The human papillomavirus (HPV) vaccine is recommended for preteens ages 11 to 12 to provide protection against HPV infection before exposure occurs. However, the vaccine may still be beneficial for some adults ages 27 to 45 who have not been vaccinated previously.
HPV Vaccine Recommendations
The Centers for Disease Control and Prevention (CDC) currently recommends routine HPV vaccination at ages 11-12 for both boys and girls. The vaccine is most effective when given before onset of sexual activity and HPV exposure. Two doses are recommended at this age with an interval of 6-12 months between doses.
HPV vaccination is also recommended through age 26 for those who were not adequately vaccinated previously. For ages 15-26, three doses are recommended over 6 months. HPV vaccination may be given beginning at age 9.
HPV Vaccine Efficacy in Older Adults
While HPV vaccination is not currently routinely recommended after age 26, some adults ages 27-45 who are at risk for new HPV infections may still benefit. Studies have found the HPV vaccine to be safe and effective in producing an immune response in adults ages 27-45.
However, immune response to vaccination declines with increasing age. The highest antibody levels are seen in those vaccinated at younger ages. Vaccine efficacy is lower in older adults compared to preteens and teens.
HPV Vaccination in Women Ages 27-45
In women ages 27-45, HPV vaccination may provide some protection against new HPV infections. Most women in this age group have already been exposed to HPV strains 16 and 18, which are responsible for 70% of cervical cancers. However, vaccination may still defend against other cancer-causing HPV types not yet acquired.
In a study of women ages 27-45 who received the quadrivalent HPV vaccine, antibody levels against HPV strains 6, 11, 16 and 18 were significantly higher in vaccinated women compared to unvaccinated women. While higher antibody levels indicate an immune response, duration of protection is unknown in older women.
HPV Vaccination in Men Ages 27-45
Compared to women, a higher proportion of men ages 27-45 may still benefit from HPV vaccination. Data indicates men are more likely to acquire new HPV infections through their late 20s and 30s. Vaccination may provide protection against developing genital warts and certain HPV-related cancers.
Clinical trials have found HPV vaccination to be safe and effective in producing an immune response in men ages 27-45. As with older women, antibody levels were higher in vaccinated men compared to unvaccinated men. However, efficacy declined with increasing age at vaccination.
CDC Guidance on HPV Vaccination Ages 27-45
While routine HPV vaccination is only recommended through age 26, the CDC states vaccination may be given at the clinician’s discretion in some adults ages 27-45. Those who may benefit include:
- Men ages 27-45
- Women ages 27-45 if not adequately vaccinated previously
- Adults with immunocompromising conditions through age 45
- Men who have sex with men through age 45
- Transgender individuals through age 45
Vaccination is less urgent in this age group but may provide some protection against new HPV infections. Shared clinical decision-making between the patient and provider is recommended to determine if vaccination is appropriate.
Cost and Insurance Coverage of HPV Vaccination
The HPV vaccine is expensive, with each dose costing $200-$300 depending on the brand. The vaccine series can cost up to $1000 in total for those needing three doses. Insurance coverage varies:
- Private insurance: Most plans cover recommended HPV vaccination through age 26. Coverage ages 27+ varies.
- Medicaid: All state Medicaid programs cover HPV vaccination through age 26. Some may cover ages 27-45.
- Uninsured: Those who are uninsured may be able to get the vaccine at low or no cost through the Vaccines for Children (VFC) program at their local health department. Eligibility is based on age/income.
Adults should check with their insurance provider or health department to learn about HPV vaccine coverage options in their location.
Conclusion
While HPV vaccination is primarily recommended for preteens and young adults, it may still benefit some adults up to age 45. Vaccination can produce an immune response in older age groups but is less effective than vaccinating at younger ages. Adults ages 27-45 should discuss the risks and benefits of HPV vaccination with their healthcare provider.
