Is There an HPV Vaccine Age Limit—and How Effective Is It for Adults?

Make no mistake about it: We’re living in a time where there seems to be not much good news in sight, and women’s health care—specifically with regard to cancer rates increasing among young women—is no exception. However, there is a bright spot that calls for rejoicing: Cervical precancer rates are down 79%, according to a new report by the CDC. The reduction, which happened between 2srcsrc8 and 2src22, is consistent with the widespread use of the human papillomavirus (HPV) vaccine since it was approved by the FDA in 2srcsrc6.

Many people, particularly women, are probably aware that the vaccine is recommended for women and girls under the age of 26. Specifically, the CDC recommends the HPV vaccine at age 11 or 12, though it can be started as young as 9; for anyone who didn’t receive it as a kid, the agency suggests still getting it through age 26. But what about if you’re past that? Could you still benefit from the protection the vaccine offers against HPV and its related cancers?

I, too, was wondering this exact thing recently. The vaccine didn’t come out until I was in college, so I just never got it. I went through periods in my 2srcs when I was between jobs and without health insurance, and when I found myself in a place where I could potentially have the vaccine covered, most doctors told me I was simply too old for it. Until last year, when my current ob-gyn informed me that the HPV vaccine age limit had changed. In 2src18, the FDA expanded its approval to include women and men aged 27 through 45 years. While the CDC still doesn’t explicitly recommend the vaccine past age 26, noting that there’s less of a benefit after a person has already been exposed to HPV, the agency does say that adults in this age group may decide with their clinician that it’s appropriate for them. My doctor recommended it for me, personally, at age 37. (And I happily got it.)

To help you understand your risk and figure out if you might benefit from getting the HPV vaccine as an adult, we asked ob-gyns to explain HPV, how the vaccine works, and how to make the right decision for you.

What is HPV?

HPV refers to a group of over 2srcsrc viruses, with over 4src being spread through sexual contact. In fact, HPV is the most common sexually transmitted infection: Almost everyone will have had it at some point in their lives, and while there is no cure, most infections clear up before you even know you have them, Camille Boon, MD, an ob-gyn in Houston, tells SELF. However, about a dozen strains of HPV can cause various types of cancer, including cervical (the most common), anal, oropharyngeal (throat), penile, vulvar, and vaginal.

Unless you also have genital warts (which are only caused by two types of HPV that are typically not associated with cancer), you won’t have any symptoms or signs of the virus, which means you won’t know you have it unless you receive a positive HPV test. These are typically performed as part of regular cervical cancer screening, either on its own or oftentimes in tandem with a Pap smear (which tests for precancerous cells on the cervix), commonly referred to as “cotesting.” (More on testing guidelines in a bit.)

Additionally, according to new research from the CDC, HPV is actually more common in men than women. However, there is still no testing available to confirm an infection in males—meaning, they can unknowingly spread it to a partner—which is why the HPV vaccine is now recommended for people of all genders.

How does the HPV vaccine work?

According to Wendy Wilcox, MD, an ob-gyn in New York City, the HPV vaccine protects against certain high-risk forms of HPV that are known to cause cancer. “When someone gets the HPV vaccine, they’re building up immunity, so their body will be immune if they ever encounter that high-risk type of HPV,” Dr. Wilcox tells SELF. Like most vaccines, the goal of this one is to give the immune system the tools it needs to fend off HPV should it ever encounter it in the future, preventing infection.

“This is why, ideally, we are targeting the pediatric population so that we’re getting them vaccinated before they have any sexual contact where they could be exposed to that high-risk type of HPV,” Dr. Wilcox says.

The vaccine is typically given in a series of two doses 6 to 12 months apart for kids or teenagers, and three doses over the course of six months for adults and people who are immunocompromised.

What exactly are the current HPV vaccination recommendations?

The HPV vaccine is recommended for boys and girls beginning at age nine, preferably between the ages of 11 and 12. It used to only be FDA-approved and therefore recommended up to age 26, though you can now get it up to age 45 if you and your healthcare provider determine that it could benefit you. Again, the CDC does not officially recommend it for folks over 26, but its approval means you can get it if your doctor suggests it—and there are a few reasons they may.

“I’m regularly recommending the vaccine for people of all ages, [but during childhood] is definitely the best time to do it, before you’re ever exposed,” Dr. Boon says. “That’ll give you the highest chance of not getting any abnormal cells.” But even if you have previously had a positive HPV test, the vaccine may still be worth getting because it can prevent future infections, particularly from different or higher-risk strains.

“You also may not know what your [future] social circumstances may be, and there might be more exposures as you get older and [possibly] have a relationship change,” Dr. Boon says. It’s never too late to try to do everything you can to prevent a virus that can potentially cause cancer, she says. And the fact that there is a vaccine that is so effective at preventing multiple types is amazing, she adds, “so I would recommend patients of all ages and genders complete the vaccine series as soon as they can.”

Mine was fortunately covered by my insurance, which made getting it even more of a no-brainer. Coverage may vary, though, by insurance plans if you’re on the older side, Dr. Boon notes.

The bottom line

Among the medical community, it’s widely known and understood that almost everyone will have an HPV infection at some point in their lives, possibly without ever even knowing it. The majority of the time, it’s completely harmless and the body fights it off. But because there is a chance certain strains of the virus could lead to cancer, both Drs. Boon and Wilcox advise doing everything you can to prevent it—especially since men can’t be tested.

Regardless of your vaccination status, Drs. Boon and Wilcox also emphasize the importance of staying on top of your regular cervical cancer screenings via HPV and Pap tests. Cervical cancer screenings are kind of confusing and have changed in recent years, but in general, the US Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend a Pap smear every three years from ages 21 to 24. After that, the ACS suggests screening with an HPV test alone every 5 years from age 25 until age 65. Alternatively, if HPV testing alone is not available, people can receive an HPV/Pap cotest every 5 years or a Pap test every 3 years. The USPSTF recommendation differs slightly in that it does not give preference to the HPV test.

“Research is showing more of a benefit in doing HPV testing alone, as an HPV test can show up as positive months to years before there are abnormal cells that can be detected on a Pap smear, and it is very rare to have abnormal cervical cells without HPV,” Dr. Boon adds.

If you have a positive HPV test or abnormal Pap, the standard recommendation is to test again after a year, after which you will likely be advised to have a colposcopy, a procedure to more closely view the cervix, usually accompanied with a cervical biopsy to remove cells or tissue to test for signs of cervical cancer. Most HPV infections do clear up on their own, however, so once you receive a negative test again (and if nothing concerning shows up on a colposcopy or biopsy), your doctor will likely recommend you go back to co-testing every five years.

Ultimately, cervical cancer is highly preventable and curable if it’s recognized and treated early, Dr. Wilcox says. “The HPV vaccine really is a safe vaccine that seems to offer long-term protection, so there really is no downside to getting it.”

“There are no other cancers, except others caused by HPV, that can be prevented with a simple vaccine,” Dr. Boon adds, “and that is quite remarkable.”

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