HPV Vaccination: Who, When, Why?

If you're 19, 24 or 26 and wondering whether HPV vaccination still applies to you. If you're a parent and the school nurse just mentioned it for your secondary-school-age child. If you're asking whether boys really need it, whether it's safe, or whether it's worth it after you've already become sexually active — this article answers all those questions, based on the most recent international and French recommendations. For what to do after a positive HPV test, see our companion article: HPV positive after pap smear: what to do next.

The essentials in 3 points

Who? Girls and boys aged 11–14 (top priority). Catch-up vaccination up to age 26 — increasingly available regardless of gender or sexual orientation.

Why? To prevent six HPV-related cancers: cervix, anus, oropharynx, vulva, vagina, penis. Plus 90% of genital warts.

Which vaccine? Gardasil 9 — the standard nine-valent vaccine worldwide. Covers nine HPV types responsible for around 90% of cervical cancers.

Why get vaccinated against HPV?

Human papillomavirus (HPV) causes around 6,400 new cancers each year in France, and significantly more across the UK, US and other developed countries. The best-known HPV-related disease is cervical cancer (around 3,000 new cases per year in France, 2,700 in the UK, 14,000 in the US). But HPV also causes cancers of the anus, oropharynx (throat), vulva, vagina and penis, plus around 35,000 precancerous cervical lesions detected every year — many of which require cervical conisation or other treatments.

HPV vaccination is now considered the most effective primary prevention available against these cancers. The Australian experience speaks for itself: a national HPV vaccination programme launched in 2007 has put Australia on track to virtually eliminate cervical cancer by the early 2030s. Studies show dramatic falls in HPV 16 and 18 infections, in precancerous lesions, and — increasingly — in cancers themselves, in vaccinated cohorts. It is the strongest evidence we have that a vaccine can prevent a cancer.

The 2026 vaccination schedule

Top priority: ages 11 to 14

Public health authorities worldwide — the WHO, the CDC's Advisory Committee on Immunization Practices (ACIP), the UK's NHS, France's Haute Autorité de Santé — all agree on one point: the priority is to vaccinate adolescents aged 11 to 14, both girls and boys, before they become sexually active. At this age, vaccine immunogenicity is at its peak, and exposure to HPV is unlikely. Vaccinating early means vaccinating better.

The standard schedule at this age is two doses, six months apart. In France, vaccination is delivered through GP surgeries, pharmacies and a national school-based programme in collège (Year 8 / Year 9 equivalent). In the UK, the routine NHS programme offers vaccination in Year 8 or 9. In the US, the CDC recommends starting at age 11–12, with catch-up through age 26.

Ages 15 to 26: catch-up vaccination

If you weren't vaccinated as a teenager, catch-up vaccination is recommended in most countries. The schedule is three doses over six months (months 0, 2 and 6). The vaccine can be prescribed by a GP, midwife, nurse or — increasingly — directly by a pharmacist.

The expanded catch-up programme

One of the most important recent developments: catch-up vaccination is increasingly available regardless of gender or sexual orientation, up to age 26. In France, the December 2025 reform extended Gardasil 9 reimbursement up to age 26 for everyone — closing a long-standing inequality where men in same-sex relationships were the only male group eligible after 19. The CDC in the United States has long recommended catch-up through age 26, and shared clinical decision-making for adults aged 27 to 45.

Why does this matter? Because around three-quarters of young adults aged 15 to 26 have not yet been exposed to all HPV strains. Vaccination during this window therefore provides meaningful protection against the strains they haven't yet contracted. Long-term studies have confirmed Gardasil 9 efficacy up to 12 years after the initial dose.

Why vaccinate boys too?

The question comes up regularly because cervical cancer is the best-known HPV-related disease. But HPV doesn't stop at the cervix: in men, it causes cancers of the anus, oropharynx (throat, base of tongue, tonsils) and penis, as well as genital warts (condylomata), which are often recurrent and uncomfortable.

Vaccinating boys protects them directly against these male cancers, and indirectly their partners: the less the virus circulates in the population, the less it reaches those who couldn't be vaccinated. This is the logic of community protection that led the UK to extend HPV vaccination to boys in 2019, France in 2021, and the US since 2011.

One emerging concern: HPV-related oropharyngeal cancers have risen sharply over the past 20 years, particularly in younger men — and they're far harder to screen for than cervical cancer. Vaccination is the only realistic prevention.

Myths: what's true, what's false

Special situations

Pregnancy and breastfeeding

HPV vaccination is not recommended during pregnancy — not because there's evidence of harm (the available data show no safety signal), but as a precaution. If you started a vaccination course before becoming pregnant and didn't finish, simply complete the remaining doses after delivery. Breastfeeding is not a contraindication.

Immunocompromised patients

Vaccination is particularly recommended for immunocompromised patients (HIV, immunosuppressive therapy, organ transplant), where HPV-related disease risk is significantly higher. In transplant candidates, vaccination can begin as early as age 9, with a three-dose schedule regardless of age.

After a treated HPV-related lesion

HPV vaccination is increasingly considered as secondary prevention after treatment of a lesion (conisation, laser ablation). Multiple international studies suggest a meaningful reduction in recurrence. The decision depends on age and clinical context — to be discussed with your gynaecologist.

Vaccination AND screening: not an either/or

This is the most important message of the article: vaccination doesn't replace screening. It doesn't cover all HPV strains, and it's less effective when given after exposure. Regular cervical screening remains the second essential pillar of cervical cancer prevention — even for vaccinated women.

For a detailed walkthrough of pap smear results, see our companion article: Abnormal pap smear: understanding your results (ASC-US, LSIL, HSIL, ASC-H, AGC).

Frequently asked questions

Is the HPV vaccine mandatory?

No. HPV vaccination is recommended, not mandatory, in France, the UK and the US. It requires informed consent — both parents' agreement for minors. Public health authorities consistently emphasise that the priority is improving vaccination coverage in 11–14-year-olds, where protection is optimal.

How much does HPV vaccination cost?

In France, Gardasil 9 is reimbursed at 65% by the health system for ages 11 to 26 (free at school). In the UK, vaccination is free on the NHS for routine and catch-up indications. In the US, most insurance plans cover HPV vaccination, and the Vaccines for Children programme provides it free for eligible under-19s. Outside these schemes, Gardasil 9 typically costs around €120–160 per dose privately.

What are the side effects?

The most common side effects are mild and short-lived: pain, redness or swelling at the injection site, sometimes mild fever, fatigue or headache for 24–48 hours. Serious adverse events are extremely rare; no causal link has been established with autoimmune disease, fertility problems or other serious outcomes — over more than 20 years of worldwide surveillance. The 2026 ANSM safety review confirms an excellent safety profile.

Are booster doses needed?

No, not based on current evidence. Long-term studies have confirmed Gardasil 9 efficacy up to 12 years after initial vaccination. No routine booster is currently recommended. Surveillance continues to assess longer-term protection.

Should my partner get vaccinated too?

If your partner is under 26, yes — vaccination protects them (anal, oropharyngeal, penile cancers, genital warts) and contributes to protecting others. Beyond 26, routine reimbursement no longer applies in most countries, but vaccination can still be discussed individually. The FDA has approved Gardasil 9 use through age 45.

Can I get vaccinated after a known HPV infection?

Yes. A known HPV infection is not a contraindication: the vaccine covers nine strains, and it's very unlikely you've been exposed to all of them. Real protection remains for the strains you haven't yet contracted. This is particularly relevant after treatment of a lesion (e.g. after a conisation), where vaccination reduces recurrence risk.

Does Gardasil 9 also protect against genital warts?

Yes. Gardasil 9 covers HPV types 6 and 11, which cause around 90% of genital warts (condylomata acuminata). It therefore protects both against cancers (high-risk oncogenic types) and against this benign but often recurrent manifestation.