The human papillomavirus (HPV) vaccine protects against HPV infection and the cancers caused by HPV. HPV is very common, and most sexually active people will get it at some point. There are many different types of HPV. Some types lead to genital warts or cancers of the cervix, vulva, vagina, penis, anus, and throat. Other types can cause abnormal results on Pap tests.
The HPV vaccine works best when given at age 11-12 years, before exposure to HPV through sexual contact. However, it can be given as early as age 9 and through age 26. Adults ages 27-45 who have not been previously vaccinated can also get the HPV vaccine based on a discussion with their healthcare provider.
Many adults wonder if they should get the HPV vaccine. Here we look at the benefits and risks of getting vaccinated against HPV after age 50.
HPV vaccine recommendations by age
| Age | HPV vaccine recommendations |
|---|---|
| 9-12 years | 2 doses 6-12 months apart |
| 15-26 years | 3 doses over 6 months |
| 27-45 years | 3 doses over 6 months |
| Over 45 years | Not routinely recommended |
The HPV vaccine is routinely recommended for preteens aged 11-12 years and for all young adults through age 26 years if not previously vaccinated. The vaccine can prevent new HPV infections and HPV-associated diseases.
Adults ages 27-45 years who have not been vaccinated previously can also get the HPV vaccine based on a discussion with their healthcare provider. The decision to get vaccinated should take into consideration the likelihood of previous HPV exposure and benefit from vaccination.
The HPV vaccine is not currently recommended for those over age 45. As people get older, they are less likely to benefit from vaccination. Most sexually active adults have already been exposed to HPV, although not necessarily all high-risk types.
Benefits of HPV vaccine at age 50+
Here are some potential benefits of getting the HPV vaccine after age 50:
May prevent new HPV infections
While HPV infection is common, some adults over 50 may not have been exposed to all strains of high-risk HPV that are covered by the vaccine. Getting vaccinated could still give protection against acquiring a new HPV infection.
May prevent HPV-related cancers and diseases
For those not previously exposed to vaccine-type HPV, getting vaccinated could potentially prevent cellular changes that can lead to cancer. The HPV vaccine protects against the types that cause around 90% of cervical cancers. It also protects against types that cause cancers of the vulva, vagina, penis, anus, and throat.
Peace of mind
Some adults over 50 who are concerned about getting an HPV-related cancer, or whose partner has an HPV-related cancer, may want the vaccine for peace of mind. While it may not prevent new disease from a prior infection, it could prevent future re-infections or infections with other high-risk types.
No maximum age limit
The HPV vaccine is licensed by the FDA for use up to age 45, but there is no upper age limit for getting the vaccine. Off-label use over age 50 is allowed. Immunity from the vaccine may last a decade or more.
May provide herd immunity
Vaccinating older adults against the types of HPV not already acquired could help prevent spread to others. This can provide indirect protection through herd immunity.
Risks and disadvantages of HPV vaccine at age 50+
Here are some potential risks and disadvantages to consider about getting the HPV vaccine over age 50:
Less cancer prevention benefit
The HPV vaccine is most effective when given before exposure to HPV. By age 50, most sexually active adults have already been exposed to common high-risk HPV types. The vaccine cannot treat existing HPV infections or diseases. So the cancer prevention benefit is reduced.
Potential lack of cost coverage
Health insurance plans often do not cover the cost of HPV vaccination in those over age 45. Without coverage, the vaccine series can cost over $500.
Unknown duration of protection
How long immunity lasts from the vaccine after age 50 is uncertain. Immunity may wane faster in older individuals. This is still being researched. More booster doses may be needed.
Side effects
The HPV vaccine is very safe, but side effects can occur. About 10% experience mild side effects like pain, redness or swelling at the injection site. Fever, headache, nausea and muscle pain can happen but are less common. Severe side effects are very rare.
May not be as effective
Vaccines in general don’t work quite as well in those with older, weaker immune systems. The HPV vaccine could be somewhat less effective in preventing new infections after age 50 compared to younger ages. But it still offers protection.
Not routinely recommended
Current guidelines only routinely recommend the vaccine through age 45. Some doctors may be hesitant to provide the vaccine off-label to those older than 45.
Who may benefit from HPV vaccine after 50
Here are some people over 50 who could potentially benefit from HPV vaccination:
- Women up to age 65 years – May reduce risk of new HPV-related cervical disease
- Adults with a new sex partner – Less likelihood of prior exposure to all HPV types so vaccine may offer more benefit
- MSM up to age 65 years – Help protect against anal cancer and genital warts
- Individuals with HIV or weakened immune systems – Higher risk of HPV-associated cancers so vaccine may provide advantage
- Previous precancer lesions or HPV-related cancers – Prevent re-infection with other high risk types
- Unvaccinated partners of vaccinated individuals – Provides herd protection
Adults over age 50 with lifestyle risks for new HPV exposures, who have vaccine-type HPV associated conditions, or who want extra reassurance may gain some benefit from vaccination. But routine use is not recommended.
Should you get the HPV vaccine after age 50?
The decision to get the HPV vaccine after age 50 is an individual one between you and your healthcare provider. Here are some key points to consider when making this decision:
- How likely you are to have a new HPV exposure – Your risk of benefiting is higher if you have a new sexual partner
- Your personal risk and concern about HPV-related diseases – Higher if you have a weakened immune system
- Cost and coverage of the vaccine – Check if your insurance will pay since it is not routinely covered after age 45
- Safety concerns – Discuss risks, but side effects are usually mild
- Peace of mind – Some adults over 50 desire the vaccine for added assurance
While the vaccine may be less effective and have lower cancer prevention potential after age 50 compared to younger ages, it can still offer some degree of protection for many older individuals. Discuss your individual circumstances and risks with your doctor to decide if HPV vaccination is right for you.
Conclusion
The HPV vaccine is primarily recommended for preteens and young adults under 26. While adults over age 50 are less likely to benefit compared to vaccination at younger ages, the vaccine can still provide protection against new HPV infections and diseases for some older individuals.
Those who may get the most advantage from HPV vaccination after 50 include adults with new sex partners, compromised immune systems, or previous HPV-related diseases. The vaccine could offer reassurance and peace of mind for some older adults concerned about HPV. But routine vaccination is not recommended over age 45.
The decision to get the HPV vaccine over age 50 is best made on an individual basis after discussing your risks, lifestyle, and concerns with your healthcare provider. While advantages likely decrease with age, vaccination can still be considered for older adults who could benefit. But most adults over 50 will receive little added protection from the vaccine.