When the first HPV vaccine, Gardasil, was approved in 2006, it marked a huge step forward in women’s health. Gardasil protected against four HPV strains: types 6 and 11, which cause most genital warts, and types 16 and 18, which are responsible for the majority of cervical cancers.
In 2014, a newer version called Gardasil 9 was approved. As the name suggests, it protects against nine strains. In addition to the original four, it also covers five more high-risk types (31, 33, 45, 52, and 58). Together, these nine strains cause about 90 percent of cervical cancers worldwide. Gardasil 9 is now the standard vaccine, and the original Gardasil is no longer available in the United States. The last doses of the original Gardasil expired in May 2017.
Gardasil protected against four HPV types (6, 11, 16, 18). Gardasil 9 protects against nine types, covering the original four plus five additional high-risk strains. This broader protection is important, since those five extra types are responsible for many cases of cervical, vaginal, vulvar, anal, and oropharyngeal cancers.
One of the most significant additions is HPV type 31. After types 16 and 18, HPV 31 is one of the most common cancer-causing strains and is strongly linked to cervical precancers. Women who received the original Gardasil did not get protection against HPV 31. This is one reason Gardasil 9 offers a meaningful benefit and why some women consider revaccination.
If you received your HPV vaccine before 2014, you almost certainly received the original Gardasil. Between 2014 and early 2016, both vaccines were in circulation, and which one you received depended on your provider’s supply. By late 2016 through May 2017, most women were getting Gardasil 9, although some clinics were still using up remaining stock of the original.
The only way to know for sure is by checking your vaccine records, which list the product name and lot number.
The big question many women ask is whether they should be revaccinated with Gardasil 9 if they already received the original series. Current CDC guidelines say revaccination is not routinely recommended. That’s because the original Gardasil still provides strong protection against HPV types 16 and 18, the two strains most likely to cause cancer.
However, Gardasil 9 does provide broader coverage, and some women, especially those at higher risk or who started vaccination at a younger age, may choose to get Gardasil 9 after talking it over with their healthcare provider. The decision often comes down to personal risk factors and preference.
Originally, HPV vaccination was only recommended through age 26. In October 2018, the FDA expanded the approval of Gardasil 9 to include adults up to age 45.
That doesn’t mean everyone between 27 and 45 should automatically get the vaccine. The CDC and its Advisory Committee on Immunization Practices recommend “shared decision-making” for this age group. Because many adults have already been exposed to HPV, the benefit may be smaller than in younger people. But for adults who may still be at risk of new HPV exposure, such as those entering new relationships or with fewer prior partners, the vaccine can still provide meaningful protection against strains they haven’t yet encountered, including HPV 31.
When Gardasil 9 first came out, it was primarily promoted for prevention of cervical and other genital cancers. Over the past decade, strong evidence has shown that HPV is also a major cause of oropharyngeal cancers, which affect the throat, tonsils, and base of the tongue. These HPV-related head and neck cancers are now among the most common HPV-associated cancers in the United States, especially in men.
Because of this, both the FDA and CDC recognize Gardasil 9 as a preventive measure not only for cervical cancer but also for certain head and neck cancers. Most major insurance plans in the U.S. cover HPV vaccination for the recommended age groups, since it is considered preventive care. Under the Affordable Care Act, vaccines recommended by the CDC must be covered without patient cost-sharing when given within the approved age ranges.
For adults between 27 and 45, where vaccination involves shared decision-making, insurance coverage may vary. Some plans will cover it if a provider documents medical necessity, while others may require prior authorization. Patients considering vaccination in this age range should confirm coverage with their insurance company before starting the series.
Both Gardasil and Gardasil 9 have been extensively studied and are considered safe. Common side effects include soreness, redness, or swelling at the injection site, mild fever, headache, or fatigue. Fainting can happen in teens, which is why a short observation period after the shot is recommended. Serious reactions are extremely rare.
HPV vaccination is recommended for all boys and girls starting at ages 11 to 12, though it can begin as early as 9.
Catch-up vaccination is advised up to age 26 if someone was not vaccinated earlier.
For adults 27 to 45, vaccination may still be helpful, but the decision should be made together with a healthcare provider.
If you received the original Gardasil, you are already protected against the two most dangerous HPV strains, 16 and 18. Gardasil 9 adds protection against other high-risk strains, including HPV 31, which is a significant cause of cervical cancer. Revaccination is not required for everyone, but some women may choose it for added peace of mind.
Whether you are considering the vaccine for yourself or your child, Gardasil 9 remains one of the most powerful tools we have to prevent HPV-related cancers including cervical and certain head and neck cancers. Most insurance plans cover it when given within recommended age groups. Talk to your healthcare provider about what makes the most sense for your situation.
What is Gardasil?
The first HPV vaccine, approved in 2006.
Protected against 4 HPV types: 6, 11, 16, and 18.
The last doses expired in May 2017.
What is Gardasil 9?
Approved in 2014 and now the only HPV vaccine used in the U.S.
Protects against 9 HPV types, including the 4 from the original plus 5 more high-risk types.
Prevents about 90% of cervical cancers.
Why HPV 31 matters:
HPV 31 is one of the most common cancer-causing HPV strains after 16 and 18.
It is linked to cervical precancers and cancers that would not be prevented by the original Gardasil.
Because Gardasil 9 covers HPV 31 (and four other high-risk types), some women may choose revaccination for this broader protection.
If you were vaccinated before 2017:
Most likely you received the original Gardasil.
Between 2014 and 2017, some women got Gardasil 9 depending on the clinic’s supply.
Your vaccine record is the best way to know for sure.
Do you need to be revaccinated?
CDC does not recommend routine revaccination if you already had the full Gardasil series.
You are still protected against the most dangerous strains (16 and 18).
However, if you want protection against additional types like HPV 31, talk to your provider about whether Gardasil 9 makes sense for you.
Who should get Gardasil 9 today?
All boys and girls starting at ages 11–12 (can begin at age 9).
Catch-up vaccination up to age 26.
Adults age 27–45 may benefit depending on individual risks.
Bottom line:
The original Gardasil gave important protection, but Gardasil 9 covers more cancer-causing strains, including HPV 31. Revaccination isn’t necessary for everyone, but it may be worth considering if you want the added protection.
Disclaimer: The information on this blog is for general informational purposes only and does not constitute medical advice. Do your own research and consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. Use supplements thoughtfully and at your own risk.
