Every effort should be made to adhere to the recommended dose intervals as efficacy data for the HPV vaccines are based on them. However where receipt of three doses of bivalent or quadrivalent HPV vaccine is documented, the risk of a suboptimal immune response with clinically significant reduction in protection against HPV infection is low.
The highest risk of suboptimal response would be where there was a shorter than minimum recommended interval between both Dose 1 and 2 and Dose 2 and 3.
In the event that HPV vaccine has been administered outside the recommended intervals, the following is recommended:
|Total interval between Dose 1 and Dose 3||Age of vaccine recipient||Recommendation|
|111 days or longer||All ages||No further dose|
|74 to 110 days||15 years or less at the time of the 2nd dose.||No further dose|
|74 to 110 days||Older than 15 years at the time of the 2nd dose||Give Dose 4 at least 6 months after Dose 3|
|Less than 74 days||All ages||Give Dose 4 at least 6 months after Dose 3|
Advice for informed consentWhen the minimum recommended intervals between doses of HPV vaccine have not been followed, the clinician needs to discuss the potential risks and benefits to the client. This should include the limitations of the available data and the potential for increased risk of reaction to a fourth dose.
If the course can not be completed within 12 monthsIf the duration between doses has been longer than 12 months, there is no need to repeat the earlier doses.Give the missing dose(s) as soon as is practicable.
This advice was developed in consultation with the National Centre for Immunisation Research and Surveillance and other immunisation experts. More detailed information is available in the document Guidance on revaccination where HPV vaccine doses have been given at less than recommended intervals on the Immunise Australia website.