According to the CDC, all children should receive the human papillomavirus vaccine at age 11 or 12 years and the vaccine can be administered to children as young as age 9 years. While two-thirds of adolescents aged 13 to 17 years had received at least one dose of the vaccine as of 2017, many adults have not.

That’s a problem, because HPV is the most common sexually transmitted infection in the United States, with 14 million new infections each year. Nearly 80% of adults will contract the infection at some point. While most HPV infections will resolve on their own, others become chronic, with potentially deadly consequences.

Notably, HPV causes half a dozen types of cancer. Those cancers increased nearly 50% between 1999 and 2015, from 30,115 new cases to 43,371 incident diagnoses.

HPV causes nearly 100% of cervical cancer, indicating that universal immunization could essentially eradicate a disease that kills more than 4,000 women in the U.S. each year. The virus is the leading factor in development of vaginal and vulvar cancers as well.

The virus doesn’t just affect women, however. HPV also causes nearly 80% of oral and oropharyngeal cancers, which affect up to four times as many men as women. Over the last decade, oral and oropharyngeal malignancies have risen exponentially. Physicians will diagnose 53,000 new cases of these diseases in 2019, and nearly 11,000 people will die of them. In addition, HPV is also responsible for 90% of penile and anal cancers, as well as nearly all anogenital warts.

Fortunately, the HPV vaccine provides nearly 100% protection against these cancers, if administered as recommended. Only the Gardasil 9 vaccine is available in the U.S.

Because of changes in the recommendations for the vaccine over the last decade, many parents did not know that their children should receive the vaccine and why, and some adults may not realize that they should still be immunized.

The initial FDA approval for the vaccine in 2006 limited it to girls and young women up to age 26 years. Since then, the recommendations have expanded significantly. In August, the Advisory Committee on Immunization Practices (ACIP) made the broadest recommendations yet.

The latest announcement maintained HPV vaccination as part of the regular schedule of immunizations for all children at age 11 or 12 years. It further advised “catch-up” vaccination for all males and females up to age 26 years who had not been fully vaccinated earlier. The ACIP noted that some individuals up to age 45 years, particularly those with limited sexual history and those likely to have new sexual partners, could benefit from immunization, significantly expanding the recommended age range for the vaccine.

While the CDC recommends a two-dose schedule for younger adolescents, individuals aged 15 years and older should received three doses. The second dose should be administered 1 to 2 months after the first and the third dose 12 weeks later. At least 4 weeks should pass between the first and second dose and 12 weeks between the second and third, though no maximum amount of time is specified.

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