Human Papillomavirus (HPV)

In the News

The 2014 National Immunization Survey Teen Data show that while increasing, HPV vaccination rates remain low.

  • Coverage with one or more doses of HPV vaccine for girls increased by 3.3 percentage points from 56.7% in 2013 to 60.0% in 2014.
  • Coverage with one or more doses of HPV vaccine for boys increased by 8.1 percentage points from 33.6% in 2013 to 41.7% in 2014.


Resources on NIS Teen Data


9-valent HPV Vaccine

The 2015 Red Book HPV Chapter is now available! (Exit site 266kb)


Last year a new HPV vaccine, Gardasil 9, was licensed by the FDA. Read the FAQs below to learn more.


What is the difference between the 9-valent HPV vaccine and the other HPV vaccines?
2-valent HPV, 4-valent HPV and 9-valent HPV vaccines all protect against HPV strains 16 and 18, the types that cause about 66% of cervical cancers and the majority of other HPV-attributable cancers in the United States. 9-valent HPV targets five additional cancer causing types, which account for about 15% of cervical cancers. 4-valent HPV and 9-valent HPV vaccines also protect against HPV 6 and 11, the types that cause genital warts.



2-valent HPV vaccine (Cervarix)

4-valent HPV vaccine (Gardasil)

9-valent HPV vaccine (Gardasil-9)

High risk HPV strains covered 16, 18 16,18 16, 18, 31, 33, 45, 52, 58
Low risk HPV strains covered N/A 6, 11 6, 11



What are the ACIP recommendations for the 9-valent HPV vaccine?
In February 2015 the ACIP voted to add the 9-valent HPV vaccine to the current HPV vaccine recommendations. They did not express a preference for one HPV vaccine product over another.

What should I do with patients who started the HPV vaccine series with 2-valent HPV or 4-valent HPV vaccine?

ACIP recommends that any appropriate HPV vaccine (2v, 4v or 9v for females and 4v or 9v for males) can be used to continue or complete the HPV vaccine series.

What should I do with patients who have already completed the HPV vaccine series with the 4-valent or 2-valent HPV vaccine?
The ACIP did not address revaccination with 9-valent HPV vaccine in patients who have completed the series in their February meeting. This will likely be discussed at their next meeting in June 2015.

Why is the use of 9-valent HPV vaccine off-label in males over the age of 15?
Merck sought and received FDA approval for 9-valent HPV vaccine for females ages 9-25 and males ages 9-15. They have since submitted additional data on males ages 16-26, and are also seeking FDA approval for this age group. The ACIP has reviewed this data and has recommended off-label use for males ages 16-26.



The Disease

Human papillomavirus (HPV) is the most common sexually transmitted virus in the US. More than 50% of sexually active men and women are infected with HPV at some time in their lives. There are about 40 different types of HPV that can cause infection. Certain types can cause genital warts in women and men, as well as serious health problems such as cervical cancer in women and other cancers in the genital area and throat in women and men.


The Immunization

HPV vaccine can prevent most genital warts and many of the cancers mentioned above. HPV vaccine is routinely recommended for both boys and girls in a 3-dose series. The first dose is given at 11-12 years of age, a second dose is given 1-2 months after the first dose, and a 3rd dose is given approximately 6 months after the first dose. The vaccine is also recommended for men up to 21 and women up to 26 years of age who did not receive it when they were younger.


Younger children respond better to the immunization. This is why it is recommended at 11-12 years. It is also important to get the vaccine series before the first sexual encounter so that it can provide the most protection. Even with just one partner, the risk of being exposed to HPV is high.



Resources for Pediatricians



Recommendations for Pediatricians



Information to Share with Parents and Teens



Key Messages to Share with Families

These messages can be customized or sent directly to parents or adolescents via e-mail or text message.


  • Doctors urge parents to bring 11 to 12 year olds in for HPV vaccine to prevent certain cancers.
  • HPV is a very common virus that can lead genital warts as well as cancers of the mouth, throat, and sex organs.  A vaccine is available to protect your teen.
  • Your child’s immune system may respond to HPV vaccine best when 11 to 12 years old. Be sure to get him/her vaccinated.
  • HPV vaccine works and it’s safe.  Be sure to get your pre-teens and teens vaccinated.
  • HPV vaccine takes 3 doses to work.  Don’t forget to bring your teen in to finish the series.

Finally, the AAP asks that pediatricians provide a strong recommendation for HPV vaccine. Studies have shown that parents trust their pediatrician’s guidance; unfortunately, some providers report not issuing a strong recommendation for HPV vaccine. Be sure to give a strong recommendation for all vaccines on the current immunization schedule and not merely mention that they are available. Rates of vaccination remain low for a variety of reasons. One of the best things you can do to help encourage better uptake rates is to answer parents' questions about the vaccine, and strongly recommend adolescents are vaccinated with HPV vaccine at 11-12 years of age, before being exposed to the virus.

Other Resources


Last Updated: 7/31/2015


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