Human Papillomavirus (HPV) Vaccination
Frequently Asked Questions: Women's Health
In October 2018, the U.S. Food and Drug Administration (FDA) approved the human papillomavirus (HPV) vaccine for people aged 27–45 years. The vaccine was already approved for people aged 9–26 years. Experts are now discussing how and when the vaccine should be offered to adults. In the meantime, if you are older than 26 years and interested in getting the HPV vaccine, talk with your health care professional. The vaccine is safe and effective in preventing new HPV infections in people aged 27–45 years.
Human papillomavirus (HPV) is a virus. Like all viruses, HPV causes infection by entering cells. Once inside a cell, HPV takes control of the cell’s internal machinery and uses it to make copies of itself. These copies then infect other nearby cells.
There are more than 150 types of HPV. About 40 types infect the genital area of men and women and are spread by skin-to-skin contact during vaginal, anal, or oral sex. Genital HPV infection can occur even if you do not have sexual intercourse.
HPV infection is the most common sexually transmitted infection (STI) in the United States. Almost everyone who is sexually active will get an HPV infection at some point during their life.
Like many other STIs, genital HPV infection often has no signs or symptoms. The infected person usually is not aware that he or she has been infected and can unknowingly pass the infection to others.
HPV can cause the following diseases:
- Genital warts—About a dozen types of HPV cause genital warts. These types are called “low-risk types.” Most cases of genital warts are caused by just two low-risk types of HPV: 1) type 6 and 2) type 11. Genital warts are growths that can appear on the outside or inside of the vagina or on the penis and can spread to nearby skin. Genital warts also can grow around the anus, on the vulva, or on the cervix. Genital warts are not cancer and do not turn into cancer. Warts can be removed with medication or surgery.
- Cancer—At least 13 types of HPV are linked to cancer of the cervix, anus, vagina, penis, mouth, and throat. Types of HPV that cause cancer are known as “high-risk types.” Most cases of HPV-related cancer are caused by just two high-risk types of HPV: 1) type 16 and 2) type 18.
No. In most people, the immune system fights most high-risk and low-risk HPV infections and clears them from the body.
Infections that are not cleared from the body are called persistent infections. A persistent infection with a high-risk HPV type can cause cells to become abnormal and can lead to a condition called precancer. It usually takes years for this to happen. Cervical cancer screening can detect signs of abnormal cell changes of the cervix and allows early treatment so they do not become cancer.
A vaccine is available that can prevent infection with HPV. The vaccine protects against the HPV types that are the most common cause of cancer, precancer, and genital warts.
Girls and boys should get the HPV vaccine as a series of shots. Vaccination works best when it is done before a person is sexually active and exposed to HPV, but it still can reduce the risk of getting HPV if given after a person has become sexually active. The ideal age for HPV vaccination is age 11 years or 12 years, but it can be given starting at age 9 years and through age 26 years.
For those aged 9–14 years, two shots of vaccine are recommended. The second shot should be given 6–12 months after the first one. For those aged 15 years through 26 years, three shots of vaccine are recommended.
If your child has not gotten all of the recommended shots, he or she does not need to “start over.” He or she can get the next shot that is due even if the time between them is longer than recommended. This is also true for you if you have not completed the recommended number of shots through age 26 years.
Studies show that getting all doses of the HPV vaccine before you are sexually active can reduce your risk of getting certain types of HPV-related cancer by up to 99%. If you have had sex, you may already be infected with one or more types of HPV, but you can still get the vaccine if you are younger than 26 years. The vaccine may help protect you against the other types of HPV included in the vaccine that you are not infected with.
Millions of people have been vaccinated against HPV since the vaccine came out. There have been no reports of severe side effects or bad reactions to the vaccine. The most common side effect of the HPV vaccine is soreness and redness where the shot is given.
Yes. HPV vaccination helps prevent HPV infection. It is not a cure for an HPV infection that has already occurred. Women who have been vaccinated still need to have regular cervical cancer screening as recommended for their age group and health history (see FAQ085 Cervical Cancer Screening).
Even if you get the HPV vaccine, it still is important to take other steps to protect yourself against HPV and other STIs:
- Limit your number of sexual partners. The more partners you have over the course of your life, the greater your risk of infection.
- Use a male or female condom to reduce your risk of infection when you have vaginal, anal, or oral sex. But be aware that condoms cover only a small percentage of skin and do not completely protect against HPV infection. HPV can be passed from person to person by touching infected areas not covered by a condom. These areas may include skin in the genital or anal areas.
Anus: The opening of the digestive tract through which bowel movements leave the body.
Cells: The smallest units of a structure in the body; the building blocks for all parts of the body.
Cervix: The lower, narrow end of the uterus at the top of the vagina.
Human Papillomavirus (HPV): The name for a group of related viruses, some of which cause genital warts and some of which are linked to cancer of the cervix, vulva, vagina, penis, anus, mouth, and throat.
Immune System: The body’s natural defense system against foreign substances and invading organisms, such as bacteria that cause disease.
Penis: An external male sex organ.
Sexual Intercourse: The act of the penis of the male entering the vagina of the female (also called “having sex” or “making love”).
Sexually Transmitted Infection (STI): An infection that is spread by sexual contact, including chlamydia, gonorrhea, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).
Vagina: A tube-like structure surrounded by muscles leading from the uterus to the outside of the body.
Virus: An agent that causes certain types of infections.
Vulva: The external female genital area.
If you have further questions, contact your obstetrician–gynecologist.
FAQ191. Copyright June 2017 by the American College of Obstetricians and Gynecologists
This information is designed as an educational aid to patients and sets forth current information and opinions related to women’s health. It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care. It is not a substitute for a treating clinician’s independent professional judgment. Read ACOG’s complete disclaimer.