Vaccines: VPD-VAC/HPV/Vaccine FAQ

Vaccines and Preventable Diseases:
HPV Vaccine - Questions & Answers

Why are HPV vaccines needed?
HPV vaccines prevent serious health problems, such as cervical cancer and other, less common cancers, which are caused by HPV (human papillomavirus). In addition to cancer, HPV can also cause other health problems, such as genital warts. HPV is a common virus that is easily spread by skin-to-skin contact during sexual activity with another person. It is possible to have HPV without knowing it, so it is possible to unknowingly spread HPV to another person. Safe, effective vaccines are available to protect females and males against some of the most common types of HPV and the health problems that the virus can cause.

How common are the health problems caused by HPV?
HPV is the main cause of cervical cancer in women. There are about 11,000 new cervical cancer cases each year in the United States. Cervical cancer causes about 4,000 deaths in women each year in the United States.

About 1 in 100 sexually active adults in the United States have genital warts at any one time.

What HPV vaccines are available in the United States?
Two HPV vaccines are licensed by the FDA and recommended by CDC. These vaccines are Cervarix (made by GlaxoSmithKline) and Gardasil (made by Merck).

How are the two HPV vaccines similar?
Both vaccines are very effective against HPV types 16 and 18, which cause most cervical cancers. So both vaccines prevent cervical cancer and precancer in women.
Both vaccines are very safe.
Both vaccines are made with very small parts of the human papillomavirus (HPV) that cannot cause infection with HPV, so neither of the vaccines can cause HPV infection.
Both vaccines are given as shots and require 3 doses.

How are the two HPV vaccines different?
Only one of the vaccines (Gardasil) also protects against HPV types 6 and 11. These HPV types cause most genital warts in females and males.
The vaccines have different adjuvants—a vaccine adjuvant is a substance that is added to the vaccine to increase the body's immune response.

Who should get HPV vaccine?
Cervarix and Gardasil are licensed, safe, and effective for females ages 9 through 26 years. CDC recommends that all girls who are 11 or 12 years old get the 3 doses (shots) of either brand of HPV vaccine to protect against cervical cancer and precancer. Gardasil also protects against most genital warts. Girls and young women ages 13 through 26 should get all 3 doses of an HPV vaccine if they have not received all doses yet.

Gardasil is also licensed, safe, and effective for males ages 9 through 26 years. Boys and young men may choose to get this vaccine to prevent genital warts.

People who have already had sexual contact before getting all 3 doses of an HPV vaccine might still benefit if they were not infected before vaccination with the HPV types included in the vaccine they received. The best way to be sure that a person gets the most benefit from HPV vaccination is to complete all three doses before sexual activity begins.

Why is Gardasil not on the immunization schedule for boys and men?
CDC did not add this vaccine to the recommended immunization schedules for males in these age groups because studies suggest that the best way to prevent the most disease due to HPV is to vaccinate as many girls and women as possible. Parents of boys can decide if Gardasil is right for their sons by talking with their sons’ health care providers. Young men can also discuss this vaccine with their doctors.

Why is HPV vaccine recommended at ages 11 or 12 years?
For the HPV vaccine to work best, it is very important to get all 3 doses (shots) before being exposed to HPV. Someone can be infected with HPV the very first time they have sexual contact with another person. It is also possible to get HPV even if sexual contact only happens one time.

How does getting HPV vaccine at ages 11 or 12 fit with other health recommendations?
Doctors recommend health check-ups for preteens. The first dose of an HPV vaccine should be given to girls aged 11 or 12 years during a pre-teen health check-up. The first dose of Gardasil can also be given to boys during their pre-teen check-ups. Two other vaccines are recommended for pre-teens. During one visit, either HPV vaccine can be given safely with these other pre-teen vaccines. A check-up in the pre-teen years is also a time when pre-teens and their parents can talk to their providers about other ways to stay healthy and safe.

What is the recommended schedule (or timing) of the 3 HPV doses (shots)?
For both females and males, 3 doses (shots) are needed. CDC recommends that the second dose be given one to two months after the first, and the third dose be given six months after the first dose.

Will someone be protected against HPV-related diseases if they do not get all 3 doses?
No studies so far have shown whether or not 1 or 2 doses protect as well as getting 3 doses, so it is very important to get all 3 doses.

Are the HPV vaccines safe and effective?
FDA has licensed the vaccines as safe and effective. Both vaccines were tested in thousands of people around the world. These studies showed no serious side effects. Common, mild side effects included pain where the shot was given, fever, headache, and nausea. As with all vaccines, CDC and FDA continue to monitor the safety of these vaccines very carefully.

Do people faint after getting HPV vaccines?
People faint for many reasons. Some people may faint after getting any vaccine, including HPV vaccines. Falls and injuries can occur after fainting. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries.

Can HPV vaccines treat HPV infections, cancers, or warts?
HPV vaccines will not treat or get rid of existing HPV infections. Also, HPV vaccines do not treat or cure health problems (like cancer or warts) caused by an HPV infection that occurred before vaccination.

Are there other HPV diseases that the two vaccines may prevent?
Studies have shown that Gardasil prevents cancers of the vagina and vulva, which like cervical cancer, can be caused by HPV types 16 and 18. Studies of Cervarix have not specifically looked at protection against vaginal and vulvar cancers.

Published studies have not looked at other health problems that might be prevented by HPV vaccines. It is possible that HPV vaccines will also prevent cancers of the head and neck, penis, and anus due to HPV 16 or 18. Gardasil might prevent recurrent respiratory papillomatosis (RRP), a rare condition caused by HPV 6 or 11 in which warts grow in the throat.

Are kids getting too many vaccines?
Vaccines strengthen the body’s immune system—they do not overload it. No reputable science shows that getting recommended vaccines hurts the immune systems of healthy kids. The HPV vaccines are important tools to prevent cervical cancer and genital warts. As with all vaccines, the benefits outweigh potential risks.

Why aren’t HPV vaccines recommended for people older than 26?
Both vaccines were studied in thousands of people from 9 through 26 years old and found to be safe and effective for these ages. The FDA will consider licensing HPV vaccines for other ages if new studies show that this would also be safe and effective.

Should pregnant women be vaccinated?
Pregnant women are not included in the recommendations for HPV vaccines. Studies show neither vaccine caused problems for babies born to women who got the HPV vaccine while they were pregnant. Getting the HPV vaccine when pregnant is not a reason to consider ending a pregnancy. But, to be on the safe side until even more is known, a pregnant woman should not get any doses of either HPV vaccine until her pregnancy is completed.

What should a woman do if she realizes she received HPV vaccination while pregnant?
If a woman realizes that she got any shots of an HPV vaccine while pregnant, she should do two things:

Wait until after her pregnancy to finish the remaining HPV vaccine doses.
Report the vaccination to the appropriate pregnancy registry. There are pregnancy registries to help us learn more about how pregnant women respond to each of the vaccines. So, if a woman realizes that she got any shots of either HPV vaccine while pregnant, she should work with her health care provider to report it to the appropriate pregnancy registry:
The toll-free number for Gardasil is 800-986-8999
The toll-free number for Cervarix is 888-452-9622

Will HPV vaccination be covered by health insurance?
Most health insurance plans cover recommended vaccines. But there may be a lag time after a vaccine is recommended before it gets added to insurance plans. Some insurance plans may not cover any or all vaccines. Check with your insurance provider to see if the cost of the vaccine is covered before going to the doctor.

How can my child get an HPV vaccine if I don’t have insurance?
The Vaccines for Children (VFC) program helps families of eligible children who might not otherwise have access to vaccines. The program provides vaccines at no cost to doctors who serve eligible children. Children younger than 19 years of age are eligible for VFC vaccines if they are Medicaid-eligible, American Indian, or Alaska Native or have no health insurance. "Underinsured" children who have health insurance that does not cover vaccination can receive VFC vaccines through Federally Qualified Health Centers or Rural Health Centers. Parents of uninsured or underinsured children who receive vaccines at no cost through the VFC Program should check with their health care providers about possible administration fees that might apply. These fees help providers cover the costs that result from important services like storing the vaccines and paying staff members to give vaccines to patients. For more information about the VFC program, visit www.cdc.gov/vaccines/programs/vfc/.

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Vaccines: VPD-VAC/HPV/Vaccine FAQ