October 11th, 2010
09:25 AM ET

If I didn't finish HPV vaccine, do I have to start over?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Monday, it's Dr. Jennifer Shu, a pediatrician.

Question asked by Laura of Wyoming:

At least two years ago, I received the first of three shots for the HPV vaccine. At the time, I was not told about the additional shots, and so never got them. Am I still able to do the vaccine, whether I start over again or just get the next two shots? Can I be tested for HPV to see if it's even worth it any more?

Expert answer:

Thank you for your questions. I consulted with Dr. Jill Grimes, author of "Seductive Delusions: How Everyday People Catch STDs," to better address your concerns. She reports that HPV (human papillomavirus) currently affects about 20 million people in the United States, including more than half of all adults at some point in their lifetime. While most infections cause no symptoms and go away on their own, some virus strains can cause genital warts as well as cancer of the cervix or anus.

The HPV vaccine that you most likely received two years ago protects against two different strains of virus that cause cervical cancer and two others that cause genital warts. The vaccine schedule calls for three shots spread out over the course of six or more months to help maximize immunity. Having one dose may give a person some protection against the virus strains but three doses will probably help the protection last longer. Patients are also advised to complete the entire series in hopes of protecting against any strains they have not yet contracted and are at risk of catching.

It is not necessary to repeat the first dose; however, the second dose is recommended to be given now (at least one month following the first dose) and the third dose should be given at least three months after the second dose, with a minimum of six months between the first and third doses. Of note, the HPV vaccine has recently been licensed for use in males to prevent two strains that cause genital warts and follows the same vaccination schedule.

Current recommendations call for starting Pap and HPV testing at age 21 but it's never too soon to start testing for other sexually transmitted diseases as soon as one becomes sexually active. Remember, STDs are often silent, and infections such as chlamydia and gonorrhea can cause damage that leads to chronic pelvic pain or infertility if left untreated.

Be sure to consult with your own gynecologist or primary care physician for more guidance about your own situation. Good luck!

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