Federal health authorities have approved a two-dose schedule for HPV vaccine for adolescents
under age 15 years.
New research shows a two-dose schedule for younger adolescents provides effective,
long-lasting protection from HPV-related cancers and is economical, according to a
report from the Centers for Disease Control and Prevention (CDC).
The Academy and CDC recommend HPV vaccine as part of routine immunization for males and females at age 11 or 12 years, although
it can be started as early as 9 years.
The vaccine, now available as the 9-valent Gardasil 9, traditionally has been given
in a three-dose series, but in October, the Food and Drug Administration approved
a two-dose series for children ages 9-14. The CDC’s Advisory Committee on Immunization
Practices (ACIP) followed suit later that month saying a two-dose schedule could help
improve vaccination rates. Only about 42% of teen girls and 28% of teen boys receive
all three doses.
The CDC’s latest move codifies ACIP’s recommendations for a two-dose schedule for
girls and boys who start the series at age 9-14. Those children should receive the
second dose six to 12 months after the first dose.
“Based on the available immunogenicity evidence, a 2-dose schedule (0, 6-12 months),
will have efficacy equivalent to a 3-dose schedule (0, 1-2, 6 months) if the HPV vaccination
series is initiated before the 15th birthday,” according to the report.
For those starting the series at age 15-26 and for immunocompromised people, a three-dose
series is recommended. The second dose should be given one to two months after the
first dose, and the third dose should be given six months after the first dose.
Those who already started the series with any HPV vaccine will be considered adequately
vaccinated if they
started before their 15th birthday and received two doses with the second dose six
to 12 months after the first,
started before their 15th birthday and received three doses at the recommended dosing
started on or after their 15th birthday and received three doses at the recommended
A schedule that has been interrupted does not need to be restarted, and the 9-valent
vaccine may be used to complete a series started with a quadrivalent or bivalent vaccine.
ACIP does not have a recommendation as to whether those who were fully vaccinated
with a quadrivalent or bivalent vaccine should receive the 9-valent vaccine, but the
Academy has said it will work with the CDC to determine if such guidance can be developed.