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HPV vaccine recommendations by age

The HPV vaccine is most effective if it¡¯s given before HPV exposure.

All males and females ages 9 to 26 should get the HPV vaccine. It is most effective when given as early as possible and before the potential for HPV exposure. Unvaccinated men and women ages 27 to 45 should talk to their doctor about the benefits of the vaccine.

The age you get your first dose of the HPV vaccine determines how many doses you will need. Here's more information specific to each age group.

Ages 9 to 14

The CDC recommends all males and females ages 9 to 14 get two HPV vaccine shots between 6 and 12 months apart.

¡°Ideally, we want you to be vaccinated completely before you turn 13,¡± Ramondetta says, noting that HPV exposure risk increases the older you get.

Children can get their first dose of the HPV vaccine starting at age 9. Getting the first HPV vaccine dose at age 9 means that children can get their second dose at age 11 when they come in for other adolescent vaccines, such as Tdap and the meningococcal and flu vaccines.

¡°If you're at the doctor for any reason at age 9 or age 10, ask your doctor if you can start the HPV vaccine series,¡± Ramondetta says. ¡°Then, when you come back for the other adolescent vaccines at age 11 or 12, you can get the second HPV vaccine and you're done! You don't have to come back again; you're fully vaccinated.¡±

A note for cancer patients: The  recommends immunocompromised people ages 9 to 26 get three doses of the HPV vaccine.

Ages 15 to 26

All males and females between ages 15 and 26 should get the HPV vaccine if they haven't gotten it on time. If you wait until this age range to get your first shot, you will need to get three total doses instead of two over the course of 6 months.

¡°The older you are, the higher the likelihood that you've already been exposed to HPV. The vaccine really works best if you are vaccinated before exposure. Furthermore, the older you are, the more shots you need to prime your immune system,¡± Ramondetta explains.

Even so, being a bit late to start your HPV vaccination doesn¡¯t mean it¡¯s too late to benefit from its protection.

¡°If you're over 15 and up to 26, getting the vaccine is still important and beneficial. You should still get vaccinated. Just know that you're getting it later than recommended and it may not be quite as effective,¡± she says.

Ages 27 to 45

Should unvaccinated adults who may have already been exposed to HPV still get vaccinated?

It depends. The HPV vaccine prevents new HPV infections, but it doesn¡¯t treat existing infections, the . However, the HPV vaccine protects against nine different strains of HPV. This means that even if you have already been exposed to one strain of HPV, the vaccine could still protect you against others.

Ultimately, if you're 27 to 45 and haven¡¯t gotten the HPV vaccine, you should talk to your doctor to decide if you are at risk of HPV exposure and if the HPV vaccine will benefit you.

For example, people ages 27 to 45 with the potential for new sexual partners may benefit from HPV vaccination.

¡°If you¡¯re in that age group and never got the HPV vaccine and are not in a monogamous relationship or are concerned about risk for future exposure, then yes, I would get vaccinated,¡± Ramondetta says.

Additionally, health care workers who work in the operating room with patients who are being treated for HPV-related disease may be exposed to aerosolized HPV. In these situations, unvaccinated health care workers should talk to their doctors about vaccination, Ramondetta says.

Ages 45 and older

The HPV vaccine isn¡¯t recommended for people over age 45.

¡°If somebody is over 45, they've likely already been exposed, in which case the vaccination will not be preventative of infection, or their immune system isn't going to respond well enough to make such a late vaccination effective,¡± Ramondetta says.

Why do I need multiple doses of the HPV vaccine?

At this point in our understanding, studies have shown the best immune response is achieved when the vaccine is given to preteens rather than older individuals.

To understand why, think of the HPV vaccine as a study session and your immune cells as students. After two or three study sessions, your cells are more likely to remember the material than after just one session, Ramondetta explains.

¡°Your immune system is better when you're younger, so you only need two shots,¡± she says. ¡°It takes us older people longer to remember things sometimes. It's kind of like, ¡®Do you have to hear the song twice to remember the words, or do you need to hear it three times?¡¯¡±

However, emerging data suggests fewer shots may still be just as effective, she notes. This information is still being evaluated by the CDC¡¯s Advisory Committee on Immunization Practices.

What happens if I don¡¯t get all of my HPV vaccine doses?

It¡¯s important to complete the HPV vaccination series needed for your age to get the most protection.

According to the , this means:

• 2 doses within a 6- to 12-month period if you are ages 9 to 14.
• 3 doses within a 6-month period if you are immunocompromised and ages 9 to 26.
• 3 doses within a 6-month period if you are ages 15 to 45.

¡°If you don't fully vaccinate, based on the information we have now from research studies, with the two or the three doses depending on your age group, then you are considered not fully vaccinated and therefore may not be fully protected,¡± Ramondetta says, adding that this may change in the future as we get more information.

If you are under 26 and started an HPV vaccination series that you didn't finish, the CDC recommends completing the series according to whether you got your first vaccine before age 15 or after. If you got your first vaccine before age 15, you need a total of 2 shots. If you got your first vaccine at age 15 or older, you need a total of 3 shots. If you don't know when or if you started the vaccine series, you should get a total of 3 shots, Ramondetta says.

Remember to get HPV testing ¡ª and look for new guidelines and information on self-testing in the future

The HPV vaccine doesn¡¯t protect you from every type of HPV. That¡¯s why it¡¯s important to follow the age-based recommendations for Pap and HPV tests.

Women ages 21 to 29 should have a Pap test every three years or have an HPV test every five years beginning at age 25. Women ages 30 to 64 should have an HPV test, with or without a Pap test, every five years, or a Pap test every three years. Currently, there is no HPV test for men.

RELATED: HPV tests with self-collection: What to know

These tests can¡¯t prevent cancer, but they can help find it early, when it¡¯s easiest to treat.

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