Questions and Answers about HPV and the Vaccine
Many people have questions about human papillomavirus (HPV) and the vaccine that prevents it. Here, you can find a compilation of some common questions. Can't find what you're looking for? Ask your HPV questions here.
HPV infection - general
At what age can someone be infected with HPV?
Anyone can be infected with HPV regardless of their age. For example, if a pregnant woman has HPV, her baby can be born with an HPV infection.
If someone is infected with one type of HPV and their immune system clears it, are they immune to other types of HPV too?
Immunity to one type of HPV does not afford protection against the other types. The current vaccine protects against 9 different types of HPV, which protects against the types most likely to cause disease.
If a person is diagnosed with cervical HPV, does that mean they also have HPV anally if they’ve had anal intercourse, and is there a test for the presence of HPV anally?
A person found to have HPV in cells of the cervix may or may not have the infection in cells of the anus. The virus does not travel in the body; however, people often do not know when they were infected. So, it is possible that the cells of the anus could have been infected if the HPV exposure that resulted in cervical infection occurred during relations that also involved anal intercourse. In some cases, anal cells can be isolated to check for changes suggestive of cancer. However, because this type of “pap” test does not only detect changes caused by HPV, but those caused by other pathogens as well, its use is limited to certain high-risk populations, and it may or may not be able to confirm an HPV infection.
If a person is diagnosed with genital HPV, does that mean they also have HPV orally, and is there a test for the presence of HPV orally?
The HPV virus does not travel to other parts of the body, so a genital infection does not automatically mean an oral infection. Unfortunately, no test is available to check for oral HPV at this time.
How long does an HPV infection last?
HPV infections can last up to 24 months before the immune system eliminates the infection. During this time, most people do not know they are infected. This is why it is difficult to stop transmission of the virus.
What does it mean when people say an HPV infection “cleared?” Is the infection gone or is it dormant? Can it still be spread to someone else?
HPV virus can cause persistent infections. This means that when a person is infected, the virus is reproducing in the cells that line the infected area. It does not live silently inside of cells like herpes viruses. This means that when the immune system “clears” the infection, it is no longer present, so it cannot be spread to someone else.
However, what is important to understand is that many people have HPV infections without symptoms, so they do not realize they are infected. Further, since a Pap test checks for cellular changes and not the presence of virus, a “negative” Pap test does not mean that no HPV infection is present. It only means that the cells that line the cervix do not currently show signs of damage caused by a persistent HPV infection. This is why it is important to get regular Pap tests.
How does HPV cause cancer?
HPV infects epithelial cells that line mucosal surfaces of the body. When HPV enters these cells, such as in the throat, genital tract or anus, it causes the cells to produce HPV proteins. In most cases, the immune system recognizes the cells that are infected and eliminates them, clearing the infection. However, in some instances a persistent infection occurs causing the cells to mutate, or change. These mutations can ultimately lead to cancer.
Am I really at risk of getting HPV?
HPV is spread through genital contact, most often, but not always, during sex. It can also spread through oral sex. Most people don’t know they have HPV, so they often don’t realize they are spreading the virus. Since HPV is so common, if you are intimate with anyone, the best way to reduce your chance of getting infected is to be vaccinated with the HPV vaccine.
How common is HPV?
HPV is one of the most common sexually transmitted diseases among both men and women in the United States. Currently, about 42.5 million Americans are infected with HPV, and every year, about 13 million new infections occur.
HPV causes cervical cancer, one of the most common cancers in women. Every year in the United States, approximately 13,000 women get cervical cancer and about 4,000 women die from the disease. Worldwide, the total number of deaths from cervical cancer every year is more than 300,000. HPV is also known to cause genital warts as well as cancers of the penis, vagina, vulva, anus and oropharynx.
How do I know if my partner or I have been exposed to HPV?
Because most people do not develop symptoms of infection, they do not know they are infected. To avoid or decrease the chance of exposure, you can abstain from sexual activity, limit the number of sexual partners you have and use condoms. Unfortunately, other than abstinence, none of these methods offers complete protection.
Is HPV deadly?
Yes, in some people the virus causes changes in cells that lead to the development of potentially fatal cancers.
Once a person has HPV, can he or she get rid of it?
Yes, in fact, most people (9 of every 10) do clear the infection within two years, often never having symptoms. Those who don't clear the infection (the remaining 1 of every 10 people) may suffer from genital warts, cervical cancer or other cancers.
Can someone be infected with more than one type of HPV?
Yes, you can be infected with more than one type of HPV at a time.
Do I need to worry about HPV if my boyfriend and I always use a condom?
If your boyfriend has an HPV infection (with or without symptoms), you can still be infected with HPV even when using a condom for two reasons. First, because condoms aren’t foolproof at containing the virus, you could still be infected and, second, while HPV is most often transmitted during sexual intercourse, it can also be transmitted during oral sex or during genital-to-genital contact.
How long does it take for symptoms of HPV to appear?
People can be infected with HPV for years, or even decades, before they experience any symptoms of infection. This is why women should get regular Pap screenings. Because Pap screenings show early signs of changes in cells of the cervix (precancerous changes), treatment is often more successful than after physical symptoms, such as bleeding and pain, appear.
If someone has genital warts, does that mean HPV virus is still present?
Yes. If a person has outward signs of infection, such as genital warts, he or she can transmit the virus. However, it is important to realize that people can also transmit HPV when they do not have any symptoms. Additionally, even if someone has genital warts removed, they may still be infected and able to transmit the virus.
Even though I got the HPV vaccine, I got genital warts. Will I always have them?
Even if you had the HPV vaccine, you could still develop genital warts if you were infected with a strain of HPV not contained in the vaccine. You may want to consider visiting your healthcare provider to confirm the diagnosis of genital warts. If you do have genital warts, your doctor can go over treatment options with you depending on your particular situation. You can read the information about treating genital warts from the Centers for Disease Control and Prevention.
Regarding whether you will always have genital warts, it is difficult to say. In most people, their immune system will eventually clear the infection and the warts will go away, but for some, they may remain. We have no way of telling whether an individual’s immune system is likely to clear the infection or not.
How soon will genital warts appear if I get infected with HPV? Am I really at risk of getting HPV?
Genital warts typically develop four weeks to eight months after contracting one of the types of HPV that cause genital warts. However, HPV can also replicate without causing symptoms for several years before genital warts appear.
How soon after an HPV infection does cervical cancer develop?
Progression from an initial HPV infection to cancer requires prolonged infection with one of the types of HPV that causes cancer. For this reason, cervical cancer typically develops 20 to 25 years after the initial HPV infection. Regular Pap tests and HPV tests will help your doctor monitor for precancerous changes to the cells of the cervix.
I recently had an LEEP procedure to remove high-risk cells from my cervix following a positive Pap test. Can I still pass HPV on to my partner after having this procedure done?
The loop electrosurgical excision procedure (LEEP) does not rid you of HPV. It rids you of some cells that are showing signs of changes resulting from long-term infection. If you are with the same partner that you were with prior to your diagnosis, it is possible the partner was already exposed to the type of HPV you are infected with. If you are with a new partner and that person was not previously exposed to the type of HPV that you have (either naturally or through vaccination), you might expose your partner.
Can a person spread HPV to someone after getting the HPV vaccine?
The HPV vaccine protects against nine types of HPV. Two earlier versions protected against two or four types. The types of HPV in the vaccine protect against the most common causes of cancer and genital warts. If, after being vaccinated, a person is exposed with a type of HPV that was included in the vaccine, he or she is unlikely to be infected and, therefore, wouldn’t spread the virus. However, if a vaccinated person is exposed to an HPV type not in the vaccine, they could potentially be infected and spread the virus to others.
Is it possible for a person who says they are a virgin to spread HPV?
It is possible to spread the virus through intimate contact that does not include intercourse, such as genital-to-genital contact or oral-to-genital contact. So, it is possible that someone who has not had intercourse could be infected with HPV and spread it to others.
If I am infected with HPV orally, can I pass the virus to my children if I kiss them?
While the studies looking at HPV transmission orally are minimal, it is generally agreed upon by the scientific community that HPV is spread orally through more intimate forms of engagement, such as oral sex or "open-mouth" (French) kissing, so kissing your children would not be likely to spread the virus to them if you have an oral HPV infection.
I have heard HPV can be transmitted by skin-to-skin contact. So, if a woman has HPV, can I or my children get it by being around her?
No. HPV is not transmitted by simply being near or touching someone who has it. The reference to skin-to-skin contact refers to intimate interactions, such as genital-to-genital or oral-to-genital contact.
I have never been diagnosed with HPV or genital warts, so how could my child have recurrent respiratory papillomatosis?
Recurrent respiratory papillomatosis, or RRP, is chronic infection of the vocal cords and lungs caused by passage through a birth canal infected with HPV. RRP is primarily caused by two types of HPV that also commonly cause genital warts, types 6 and 11. Because many people are infected with HPV and never have symptoms, they do not know they have an HPV infection. Therefore, unfortunately, it is possible that you could have had an undiagnosed HPV infection during delivery that led to your child’s infection.
I have been in a monogamous relationship for more than 20 years; however, I was recently diagnosed with genital warts. My wife has never had them. How could I have gotten them?
Your question is a common one. Almost everyone who is sexually active will be infected with HPV at some point. For many, they may never know when or how they were infected for a few reasons. First, symptoms can appear years after the initial infection. Second, the disease can be transmitted without having intercourse. Skin-to-skin contact or oral sex can also transmit the virus. Finally, even people who do not know they are infected and those who do not have any symptoms may still transmit the virus.
If a woman is exposed to HPV through oral sex with a man who has had genital warts, can she get HPV and if so, will her infection occur in the oral or genital region?
Yes. A woman can be exposed to HPV if she has oral sex with a man who has an HPV infection (with or without current symptoms). If this happens, the infection will occur in the mucosal areas of her mouth, such as in cells in her throat. In most cases, the woman’s immune system will clear the infection without any symptoms. In very rare cases, the virus will persist and cause a condition known as recurrent respiratory papillomatosis (RRP). People with RRP develop warts in their throat which can become large enough that they cause hoarseness or trouble breathing.
Can you get HPV from someone who does not have any symptoms of HPV?
Yes, in fact, most people do not know when they are infected with HPV. So, even if your partner does not have any symptoms of an HPV infection, he or she can still pass the virus to you.
I have heard that you do not need to have intercourse to get HPV. Is that true?
Yes. Although most infections occur following intercourse, HPV may also be passed on during oral sex and genital-to-genital contact. Even more rarely, a mom can transmit the virus to her baby during birth.
Can someone get HPV during masturbation?
HPV is transmitted through intimate interactions between an infected person and an uninfected person. They do not have to have intercourse. Genital-to-genital contact can spread the virus. Because masturbation involves touching one’s self, it will not cause someone to become infected with HPV.
Can a woman pass HPV to a male partner through intercourse?
Yes, a woman can pass the infection to a partner as well as to her baby during birth, although the latter is fairly uncommon. While the infection is most commonly transmitted through intercourse, the virus can also be passed to one's partner during genital-to-genital contact or oral sex.
HPV and pregnancy
Does having HPV put my unborn baby at risk?
In rare instances, mothers with genital HPV can pass the virus to their baby during vaginal delivery. A small number of these babies go on to develop recurrent respiratory papillomatosis (RRP), a condition in which tumors grow in the throat or lungs, sometimes causing hoarseness, difficulty breathing, talking, and swallowing. While the tumors can be surgically removed, they tend to grow back. Some people with RRP require regular surgical intervention. RRP can also cause a disease of the lungs that resembles cystic fibrosis.
A link between HPV and miscarriage, premature delivery or other complications has not been found.
Consult your doctor if you have any concerns.
Can I get the HPV vaccine if I am pregnant?
Although the HPV vaccine has not been found to cause harm to a woman or her fetus, it is recommended to wait until after delivery to start or continue with the series.
If you got the vaccine while you were pregnant, you do not need to take any special precautions.
I started getting the HPV vaccine and now I am pregnant. Can I still get the other doses of vaccine?
You should wait until after you deliver to get the remaining doses of vaccine. There is no indication that the vaccine causes harm to you or your unborn baby, but it is recommended to wait just to be safe. After you deliver, you can get the remaining doses.
HPV testing and treatment
The Centers for Disease Control and Prevention (CDC) has a helpful resource for understanding Pap and HPV tests.
What tests can a woman have related to HPV?
Two tests for women are available:
- Pap test — A Pap test is done by scraping some cells from the cervix and examining them microscopically. A normal result means your cells looked as expected; an abnormal result means that the cells appeared to have undergone some changes. This does not mean you have cervical cancer. In some cases the cell changes are minor and will return to normal when tested in the future. In other cases the changes are more dramatic and need to be monitored more closely.
- HPV test — The HPV test determines if the human papillomavirus is present in the cervix.
The CDC has a great information page about the different test results and what they mean.
If there are no screening tests for men, how can they tell if they have HPV and if so, what is the treatment?
Although there is no approved test for men to know their "HPV status," most HPV infections resolve without causing any problems. The problems caused by HPV in men can include genital warts, anal and penile cancers, or cancers of the oropharynx. There are ways to check for those:
- Genital warts - If you notice abnormalities in the area of your penis, scrotum or anus, such as warts or blisters, see your healthcare provider.
- Anal cancers - Gay, bisexual, and HIV-positive men may consider annual screening by digital rectal exam. Although it is not a formal recommendation, these men are at higher risk.
- Penile cancers - No screening tests are currently available, but early signs can include color changes or build-up or thickening of the tissue.
- Cancers of the oropharynx - Signs include issues associated with the throat including pain, constant coughing, voice changes or hoarseness, lumps or masses in the necks, and trouble swallowing or breathing.
Although no specific treatments for HPV exist, supportive treatments for the health problems caused by HPV are available.
The CDC has an excellent fact sheet related to men and HPV that can provide you with a wealth of additional information.
Is there a treatment for HPV?
No antiviral drugs are available to treat HPV. Most HPV infections, however, clear on their own in a few years without causing any health problems. While there are no treatments for the infection, there are supportive treatments for the health problems caused by HPV, such as genital warts and cancers.
If a person was treated for HPV, are they protected against a future HPV infection?
No. While the symptoms of HPV can be treated, currently, there is not a way to treat the infection. For example, genital warts can be removed, but they may return. If a woman has changes to the cells of her cervix, she may have a procedure to remove or kill the abnormal cells. However, some cells may still contain HPV. There is not a way to know for certain, which is why regular follow-ups are important.
Likewise, a person who has been treated for HPV can still be infected with other types of HPV.
The vaccine may be protective against strains to which the individual was not previously exposed, so some people can still benefit from vaccination after having HPV.
If I got the LEEP procedure done and my tests have come back negative, am I still infected or is the virus dormant, and can I still pass it to future partners? Will I always have HPV in my body?
The LEEP procedure does not rid you of an HPV infection, and therefore, it is important to get follow-up testing as suggested by your healthcare provider. HPV virus does not have a state of dormancy, so if you are still infected, the virus will continue to replicate. But because the virus can only be detected indirectly using the HPV test or the Pap test to look at cervical cells, it can be difficult to tell whether someone without symptoms is infected.
In many cases, the infected person’s immune system overcomes the infection after having LEEP, so they are no longer infected. This can depend on factors, such as the type of HPV that caused the infection and individual differences between people. For example, some people will be HPV-free within six months of the procedure; whereas, others may still be infected up to 18 months later.
However, if you are still infected, you can transmit the virus to future partners who are not immune to that type of HPV.
If I am infected with HPV, will getting vaccinated make the infection go away?
No. The vaccine only protects people against types of HPV to which they were not previously exposed. It does not treat an existing infection or protect against that type of HPV.
Does a negative Pap test mean that I am not infected with HPV?
No. A Pap test is one in which cells isolated from the cervix are examined under a microscope for precancerous changes caused by a persistent, or long-term, HPV infection. So, a negative Pap test is good news in that it means the cervical cells appear normal, but it does not give any information about a person’s HPV status.
A test that specifically detects HPV is also available. Although this test does measure the presence of HPV virus in the cervical cells, it does not provide information about whether that infection will remain long term or eventually cause cancer. Because many younger women get an HPV infection that is cleared by their immune systems, the HPV test can often be positive, causing unnecessary concern; therefore, it is not recommended for most women younger than 30 years of age.
I get regular Pap tests and they have always been normal, so how could my child have developed recurrent respiratory papillomatosis?
Pap tests identify changes to cervical cells that could lead to cervical cancer; however, the types of HPV that cause cervical cancer are rarely associated with recurrent respiratory papillomatosis (RRP). Therefore, you could have had an infection with one of the types that cause RRP and continue to have normal Pap tests. Also, HPV can infect cells without causing the types of precancerous changes that lead to an abnormal Pap smear.
My boyfriend recently had warts on his penis. When I went to the clinic and had a Pap test, the results were normal. Does this mean that I did not get infected, or is there still a chance I could get genital warts?
The types of HPV that cause genital warts typically differ from those that cause cervical cancer. Since a Pap test is meant to identify cellular changes that could potentially lead to cervical cancer, it does not provide information about HPV infections with types that cause genital warts. For this reason, your Pap test results do not mean that you did not get infected with HPV when your boyfriend had it. The good news is that for many people, the infection will clear without any symptoms, so you may never experience genital warts like your boyfriend did.
What happens if my Pap test is abnormal?
If you have an abnormal Pap test, an HPV test may be suggested to determine if human papillomavirus DNA is present in the cells of the cervix. If the results of the HPV test are positive, your doctor will determine how frequently you should be tested. In addition to HPV and Pap tests, a colposcopy or biopsy may be suggested. A colposcopy visualizes the cells of the cervix and a biopsy takes a sample of cervical cells.
For more information about understanding your test results, see the CDC’s information, “What do my cervical cancer screening test results mean?”
How frequently should you get a Pap test?
Women are recommended to get their first Pap test at age 21, and then once every three years until they turn 29. Women who are 30 to 65 years old should have both Pap and HPV tests performed every five years, or a Pap test alone every three years. Women who have an irregular Pap test or who are at risk due to other factors, such infection with Human Immunodeficiency Virus (HIV) or previous diagnosis of cervical cancer, may be required to get tested more frequently.
Find out more on the CDC’s page, “What should I know about screening?”
Find out if you qualify for free or reduced cost screening through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and where near you offers the program.
Can HPV tests replace Pap tests?
No, HPV tests should not replace routine Pap tests for two reasons:
- The tests are not measuring the same thing. Pap tests detect changes in the cells of the cervix that could lead to cancer, whereas HPV tests detect human papillomavirus DNA in the cells of the cervix. A positive HPV test could be the result of a recent infection or a chronic infection.
- The tests are recommended for slightly different age groups; routine Pap tests are recommended for all women 21 years and older, whereas HPV tests are recommended for women 30 years and older and only those women between 21 and 29 who have had an irregular Pap test.
Is there a test to determine if I have HPV?
Yes. The HPV test is used to determine if HPV DNA is present in the cells of the cervix. Positive results mean that your cervix has the types of HPV commonly linked to cervical cancer; however, a positive result does not mean you have cervical cancer. Based on the results, your doctor will determine how frequently you should be tested and whether other tests should be performed. Currently, HPV tests are recommended for all women 30 years and older and any woman 21 to 29 years old who has had an irregular Pap test.
When a person is tested for STDs is HPV testing included?
Sexually transmitted disease (STD) testing is not the same for every person as it depends upon individual risk factors. For HPV, there is no test for males. For females, HPV can be detected by either Pap tests or an HPV test. The Mayo Clinic has a good discussion regarding how to determine what STD tests you may need and what is available.
I got all necessary doses of the HPV vaccine. Do I still need to get Pap tests?
Yes. The HPV vaccine does not contain all types of HPV that can cause cervical cancer; therefore, it is important to continue getting Pap tests.
If I have had an abnormal Pap test in the past, can I still get the HPV vaccine?
Yes. You should still get the HPV vaccine even if you have had an abnormal Pap test because even if you have been infected with HPV, it is not likely that you have been infected with all of the types that the vaccine protects against. So, you can still benefit from protection afforded by the HPV vaccine.
How long after receiving the HPV vaccine does it take for the vaccine to work?
The immune system takes one to two weeks to generate immunity to vaccines or infections. In the case of HPV vaccine, the first dose (and the second one if the person is on the three-dose series) generates a primary immune response, so people will have some immunity, but protection can vary from one person to another. The last dose (given at least six months after the first dose) is important because it enhances the memory immune response. A person will have the greatest protection beginning about one to two weeks after receiving their last dose of the vaccine.
Questions about who should get HPV vaccine
Who should get the HPV vaccine and how many doses?
The HPV vaccine is recommended for adolescents between 9 and 12 years of age, and all teenagers and adults between 13 and 26 years of age who did not get the vaccine when they were younger. Individuals between 27 and 45 years of age can also discuss vaccination with their healthcare provider and receive the vaccine if they decide it can protect them from HPV infection.
- Younger than 15 years old: Two doses separated by 6 months
- 15 years and older: Three doses of HPV vaccine with the second dose given one to two months after the first, and the third dose given six to 12 months after the first
Learn more about why adolescents are recommended to get this vaccine by watching this short video.
Learn more about the recommendations related to those older than 26 years of age by watching this short video.
If I have received the first dose of HPV vaccine, is it safe to be intimate? Am I protected from HPV?
People who have received one dose of the HPV vaccine may have some protection, but the additional dose or doses (depending upon age) offer additional protection. Further, if you or your partner were already infected with a type of HPV, the vaccine will not prevent transmission of that HPV type.
I think I had the HPV vaccine about six years ago, but I am not certain. Should I get the shot? And if I do, but I was vaccinated before, will anything happen?
You should talk with your healthcare provider to see if they know whether you were vaccinated and if so, what type of HPV vaccine you received and how many doses were given. However, if that is not an option and you are uncertain, you can still get the vaccine. Extra doses are not likely to have negative effects.
I had the HPV vaccine but have since given birth to a child. Do I need the HPV vaccine again?
No, people who have been vaccinated against HPV do not need to be revaccinated after giving birth.
If someone already has HPV, does it help to get the HPV vaccine?
Yes. Typically, people with HPV have not been infected with all of the types contained in the vaccine, so the vaccine could protect them from types to which they have not been exposed previously. However, the vaccine will not help treat or protect against types of HPV to which the person has already been exposed.
I have received two doses of the HPV vaccine but missed my third dose. Do I need to start again?
For those 15 years of age and younger, the HPV vaccine is now given in two doses. So, depending on your age, you may not need a third dose:
- If you are under 15 years old and your first two doses were at least six months apart, you do not need a third dose.
- If you are 15 years or older, you still need the third dose; it should be separated from the first dose by six to 12 months. It does not need to be restarted if a longer period of time has passed.
I have heard there is an HPV vaccine that protects against more types of HPV, but I had one of the original versions. Do I need to get it again?
The HPV vaccine protects against nine types of HPV (Gardasil 9®). The CDC does not recommend giving this vaccine to people who already had the earlier HPV vaccines (Cervarix® or Gardasil®-4). However, because the vaccine protects against additional types of the virus, individuals may still reasonably get the vaccine. In this case, the person should speak with their healthcare provider regarding the relative benefits associated with this choice.
I had two doses of the HPV vaccine a while ago. Now, I hear there is a different one that protects against more types of HPV. Should I get that one and if so, do I need to get all three doses of the newer one?
The newer version, Gardasil 9®, is the only version currently available, so you can be protected against more types of the virus by getting the vaccine. The 9-valent vaccine can be used in place of either of the previous two HPV vaccines (Gardasil®-4 and Cervarix®) to complete a vaccination series, so, you do not need to start over again. You would just get the last dose with the current vaccine option. Cervarix and Gardasil-4 are no longer available in the United States.
If you are younger than 15 years old and your first two doses were separated by at least six months, you do not need any additional doses.
I am in my early 20s and would like to get the HPV vaccine, but I don’t know where to get it. What do you suggest?
You can start by checking with your primary healthcare provider. If you cannot get the vaccine from their office, you can also check with your gynecologist, the local health department or a local pharmacy. The manufacturer, Merck, also has an adult vaccine locator on their website that might be of help.
I am concerned that giving the HPV vaccine to young girls will lead them to become sexually active at an earlier age or sexually promiscuous at a later age. Has this been studied?
Yes. A few studies have looked at this and none have found that receiving the HPV vaccine causes girls to become promiscuous or engage in sexual activity at an earlier age. One such study by Robert Bednarczyk and colleagues, published October 2012 in Pediatrics, compared the medical records of 493 girls who received the HPV vaccine and 905 who didn’t. The study found no differences between the two groups in regard to the incidence of pregnancies, tests for or diagnosis of sexually transmitted diseases (STDs), and contraceptive counseling. Based on these results, the authors of the study reported that the HPV vaccine “was not associated with increased sexual activity-related outcomes.”
I heard that even people who have not received the HPV vaccine have less chance of getting HPV since the vaccine came out. Please explain how this occurred, and why I need to get the HPV vaccine?
The HPV vaccine was introduced in 2006, and according to an article published in the July 2012 issue of Pediatrics, use of the HPV vaccine resulted not only in lower rates of infection among those who were vaccinated, but also, to some degree, in those who have not been vaccinated. This phenomenon is commonly known as herd immunity.
You should still consider getting the vaccine because while herd immunity might lessen your chance of coming into contact with the virus, the vaccine will significantly decrease your chance of infection if you do come into contact with it. Unfortunately, despite the decreases in transmission resulting from HPV vaccination, millions of people are still infected with HPV and many do not know they are infected.
I didn't get the last dose of the HPV vaccine. Do I need to start over again?
No. You can just resume where you left off.
My daughter is not sexually active. Why should I even consider getting her vaccinated against HPV now?
The HPV vaccine is recommended before the start of sexual activity for two reasons:
- Young people tend to get infected more frequently; in fact, about half of all new infections are diagnosed in girls and young women between 15 and 24 years of age.
- It takes at least six months to complete the series, so even though your daughter may not be active now, or even in six months, it is better to have the series completed sooner rather than later.
I am already sexually active; should I still get the HPV vaccine?
Yes. The reason to get the HPV vaccine even if you are already sexually active is that you are not likely to have been exposed to all of the HPV types contained in the vaccine.
Why does my son need an HPV vaccine since I heard it prevents cervical cancer?
Although HPV is a known cause of cervical cancer, the virus can also cause other cancers of the reproductive tract, anal cancer, penile cancer, genital warts, and on occasion, cancers of the head and neck. In fact, about 4 of every 10 cases of HPV-related cancers occur in boys or men. Because vaccinating boys will also decrease the spread of the virus, they will not only protect themselves, but also their sexual partners.
Can my 11-year-old get the HPV vaccine at the same time as other vaccines?
Yes. The HPV vaccine can be given at the same time as other vaccines recommended at this age, including the vaccine for tetanus, diphtheria, and pertussis (Tdap) and the one for meningococcus. If it is influenza vaccine season, this vaccine can be given as well.
Can I have the vaccine if I'm not a virgin anymore? And will it still be effective?
Yes, you can still get the HPV vaccine even if you have had sexual intercourse. While you may have been exposed to one or more types of HPV, it is unlikely that you would have been exposed to all of the types that the vaccine protects against, so it may still be of benefit for you.
I am 33 years old. Can I get the HPV vaccine?
In October 2018, the vaccine was licensed for people up to 45 years of age, so inquire with your provider.
I finished all doses of the HPV vaccine before I became sexually active, but recently, I had an HPV DNA test that was positive. How can that be, and will the infection go away?
Because the HPV vaccine does not protect against all types of HPV, it is possible that a fully vaccinated person could be infected with a type of HPV that is not contained in the vaccine. Most people will clear any type of HPV infection— but it may take months to do so. In a few people, however, HPV infection will persist and possibly become cancerous. We have no way of knowing who will be affected over the long term. That said, the vaccine protects against the most common types that cause cancer or genital warts.
Questions about HPV vaccine safety
I don’t want to get the HPV vaccine for my child because I have heard that all of the safety studies were completed by the vaccine manufacturer. Is this true?
Vaccine safety is studied by many, many groups not just those who manufacture vaccines. The FDA reviews all data associated with studies completed by vaccine manufacturers as well as visiting manufacturing sites and continuing to monitor the vaccine as long as it is being made. Additionally, the CDC has systems in place to monitor vaccine safety, including:
- Vaccine Adverse Events Reporting System (VAERS) which allows anyone to report side effects, allowing CDC scientists to watch for trends.
- Vaccine Safety Datalink (VSD) is a collaboration with eight large healthcare organizations from various parts of the United States. Health records are monitored for vaccine receipt and illnesses to study vaccine safety.
- Clinical Immunization Safety Assessment Project (CISA) is a national group of vaccine experts from the CDC, seven medical research centers, and other experts who conduct research around specific vaccine safety concerns, provide consultations for individual healthcare providers on specific patients, and review adverse event data. Vaccine manufacturers do not have a role in these studies.
Additionally, the National Academy of Medicine (NAM), previously called the Institute of Medicine (IOM), periodically conducts comprehensive reviews of the literature to monitor vaccine safety. The NAM completed a review related to adverse effects of vaccines, which included HPV, in 2012. Their findings are available online.
More than 200 million doses of HPV vaccine have been given safely throughout the world. More than 100 million of these have been given in the U.S. What we know from all of these data is that the vaccine is safe and it is working to decrease transmission of HPV, genital warts, cervical changes that cause cancer, and juvenile-onset recurrent respiratory papillomatosis.
Can the HPV vaccine cause cancer?
No. Because the HPV vaccine is made using only a single protein from each type of the virus, it can’t cause HPV infection, and, therefore, it can’t cause cervical cancer or other cancers.
My son received the first dose of HPV vaccine and then two months later he was ill with severe stomach pains, rash and a headache. Could this illness have been caused by the vaccine?
It is not likely that your son’s symptoms were the result of his HPV vaccination for a couple of reasons. First, the length of time between the dose and the appearance of symptoms is not what one would expect if the vaccine was the cause. Second, of the three symptoms you mentioned, the only one that was consistently reported in HPV vaccine recipients was headache, and that was typically reported within 15 days of the first dose.
Does the HPV vaccine cause infertility?
No. HPV infections do not cause infertility, except indirectly in cases when they progress to cervical cancer, so it is not biologically plausible that the HPV vaccine would lead to infertility. To the contrary, since the HPV vaccine decreases the number of cases of cervical cancer, it may indirectly decrease the number of women unable to have a baby.
I heard stories of girls developing different illnesses after getting the HPV vaccine. Are these stories true?
The known side effects of the HPV vaccine include pain, redness or swelling at the injection site. In addition, because teens tend to faint more easily, fainting has been associated with vaccines given to this age group. Because of this, vaccine recipients should remain seated or lying down at the doctor’s office for about 15 minutes after getting the vaccine.
Reports of blood clots, strokes, heart attacks, chronic fatigue syndrome, infertility or premature ovarian failure, and even death have occurred after receipt of this vaccine; however, reviews of individual cases as well as controlled studies looking at groups of people who did and did not get the vaccine have shown that none of these problems were caused by the HPV vaccine.
My daughter is afraid to get the HPV vaccine because one of her friends said it hurts more than other vaccines. What can I tell her?
The HPV vaccine contains higher concentrations of salt than other vaccines, so they may hurt a bit more when they are administered. However, you can suggest one of the following to make your daughter more comfortable while getting the shot:
- Relax the muscle and look away while the shot is given. Take a few short, deep breaths and then a few longer breaths during the vaccine administration.
- Rub an alcohol pad on the opposite wrist right before the vaccine is given and then have her blow on it while the vaccine is administered.
- Use a distraction — friends, music, books, cell phones, or electronic games may work to distract your daughter during the vaccine administration.
- Finally, remind your daughter that the pain of the vaccine is minor compared to the pain associated with the disease.
What are the reactions to an HPV shot?
The HPV vaccine may cause redness, swelling and tenderness at the site of the injection. Some people may faint when they get the vaccine, so people are advised to stay at the doctor's office for 15-20 minutes after getting the vaccine.
Why did my son have to wait 15 minutes after getting the HPV vaccine?
Some teens are more prone to fainting after getting the vaccine; therefore, all teens are recommended to wait at the doctor's office for 15 minutes to be sure they are okay.
Questions about how HPV vaccine is made and works
Q. How long does it take for someone to be protected after getting the HPV vaccine?
A. It takes about two weeks after the first dose of vaccine for the immune system to generate an immune response. The additional doses make that response stronger, particularly the last one which fortifies the memory response.
Q. If I got the HPV vaccine, do I need to use protection?
A. It is important to understand that the HPV vaccine does not protect against other STDs, such as syphilis, chlamydia, gonorrhea, and herpes, nor does it protect against types of HPV to which one was already exposed. For these reasons, using protection is still prudent to consider.
I have had one dose of the HPV vaccine. Will I be protected if I become sexually active?
While you may have some protection after receiving the first dose of HPV vaccine, your best level of protection will occur after you receive all recommended doses.
I did not tell the doctor that I am sexually active before getting the HPV vaccine. Will it still work?
The HPV vaccine will not protect you against types of HPV to which you may have already been exposed; however, it will protect you against types to which you were not previously exposed. Since the vaccine protects against nine types of HPV, it is likely that you can still benefit from receiving the vaccine. For this reason, knowing your sexual activity status is not a requirement for deciding whether or not you should get the HPV vaccine.
How long does immunity last if you receive all doses of the HPV vaccine?
We do not know for sure whether immunity will last a lifetime; however, the data are reassuring. First, the vaccine has been studied for more than 15 years at this point, and immunity doesn’t appear to wane. Second, the immune responses generated by the vaccine are stronger than those invoked after natural infection. Finally, the hepatitis B vaccine, which is made using a technology similar to the HPV vaccine, induces a memory response that lasts at least 30 years.
If I got all necessary doses of the HPV vaccine, can I still develop genital warts?
Yes, it is possible. Although the HPV vaccine protects against the two strains of HPV that most commonly cause genital warts, it will still only prevent about 9 of every 10 cases of genital warts. Therefore, someone could still get genital warts if they are infected with a type of HPV that causes genital warts but was not in the vaccine.
I heard that the cervical cancer vaccine does not prevent all cases of cervical cancer. If this is true, aren’t people getting a false sense of security?
The strains of HPV included in the vaccine will prevent about 9 of 10 cases of cervical cancer. However, because a possibility of getting cervical cancer from one of the types of HPV not contained in the vaccine still exists, women should continue to get regular Pap tests. In addition, the vaccine does not protect against other sexually transmitted diseases, so practicing safe sex is also important.
If my partner and I had the HPV vaccine, do we still need to use condoms?
Yes. The HPV vaccine does not prevent all types of HPV or other types of sexually transmitted diseases. The Centers for Disease Control and Prevention (CDC) has a helpful fact sheet about the use of condoms.
Will an HPV booster shot ever be required?
HPV booster doses are not expected to be necessary; however, public health officials will continue to monitor rates of disease to watch for waning immunity.
Can the HPV vaccine help me get rid of genital warts?
If you already have genital warts, the HPV vaccine will not treat them. However, the vaccine may still protect you against other types of HPV to which you were not previously exposed. Consult your doctor about medicines and procedures that may be used to treat genital warts.
Can the HPV vaccine cause HPV?
No. The HPV vaccine is made using a protein from the surface of the HPV virus. Although the protein folds itself to look like a viral particle in a microscope, it does not contain any genetic material, so it cannot replicate and cause an infection. Because the proteins look like a viral particle, scientists refer to them as “virus-like particles.”
Does the HPV vaccine protect me against any other sexually transmitted diseases (STDs)?
No. The vaccine does not protect against any other STD. In fact, since there are more than 100 types of HPV, it does not even protect against all types of HPV.
Free movie! Watch Someone You Love: The HPV Epidemic compliments of the Vaccine Education Center. The 80-minute film tells the powerful story of five incredible women whose lives were forever changed by human papillomavirus (HPV) and cervical cancer. Those stories also provide an opportunity to learn more about HPV disease and common issues faced by families.
In addition, the VEC interviewed the filmmakers, during which they opened up about filming the emotional documentary, getting to know the women featured, and the impact of the women’s stories on their own lives. Watch all or parts of that interview here.
- Human Papillomavirus: What you should know Q&A sheet: English [PDF, 303KB] | Spanish [PDF, 317KB] | Japanese [PDF, 577KB]
Professional and advocacy groups
Various professional and advocacy groups provide reliable information about HPV and the HPV vaccine; several are compiled below.
Centers for Disease Control and Prevention
The CDC has several sources of information related to HPV and the HPV vaccine:
- Cervical Cancer Screening
- Genital HPV Infection Fact Sheet
- Human papillomavirus website
- National Breast and Cervical Cancer Early Detection Program (NBCCEDP)
National Institutes of Health
The NIH also has several sources of information related to HPV and the HPV vaccine:
- National Cervical Cancer Coalition
- National Foundation for Infectious Diseases (NFID)
- American Sexual Health Association
- The Yellow Umbrella
- Cervivor – a group that advocates for, assists and empowers survivors of cervical cancer
Videos and podcasts
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.