Main decision tree
HPV vaccination, ages 9–26 years
At a glance
- Routine at 11–12 years and can start at 9; the AAP recommends starting at 9–12 years.
- Started at 9–14 years: 2 doses, 6–12 months apart.
- If the 2 doses were less than 5 months apart, a 3rd dose is needed.
- Started at 15–26 years, or immunocompromised at any age: 3 doses at 0, 1–2 and 6 months.
- The age at the first dose decides: a child who starts at 14 and gets dose 2 at 15 still needs only 2 doses.
- Not given in pregnancy: wait until after delivery. No pregnancy test is needed before vaccinating.
- Never restart the series, however long the gap.
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Routine childhood vaccine schedule (AAP 2026) — schedule graph
Routine schedule
- One vaccine is used in the US: 9-valent HPV vaccine (Gardasil 9), given into the muscle.
- CDC: routine at 11–12 years, may start at 9. The AAP recommends starting at 9–12 years, because earlier starts lead to more children finishing the series.
- Boys and girls get the same schedule.
- It can be given at the same visit as Tdap, MenACWY, flu and any other vaccine.
2 doses or 3 doses?
| Who | Doses | Timing | Minimum gaps |
|---|---|---|---|
| Started at 9–14 years, healthy | 2 | 0 and 6–12 months | 5 months; if shorter, a 3rd dose is needed |
| Started at 15–26 years | 3 | 0, 1–2 and 6 months | 4 weeks (1→2), 12 weeks (2→3), 5 months (1→3) |
| Immunocompromised, started at 9–26 years | 3 | 0, 1–2 and 6 months | Same as above |
| 27–45 years, not fully vaccinated | 3 if chosen | 0, 1–2 and 6 months | Shared decision, not routine |
Catch-up rules
- Catch up anyone not fully vaccinated through 26 years.
- Count the doses already given and continue; never restart the series.
- A healthy child who got 1 dose before 15 and comes back years later needs only 1 more dose.
- A series started with an older HPV vaccine (2- or 4-valent) is finished with 9-valent HPV vaccine.
- Previous HPV infection, genital warts or an abnormal Pap test is not a reason to skip; no HPV test is needed first.
Who should not get it, or should wait
- Do not give after a severe allergic reaction (anaphylaxis) to a previous dose or a component, including yeast.
- Pregnancy: wait until after delivery, including for dose 2 or 3. If a dose was given in pregnancy by mistake, no action is needed.
- Breastfeeding is not a reason to wait.
- A moderate or severe acute illness is a reason to delay; a mild cold is not.
Side effects
- Common: pain, redness or swelling in the arm, headache, mild fever and tiredness for a day or two.
- Fainting is common in teens after any injection: give the shot seated or lying down and watch for 15 minutes.
- Studies have found no link with infertility, autoimmune disease or earlier sexual activity.
Common questions
Is the HPV vaccine 2 or 3 doses?
Two doses, 6–12 months apart, if the first dose was given at 9–14 years in a healthy child. Three doses at 0, 1–2 and 6 months if the first dose was at 15 years or older, or the child is immunocompromised.
What if the second HPV dose was given too early?
If dose 2 came less than 5 months after dose 1, give a 3rd dose at least 12 weeks after dose 2 and at least 5 months after dose 1.
Can a 9-year-old get the HPV vaccine?
Yes. It is licensed from 9 years and the AAP recommends starting at 9–12 years. For a child with a history of sexual abuse or assault, it is recommended starting at 9.
Does the HPV series need to restart after a long gap?
No. Give the next dose that is due; earlier doses still count however long ago they were given.
Can adults over 26 get the HPV vaccine?
At 27–45 years it is not routine, but it can be given after a shared decision with a clinician, as 3 doses. It is not licensed after 45.
Can you get the HPV vaccine while pregnant?
No, it is delayed until after pregnancy. A dose given before the pregnancy was known has not been linked to harm and needs no action.
Sources
- CDC: HPV vaccine recommendations
- CDC: Child and adolescent immunization schedule and catch-up guidance
- CDC: Contraindications and precautions (General Best Practice Guidelines)
- AAP: Immunization schedule (aap.org)
Written for Pedemy in our own words from the sources above; checked October 2026. For education only, not medical advice. Pedemy is independent and not affiliated with or endorsed by the organizations cited.