • Genital warts
  • Cervical precancers (abnormal cells on the cervix that can lead to cancer)
  • Cancers of the cervix, vagina, and vulva
  • Penile cancer
  • Anal cancer
  • Oropharyngeal cancer (cancer in the back of the throat, including the base of the tongue and tonsils)

Of the more than 150 different strains of HPV, 40 are known to cause cancer. The HPV vaccine approved for use in the U.S. protects against the nine strains responsible for about 90% of cervical cancers, Rebecca Perkins, MD, an associate professor of obstetrics and gynecology at the Boston University School of Medicine, told Health.

Something to note: Gardasil was not the HPV vaccine used in the 2021 study. That was, again, a first-generation HPV vaccine called Cervarix. Because Cervarix was one of the first HPV vaccines on the market, it didn't protect against as many HPV strains. The HPV vaccines in circulation now protect against more strains of HPV, which means they offer more protection, said Dr. Perkins.

At What Age Should You Get the HPV Vaccine?

The CDC says the HPV vaccine is recommended for children, teenagers, and adults ages 9–26. The earlier someone gets the vaccine, the better, said Dr. Perkins, who recommended children be vaccinated against HPV before age 12 for the most protection.

"This is because younger adolescents produce very good immune responses to the vaccine, so they only need two doses to be fully protected," said Dr. Perkins. Dr. Perkins also pointed out that almost no child has been exposed to HPV at this age, and since vaccines offer prevention, not treatment, the HPV vaccine will be less effective if someone has already been exposed to the virus.

When younger children receive the vaccine, they will also need fewer doses: The CDC says children ages 9–14 only need two doses six to 12 months apart. However, anyone over the age of 15 or those who are immunocompromised will need three total doses, given over six months, to make up for a lessened immune response.

Can Adults Older Than 26 Get the HPV Vaccine?

If you are older than 26 years old, you can still get the HPV vaccine—but there are a few caveats. The CDC does not recommend HPV vaccination for everyone over 26. However, after talking with your healthcare provider, you may consider getting vaccinated if you weren't properly vaccinated when you were younger.

"People are usually exposed to HPV within a year or so of their first sexual experience," said Dr. Perkins. That means there's a low chance of cancer prevention from the vaccine in this age group.

Still, that doesn't mean you can't get the vaccine if you're over 26: "You can still get the HPV vaccine if you've already had HPV," said Dr. Perkins. "While it will not be as effective against the HPV type you currently have [or have had], you may be protected against other strains."

In that case, some healthcare providers even recommend the HPV vaccine for patients up to 45 years old. Kate White, MD, an associate professor of obstetrics and gynecology at Boston University School of Medicine, is one of those healthcare providers. Dr. White recommended all of her patients under the age of 45 be vaccinated, even those in long-term monogamous relationships, just to err on the side of caution.

"The vaccine hasn't been examined in folks over 45, so I don't recommend it for them. Otherwise, the only people who wouldn't benefit from the HPV vaccine are people who will never again have a sexual partner," said Dr. White.

The CDC suggests adults ages 27–45 who weren't previously vaccinated against HPV speak with their healthcare provider about their risk of new HPV infections and any potential benefits they could reap from vaccination.

What if You Aren’t Sure if You Got the HPV Vaccine?

Those who started but never finished the HPV vaccine series when they were younger should see their healthcare provider for their last shots. "If you're not sure how many doses of the HPV vaccine you've received, it's better to err on the side of getting an extra dose," said Dr. White.

You also don't have to worry about the timing here—while it's best to get the shots at the recommended intervals, you won't need to start the immunization process again. "Even if the doses are off schedule, you can just finish the recommended number of doses. The series does not need to be restarted," said Dr. Perkins.

For those who don't remember whether or not they got the HPV vaccine as a child, the first step is to try and access your old medical records. Some states have immunization registries where you may find a record of the vaccines you've received, so contact your state's health department.

If you can't do that, Dr. White recommended restarting the series. Even if you received an older version of the HPV vaccine while you were younger, it is safe to get the newer vaccine at a later date, said Dr. Perkins.

What's the Best Way To Protect Against HPV-related Cancers Later in Life?

Since the HPV vaccine is less beneficial in adults, the best way to prevent HPV-related cancers is to get regular screenings, said Dr. Perkins.

There are two types of screening for cervical cancer: the Pap and the HPV test. Both are done by gently scraping the cervix to remove cells. While similar, there are a few key differences between the two tests:

  • Pap test: Also called a Pap smear, this test looks for changes in the cells of the cervix.
  • HPV test: This test looks for the HPV virus specifically.

People ages 21-29 who have a cervix should get a Pap test every three years. People ages 30-65 who have a cervix have three choices: A Pap test every three years, a Pap test and HPV test (co-test) every five years, or an HPV test only every five years. Screening is not recommended before age 21, and once you reach 65 years old, you do not need to be screened if you have a history of negative tests.

Early detection of cervical cancer can significantly improve someone's prognosis, so adults need to get screened regularly.

Meanwhile, screenings for other HPV-related cancers like anal or penile cancer are not recommended for the general population. That's because penile cancers are often detected early, as it usually starts as a noticeable change in the skin. Therefore, there are no widely recommended screening tests for penile cancer.

Screening tests for anal cancer are not routinely recommended for all people. Yet, those with a high risk of developing anal cancer—such as men who have sex with men, individuals who have had cervical or vulvar cancer, anyone who is HIV-positive, and anyone who has had an organ transplant—should consider anal cytology testing. Anal cancer screenings involve an anal Pap test, similar to a cervical Pap test.

A Quick Review

The human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. Unresolved, it can result in conditions like genital warts or certain types of cancer.

Fortunately, there's a highly effective vaccine to prevent HPV—and, thus, the cancers associated with it. However, the vaccine is recommended for children, teenagers, and adults ages 9–26. If you are over age 26, you should speak with your healthcare provider about the vaccine.

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Sources
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