# HPV Vaccine

> The content on this page is for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations. If you have health concerns, consult a qualified healthcare professional. Medova is not a medical service provider.

Source: https://medova.health/en/knowledge/vaccines/hpv · Language: en

## Vaccine Information

- Type: Subunit
- Administration: Injection
- WHO Code: HPV
- Travel Recommended: Yes

## Overview

Recombinant HPV L1 VLP (virus-like particle) vaccine. Gardasil 9 (9-valent: types 6, 11, 16, 18, 31, 33, 45, 52, 58) is the current global standard. Cervarix (bivalent: types 16, 18) still used in some national programs. Prevents ~90% of cervical cancers and significant proportions of other HPV-related cancers (anal, oropharyngeal, penile, vaginal, vulvar) and genital warts (types 6, 11).

Recombinant HPV L1 VLP (virus-like particle) vaccine. Gardasil 9 (9-valent: types 6, 11, 16, 18, 31, 33, 45, 52, 58) is the current global standard. Cervarix (bivalent: types 16, 18) still used in some national programs. Prevents ~90% of cervical cancers and significant proportions of other HPV-related cancers (anal, oropharyngeal, penile, vaginal, vulvar) and genital warts (types 6, 11).

Routine vaccination: all individuals aged 9–14 years (WHO SAGE 2022). Catch-up: ages 15–26 years (both sexes). Extended use: ages 27–45 years based on shared clinical decision-making (ACIP). Gender-neutral vaccination recommended globally. WHO SAGE 2022: single-dose schedule for girls 9–20 years equally effective as multi-dose.

Severe allergic reaction to previous dose or any component (including yeast — Gardasil 9). Pregnancy (defer until after delivery — no teratogenicity demonstrated but recommended to postpone). Moderate to severe acute illness (defer). No contraindication in immunocompromised — 3-dose schedule recommended.

Very common: injection site pain (78–90%), swelling (24%), erythema (22%). Common: headache (12–14%), fever (5%), nausea, dizziness. Syncope: relatively common in adolescents — observe 15 minutes post-vaccination (seated or supine). CIOMS/WHO Global Advisory Committee: no confirmed causal association with autoimmune conditions, chronic fatigue, CRPS, or premature ovarian insufficiency.

Age 9–14 years: 2 doses IM at 0 and 6–12 months (or single dose per WHO SAGE 2022 for girls 9–20y). Age ≥15 years: 3 doses IM at 0, 2, 6 months. Immunocompromised (any age): 3 doses. Dose: 0.5 mL IM in deltoid muscle. Minimum intervals: dose 1→2: 4 weeks; dose 2→3: 12 weeks; dose 1→3: 5 months.

Gardasil 9: near 100% efficacy against vaccine-type persistent infection and precancerous lesions (CIN2+, VIN2+, VaIN2+, AIN2+). Single-dose: KEN SHE trial (Kenya): 97.5% efficacy against persistent HPV 16/18 at 18 months. Real-world impact: 87% reduction in cervical cancer (Scotland birth cohort), 90% reduction in genital warts (Australia). Estimated to prevent 90% of cervical cancers if administered pre-exposure.

Store at +2°C to +8°C. Do not freeze (aluminum adjuvant damaged). Protect from light. Ready-to-use prefilled syringe. Shelf life: 36 months.

Can be co-administered with MenACWY, MenB, Tdap, hepatitis B, influenza, and COVID-19 vaccines at different injection sites without interference. No known drug interactions. Immunosuppressive therapy may reduce immune response — vaccinate when possible, consider 3-dose schedule.

**Pregnancy: Not recommended — defer until after delivery.**

HPV vaccination (Gardasil 9) is **not recommended during pregnancy** as a precautionary measure due to limited data.


- If pregnancy is discovered after initiating the vaccine series, defer remaining doses until after delivery.

- No teratogenicity has been demonstrated in clinical trials or post-marketing surveillance (pregnancy registry data for quadrivalent Gardasil).

- Inadvertent vaccination during pregnancy is NOT an indication for termination.

- No special monitoring needed if vaccinated inadvertently.

**Breastfeeding: Safe.**

HPV vaccine (Gardasil 9) is safe during breastfeeding. It is a recombinant, non-infectious vaccine. Breastfeeding women can be vaccinated without restriction. No modification to breastfeeding schedule required.

**Pediatric use:**


- **Routine vaccination:** 9–14 years of age (gender-neutral, WHO recommendation).

- Schedule by age:
  - 9–14 years: **2 doses** at 0 and 6–12 months.
  - ≥15 years: **3 doses** at 0, 2, 6 months.
  - WHO SAGE (2022): **single-dose** regimen for girls 9–20 years is equally effective.

- Minimum interval between doses: 5 months (2-dose schedule), 4 weeks/12 weeks/5 months (3-dose schedule).

- Syncope: observe adolescents for 15 minutes post-vaccination (common in this age group).

- Immunocompromised children (including HIV-positive): 3-dose schedule recommended regardless of age.

**Geriatric use:**


- Catch-up vaccination is available up to 45 years (FDA-approved) through shared clinical decision-making for 27–45 years.

- Efficacy in adults >26 years is lower than in younger age groups (fewer HPV-naïve individuals).

- Not routinely recommended for adults ≥46 years.

- Older adults who are HPV-naïve may still benefit from vaccination if at risk.

Vaccination does not treat existing HPV infection — preventive only. Most effective before sexual debut. Cervical screening must continue regardless of vaccination status (non-vaccine HPV types can still cause cancer). Male vaccination equally important for herd immunity, prevention of HPV-related male cancers, and elimination of reservoir. Single-dose evidence growing (Costa Rica, India, Kenya trials).

## Side Effects

- Abdominal pain (Uncommon)
- Anaphylaxis (Very rare) — Serious
- Angioedema (Very rare) — Serious
- Arthralgia (Common)
- Bronchospasm (Very rare) — Serious
- Chills (Uncommon)
- Diarrhea (Uncommon)
- Dizziness (Common)
- Erythema multiforme (Very rare) — Serious
- Fatigue (Common)
- Febrile seizure (Very rare) — Serious
- Fever (Common)
- Generalized rash (Rare)
- Guillain-Barré syndrome (Very rare) — Serious
- Headache (Very common)
- Hypoesthesia (Rare)
- Injection site bruising (Common)
- Injection site induration (Common)
- Injection site itching (Common)
- Injection site nodule (Uncommon)
- Injection site pain (Very common)
- Injection site redness (Very common)
- Injection site swelling (Very common)
- Injection site warmth (Common)
- Insomnia (Uncommon)
- Lymphadenopathy (Uncommon)
- Malaise (Common)
- Myalgia (Common)
- Nausea (Common)
- Paresthesia (Rare)
- Pruritus (Uncommon)
- Reduced arm mobility (Uncommon)
- Syncope (Uncommon)
- Urticaria (Uncommon)
- Vomiting (Uncommon)

## Contraindications

- Acute febrile illness (Precaution)
- Anaphylaxis after previous dose (Absolute)
- Allergy to vaccine component (Absolute)
- Bleeding disorder (Precaution)
- Latex allergy (Precaution)
- Moderate immunosuppression (Precaution)
- Pregnancy (Relative)
- Thrombocytopenia (Precaution)
- Yeast allergy (Relative)

## Vaccination Schedule

No schedule data available.

## FAQ

**What are the side effects of HPV Vaccine?**

Common side effects include: Abdominal pain, Anaphylaxis, Angioedema, Arthralgia, Bronchospasm.

**Who should not get HPV Vaccine?**

Contraindications include: Acute febrile illness, Anaphylaxis after previous dose, Allergy to vaccine component, Bleeding disorder, Latex allergy.

## Prevents

- [HPV Infection](https://medova.health/en/knowledge/diseases/hpv-infection)

## Indications

- [Finland](https://medova.health/en/knowledge/countries/finland): Recommended
- [Myanmar](https://medova.health/en/knowledge/countries/myanmar): Recommended
- [Saudi Arabia](https://medova.health/en/knowledge/countries/saudi-arabia): Recommended
- [South Sudan](https://medova.health/en/knowledge/countries/south-sudan): Recommended
- [Malaysia](https://medova.health/en/knowledge/countries/malaysia): Recommended
- [Qatar](https://medova.health/en/knowledge/countries/qatar): Recommended
- [Nicaragua](https://medova.health/en/knowledge/countries/nicaragua): Recommended
- [Saint Vincent and the Grenadines](https://medova.health/en/knowledge/countries/saint-vincent-and-the-grenadines): Recommended
- [Colombia](https://medova.health/en/knowledge/countries/colombia): Recommended
- [Sweden](https://medova.health/en/knowledge/countries/sweden): Recommended

## Sources & content verification

- Data sources: WHO Position Papers, CDC Pink Book 2024, EMA SmPC, WHO Position Papers 2024 + CDC Pink Book 2024 + EMA SmPC
- [www.who.int](https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/position-papers)

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The content on this page is for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations. If you have health concerns, consult a qualified healthcare professional. Medova is not a medical service provider.

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