How many doses of the HPV vaccine should I have?

The HPV vaccine is given to protect against the human papillomavirus (HPV). HPV is a group of viruses that for the most part are harmless. Some of the over 100 strains of HPV can cause things like warts on the hands and feet (these tend to affect children and teenagers more than adults), genital warts, and lead to cell changes which can cause certain types of cancer. 

The HPV vaccine most commonly used (Gardasil 9) will protect against the strains of HPV that are most likely to cause cancers associated with HPV (including cancers of the cervix vulva, vagina, penis and anus, and some cancers of the head and neck) and genital warts. 

The vaccine is given to some people in school - it’s freely available for certain people on the NHS and can be accessed privately through services like Online Doctor. 

In this article we’ll look at how many doses of the HPV vaccine you might need, how effective the different doses might be, whether you need a two or three-dose schedule, and the age guidelines for the HPV vaccine. 

JVCI HPV advice 

Up until recently, the vaccine was given in a two-dose schedule to teenagers aged 11 to 13 and then in a three-dose schedule (over a six-month period) to anyone older than this. But recent research by the Joint Committee on Vaccination and Immunisation (JCVI) suggests that two doses with the right interval gives the same amount of protection as three. 

The NHS will follow the advice of the JVCI and has already stated that most people starting their course of HPV vaccines after 1st April 2022 will be offered a two-dose schedule of the vaccine. 

But it’s important to note that despite the evidence from the JCVI and the NHS’ plan, the manufacturer of the vaccine still advise the three-dose schedule. So, a two-dose schedule is considered ‘off-licence’. 'Off-licence' means that the manufacturer hasn't applied for a licence to be administered in two doses. 

If you’re using our service to access the HPV vaccine privately, you can buy one, two or three doses of the vaccine. 

HPV vaccine 2-dose schedule  

If you’re having a two-dose course of the Gardasil 9 vaccine, the schedule should be as follows: 

• First dose of 0.5ml of HPV vaccine 
• Second dose of 0.5ml five to 24 months after the first dose (for the Gardasil vaccine the second dose should be from six months after). 

Two doses of Gardasil 9 less than five months apart (or six if you’ve had Gardasil) won’t give you long term protection, and you should get a third dose.

HPV vaccine 3-dose schedule  

If you do need to have a three-dose course (or choose to have one) the schedule should be as follows: 

• First dose of 0.5ml of HPV vaccine 
• Second dose of 0.5ml at least one month after the first dose 
• Third dose of 0.5ml at least three months after the second dose

This schedule is the same for Gardasil and Gardasil 9. 

HPV vaccine schedule guidelines

HPV vaccine for women 25+ 

Women over the after of 25 who haven’t had the HPV vaccine won’t be offered it through the NHS, but you can still access the vaccine privately through a HPV vaccine service like Online Doctor. 

If you’re using our service to access the HPV vaccine privately, you can buy one, two or three doses of the vaccine. 

HPV vaccine for men aged 25+

Adult men aged 25+ (or those who weren’t eligible for the HPV vaccine in school) won’t be offered the HPV vaccine through the NHS. However, you can still access HPV vaccine for adult men privately through a HPV vaccine service like ours. 

If you’re using our service to access the HPV vaccine privately, you can buy one, two or three doses of the vaccine. 

HPV vaccine for those aged 15 to 25

By the time most young people have reached age 15, they should have been offered the HPV vaccine, but there are catch up programmes in place. 

People aged 15 to 25 who were eligible for the vaccine in school (that’s females born after 01/09/1991 and males born after 01/09/2006) can get the vaccine for free through the NIP. All those aged 15 to 25 will get two doses of the vaccine through the NHS.

If you want three doses, you’ll most likely have to access this privately, you can do this through our online HPV vaccine service.

HPV vaccine for men aged up to 45 who have sex with men  

Men who have sex with men (MSM) are considered high risk for HPV infection, so those aged under 45 who fall into this category (and haven’t been previously vaccinated) are also offered the HPV vaccine through the NHS. 

MSM aged 45 and under will be offered the two-dose schedule. Generally, this will be offered when you attend a sexual health or HIV clinic. 

HPV vaccine for men aged 46+ who have sex with men 

MSM who are 46 and over won’t be offered the vaccine through the NHS (unless you started but didn’t finish a course before turning 46). But you could still access the vaccine through our online HPV vaccine service.

Children’s HPV vaccine 

There’s currently no children’s HPV vaccine offered through the NHS National Immunisation Programme (NIP) for kids in aged nine-11. However, Gardasil and Gardasil 9 are technically licensed by the manufacturer for children as young as nine.

HPV vaccine for young people aged 11-14 

The HPV vaccine is offered through the NHS to all young people aged 11 to 14. Typically, this will be the Gardasil 9 vaccine, but in some cases, Gardasil might be used. 

The first dose is usually offered in Year 8 (England and Wales), S1 (Scotland) or Year 9 (Northern Ireland). Young people aged 11 to 14 will receive two doses of the vaccine through the NHS. 

HPV vaccine for transgender people

Certain transgender people, who are thought to be more at risk of catching HPV, will be offered the vaccine through the NHS.

Like MSM aged 45 and under, transgender people will be offered two doses of the HPV vaccine, and this is usually done through your local sexual health or HIV services. 

HPV vaccine for HIV patients

If you fit into any of the groups above and have HIV/are on HIV medication, you will be offered the HPV vaccine through the NHS. HIV patients will be offered three doses of the HPV vaccine. 

In fact, any patients who are deemed to be immunosuppressed will be offered three doses of the vaccine. 

Could there be a HPV vaccine one-dose schedule? 

There is some evidence to suggest that a one-dose HPV vaccine could be as effective as the two or three-dose schedules. And, the JCVI has said that most likely it will at some point recommend a one-dose schedule is taken up by the NHS. This may be enough to still get the benefits from the previously advised two and three doses. 

A one-dose schedule will also free up resources and it’s thought more people will take up the vaccine, as two or three doses can be a burden, especially on teenagers who are being offered other vaccines around the same time.

Summary of HPV vaccine guidelines and dose schedules 

Getting your HPV vaccine with Online Doctor 

As we’ve discussed there’s plenty of people who can get the HPV vaccine for free on the NHS. But in case you don’t fit into any of those categories, or would prefer a three-dose schedule, you can request the vaccine through Online Doctor. 

All you have to do is answer a few simple questions, our clinicians will make sure the vaccine is right for you and prescribe it. You’ll then be sent a link to book an appointment to get your first dose administered in your local LloydsPharmacy. 

References 

https://www.gov.uk/government/publications/hpv-immunisation-programme-changes-from-april-2022-letter/hpv-immunisation-programme-changes-from-april-2022-letter
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1065283/HPV-greenbook-chapter-18a.pdf 
https://www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine/
https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/warts-and-verrucas
https://www.gov.uk/government/publications/single-dose-of-hpv-vaccine-jcvi-interim-advice/jcvi-interim-advice-on-a-one-dose-schedule-for-the-routine-hpv-immunisation-programme