Cervical Cancer Vaccine (HPV Vaccine)

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Most sexually active people encounter HPV at some point in their lives.

HPV has been proven to cause several important diseases in women. It is the main cause of cervical cancer.

It can also cause serious diseases in men and contributes to the spread of the virus through transmission to women.

Gardasil 9 (HPV cervical cancer vaccine) does not contain live virus. It consists of protein particles that mimic only the outer shell of the virus, so it cannot cause HPV infection.

Gardasil 9 protects against 9 HPV types: 6, 11, 16, 18, 31, 33, 45, 52 and 58. These types are responsible for about 90% of cervical cancers and about 90% of genital warts (condylomas).

GARDASIL® 9 Composition and Presentation:

Ready-to-use prefilled syringe containing a suspension for injection (0.5 mL) [Human Papillomavirus 9-valent Vaccine, Recombinant]

The virus is mimicked with proteins. Each dose (0.5 mL) contains:

• HPV Type 6 L1 protein — 30 micrograms
• HPV Type 11 L1 protein — 40 micrograms
• HPV Type 16 L1 protein — 60 micrograms
• HPV Type 18 L1 protein — 40 micrograms
• HPV Types 31, 33, 45, 52 and 58 L1 proteins — 20 micrograms each

To strengthen the immune response, the vaccine contains 500 micrograms of amorphous aluminium hydroxyphosphate sulfate as an adjuvant.

At what age should the vaccine be given?

Gardasil 9 can be given to girls and boys from the age of 9. The greatest benefit is achieved when it is given between ages 9 and 14, before sexual activity begins. It can also be given to women and men up to age 45 after a physician's assessment.

How many doses are needed?

For those who start vaccination between ages 9 and 14, 2 doses are sufficient: the first dose and a second dose 6–12 months later. For those who start at age 15 or older and for people with a weakened immune system, 3 doses are given: at months 0, 2 and 6.

Why is it recommended at such a young age?

Vaccination before sexual activity begins and before any HPV type has been acquired provides the highest protection. The immune response is also stronger at this age, which is why 2 doses are enough between ages 9 and 14.

Does the vaccine work in women who are already sexually active?

If the virus has not yet been transmitted to a sexually active woman, the protection provided by the vaccine is the same as in a woman who has never been sexually active.

Even if you have been infected with one of the HPV types in the vaccine, protection against the other 8 types continues. However, the vaccine does not treat an existing HPV infection or HPV-related cell changes.

How Is the HPV Vaccine Given?

Gardasil 9 is injected into the muscle (intramuscularly): into the deltoid muscle of the upper arm or the front-outer part of the thigh.

At our clinic we usually prefer the upper outer thigh, because the vaccine disperses faster in the leg and this avoids possible arm pain.

We apply an anesthetic gel to the area before the injection and a cooling spray just before the needle.

As a result, patients barely feel the needle.

The most common side effects are pain, swelling or redness at the injection site and a mild headache; they usually resolve on their own within 1–2 days. After vaccination we ask you to rest at our clinic for 15 minutes in case of dizziness or fainting.

Are Smear and HPV Tests Still Needed After Vaccination?

Yes. Gardasil 9 protects against the types that most often cause cancer, but not against all HPV types. Vaccinated women should therefore continue regular smear and HPV screening appropriate for their age.

Can Pregnant Women Be Vaccinated?

We do not recommend or administer the HPV vaccine to pregnant women.

Data on the safety of the vaccine in pregnancy are limited.

Although studies so far have not shown any harmful effect on the mother or baby when the vaccine was given inadvertently during pregnancy, the available data are not sufficient for definitive proof.

Our recommendation is to start vaccination after the pregnancy has ended, or to complete any missing doses after delivery. The vaccine can be given while breastfeeding.

Women who discover they are pregnant after receiving the first dose have no cause for concern; the remaining doses are given after delivery.

Medically reviewed by Op. Dr. Şükrü Sanus, Obstetrician & Gynecologist · Last medical review: 2 October 2026