In short: The 9-valent HPV vaccine protects against the high-risk types that are the main cause of cervical cancer and against the two types responsible for most genital warts. If started before age 15, 2 doses are given; from age 15 onwards, 3 doses. Even if the course is interrupted, it is not restarted. It is recommended for everyone up to age 26; at ages 27–45 the decision is made together with the doctor. Vaccinated women also continue smear and HPV screening.
Which types does the 9-valent HPV vaccine protect against?
- High-risk types: 16, 18, 31, 33, 45, 52 and 58. It provides a high level of protection against cancers of the cervix, vagina, external genital area (vulva) and anal area, and against advanced cell changes in these areas.
- Low-risk types: 6 and 11. It protects against these types, which cause the great majority of genital warts.
The vaccine contains no live virus; it is made of protein particles that resemble the virus but cannot cause disease. For general information on HPV, see the HPV (Human Papillomavirus) page.
At what ages is it given?
- Recommended starting age: 11–12 years (from 9 years at the earliest), in girls and boys.
- Up to age 26: Recommended for everyone who has not been vaccinated or whose series was left incomplete.
- Ages 27–45: In adults who have not been vaccinated before, the decision is made together with the doctor, taking into account the person's risk and the expected benefit.
How many doses are given?
The number of doses is determined by the age at which the first dose is given:
- Started before the 15th birthday: 2 doses — at month 0 and at months 6–12.
- Started at age 15 or older: 3 doses — at month 0, months 1–2 and month 6.
- People with a weakened immune system (at any age): 3 doses.
In the 2-dose schedule, if the interval between the two doses is shorter than 5 months, a 3rd dose is also given. Which schedule applies to you is decided together with the doctor.
If the course is interrupted, does it start again?
No. Even if the interval between doses becomes longer, or the course is left incomplete for months or years, the series is not restarted; it continues from where it stopped.
- Started in another country: The doses already given are valid. The type of vaccine, the dates of the doses and your age at the first dose, as shown on your vaccination card, are enough to determine how many more doses are needed.
- Started with a different vaccine: A series started with the 2-valent or 4-valent HPV vaccine can be completed by giving the missing doses with the 9-valent vaccine.
Is a test needed before the vaccine? I am HPV positive — can I be vaccinated?
A smear or HPV test before the vaccine is not needed and not recommended. People who have previously had a positive HPV test, an abnormal smear result, or a procedure in which a piece of the cervix is removed (conisation) can also be vaccinated. The vaccine does not treat an existing infection; however, it protects against types not yet encountered, and it has been reported that it may reduce the risk of the disease coming back after treatment.
In pregnancy and while breastfeeding
- Pregnancy: Because safety data are limited, the vaccine is not recommended; it is postponed until after the birth. A routine pregnancy test is not needed before the vaccine.
- If pregnancy occurs during the series: Ending the pregnancy is not necessary; no harm caused by the vaccine has been found. The remaining doses are left until after the birth.
- Breastfeeding: Breastfeeding mothers can be vaccinated.
Who should not have it? Side effects
Situations in which it should not be given: People who have previously had a severe allergic reaction (anaphylaxis, a sudden life-threatening allergy) to an ingredient of the vaccine (for example yeast proteins), and pregnant women.
Common and temporary side effects:
- Pain, mild redness and swelling at the injection site
- Mild fever, headache, nausea, a feeling of dizziness
Especially in adolescents and young adults, brief fainting can occur after the injection. For this reason it is recommended to wait under observation for a while, sitting or lying down, after the vaccine.
I have had the vaccine — do I still need a smear test? Yes. The vaccine does not protect against all high-risk HPV types and does not remove an infection acquired before vaccination. Vaccinated women should also continue cervical cancer screening at intervals appropriate for their age. For details, see the Smear and HPV Testing page.
Detailed articles on this topic: How many doses of HPV vaccine?, Do I still need a smear test after the HPV vaccine?
Frequently Asked Questions
Up to what age is the HPV vaccine given?
It is recommended for everyone up to age 26 who has not been vaccinated. Between ages 27 and 45, in adults who have not been vaccinated before, the decision is made together with the doctor, taking into account the person's risk and the expected benefit.
I delayed the second dose — do I have to start again?
No. The series is not restarted; it continues from where it stopped and the missing doses are completed.
I am HPV positive — is the vaccine still of use?
The vaccine does not treat an existing infection; however, it provides protection against other HPV types you have not yet encountered. An HPV test before the vaccine is not needed.
Can men also have the HPV vaccine?
Yes. The recommended starting age is the same for girls and boys (11–12 years, from 9 years at the earliest), and it is recommended for everyone up to age 26 who has not been vaccinated.
Is the HPV vaccine given in pregnancy?
No, it is postponed until after the birth. If a pregnancy is discovered during the series, ending the pregnancy is not necessary; the remaining doses are given after the birth. Breastfeeding mothers can be vaccinated.
Do I need a smear test after being vaccinated?
Yes. The vaccine does not protect against all high-risk types; vaccinated women should also continue screening at intervals appropriate for their age.
Sources
- American College of Obstetricians and Gynecologists (ACOG). Committee Opinion No. 809: Human Papillomavirus Vaccination, 2020 — recommendation up to age 26, shared decision with the doctor at ages 27–45.
- ACOG. Committee Opinion No. 704 (2017) and Practice Bulletin No. 168 (2016), cited in: Beckmann and Ling's Obstetrics and Gynecology, 8th edition, 2018 — dose schedule, no test needed before vaccination, screening continues in vaccinated women.
- American Society for Reproductive Medicine (ASRM). Current Recommendations for Vaccines: A Practice Committee Opinion. Fertil Steril 2024;122(1):44-52 — interrupted series, pregnancy and breastfeeding (based on CDC/ACIP recommendations).
- The Johns Hopkins Manual of Gynecology and Obstetrics, 6th edition, 2020 — types covered by the vaccine and age recommendations.
- Hoffman BL et al. Williams Gynecology, 4th edition, 2020; Smith RP. Netter's Obstetrics and Gynecology, 3rd edition, 2017 — contraindications.
- Steegers EAP et al. Textbook of Obstetrics and Gynaecology. Springer Nature, 2019, Chapter 25 — the effect of vaccination given around the time of treatment on the risk of recurrence.
The information on this page is based on the national and international guidelines listed above. The page is reviewed whenever those guidelines are updated.
Practice and Contact Details
The information on this page is general. Please speak to your doctor about your own situation.
- DoctorOp. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology
- AddressOp. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya
- Telephone0505 351 77 88
- HoursMonday – Saturday 09:00 – 18:00 · Closed on Sunday