The vaccine was first approved in 2006, but questions remain.

Louise Sloan
August 31, 2018

Almost everyone carries the human papillomavirus (HPV), and it's usually pretty harmless. But a few strains are the main cause of cervical cancer. Gardasil, the HPV vaccine first approved by the FDA in 2006, guards against two of these strains, plus two other strains that are responsible for most genital warts. Two other vaccines were later approved by the FDA: Gardasil 9 and Cervarix. Today, Gardasil 9 is the only one in use in the United States, according to the National Cancer Institute. In addition to the four strains Gardasil protected against, Gardasil 9 also prevents infection from five additional cancer-causing types of HPV.

Since most adults have already been exposed to HPV, the vaccine is recommended for pre-teens who haven't become sexually active yet. The Centers for Disease Control and Prevention (CDC) recommends vaccination at age 11 or 12, but Gardasil 9 can be started as early as age 9.

So far, so good. But the introduction of this vaccine stirred up a small fuss that lingers even today.

What's the controversy?

Perhaps the main fear of the vaccine's opponents is that it might encourage adolescent promiscuity.

H. Hunter Handsfield, MD, a clinical professor of medicine at the University of Washington and a nationally recognized STD expert, believes most parents are all for it, however. "It can prevent cancer?" he says, parroting the most common parental concern. "Well, duh, give my kid the shot."

Still, questions come up all the time because the vaccine is so new. Here are a couple of the most common:

Should boys get the HPV vaccine?

Originally, the HPV vaccine was only approved in girls. The thinking was that men rarely got cancer from HPV. But they do pass the virus to their female partners, they do get genital warts from HPV, and rates of HPV-related throat cancer are on the rise in men (and women).


The CDC now recommends that boys also get vaccinated at 11 or 12, and males who have not been vaccinated adequately can receive the shots up to age 21.

Men who have sex with men and trans folks are advised to get vaccinated through age 26.


RELATED: 17 Things You Should Know About HPV

What about women over 26?

The vaccine is currently recommended for women who haven't been vaccinated through age 26. "Women who get beyond their 20s are statistically at lower risk for HPV infection," says Dr. Handsfield, "so from a public-policy standpoint, it's not a priority."

Still, he says, "the vaccine almost certainly would work in older women."

After 26, insurance won't cover the vaccine, but you can pay out of pocket. It's possible it may not help if you already have those strains of the virus. "However, people who have already been infected with one or more HPV types can still get protection from other HPV types in the vaccine," according to the CDC.

If you're older than 26 and considering the vaccine, it makes sense to evaluate your sexual history. "Say there's a 28-year-old woman, she's about to be out there dating again, and she's only had three or four partners; she probably is still susceptible," says Dr. Hansdfield. "She needs the vaccine."

RELATED: How Often Do You Really Need a Pap Test?

If I get vaccinated, do I still need to get regular Pap smears?

Yes! Experts agree that the vaccine does not replace the need for regular cervical cancer screening, since it only protects against some strains of the virus that cause cervical cancers.