Who should get these vaccines?
Both Gardasil and Cervarix are proven to be effective only if given before infection with HPV, so it is recommended that they be given before an individual is sexually active. The FDA’s licensing decision includes information about the age and sex for recipients of the vaccine. The FDA has approved Gardasil for use in females and males ages 9 to 26 and Cervarix for use in females ages 9 to 25.
After a vaccine is licensed by the FDA, the Advisory Committee on Immunization Practices (ACIP) makes additional recommendations to the Secretary of the U.S. Department of Health and Human Services and the Director of the CDC on who should receive the vaccine, at what age, how often, the appropriate dose, and situations in which it should not be administered. ACIP is made up of 15 experts in fields associated with immunization.
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For females, ACIP recommends that Gardasil or Cervarix vaccination be given routinely at ages 11 or 12, although the series may be started for girls as early as 9 years of age. Vaccination is also recommended for girls and women ages 13 to 26 who have not been vaccinated already or who did not complete the three-dose series. If a woman reaches the age of 26 before completing the three-dose series, ACIP recommendations say that she can still receive the remaining doses.15
For males, ACIP recommends routine vaccination with Gardasil at ages 11 or 12 to prevent HPV infection. ACIP also recommends vaccinating males ages 13 to 21 who have not been vaccinated already or who did not complete the three-dose vaccination series. The vaccine may be given to males between the ages of 22 and 26.16
States can decide whether or not to require vaccination of children prior to their enrollment in schools or child care. Each state makes this decision individually. Information about specific state vaccine decisions is available from the National Network for Immunization Information Exit Disclaimer.
Should the vaccines be given to people who are already infected with HPV?
Although Gardasil and Cervarix have been found to be generally safe when given to people who are already infected with HPV, the vaccines do not treat infection and they provide maximum benefit if a person receives them before he or she is sexually active.17
It is possible that someone infected with HPV will still get residual benefit from vaccination, even if he or she has already been infected with one or more of the types included in the vaccines. However, this possibility is still under investigation.
At present, there is no generally available test to show whether an individual has been exposed to HPV. The currently approved HPV DNA test shows only whether a person has a current HPV infection, and it identifies the HPV type. But it does not provide information on past infections.
Should women who already have cervical cell changes get the vaccines?
ACIP recommends that women who have abnormal Pap test results, which may indicate HPV infection, should still receive HPV vaccination if they are in the appropriate age group because the vaccine may protect them against high-risk HPV types that they have not yet acquired.
However, these women should be told that the vaccination will not cure them of current HPV infections and that it will not treat the abnormal results of their Pap test.15
