Yes, Gardasil is still on the market, though the version available today is Gardasil 9, an updated vaccine that protects against nine strains of HPV. It is manufactured by Merck and remains FDA-approved for use in both males and females ages 9 through 45. The original four-strain Gardasil was phased out years ago, with its last doses expiring on May 1, 2017.
What Changed From the Original Gardasil
The original Gardasil covered four HPV types. Gardasil 9, approved by the FDA in December 2014, added protection against five additional strains that account for roughly 20% of cervical cancers. It now targets nine HPV types in total: 6, 11, 16, 18, 31, 33, 45, 52, and 58. Types 16 and 18 are responsible for the majority of HPV-related cancers, while types 6 and 11 cause most genital warts.
Once Gardasil 9 became widely available, Merck stopped producing the older version. If you received one or more doses of the original Gardasil before 2017, the CDC considers those doses valid. You don’t need to restart the series, though your provider may recommend completing it with Gardasil 9.
What Gardasil 9 Protects Against
Gardasil 9 is approved for prevention of cervical, vulvar, vaginal, and anal cancers, as well as oropharyngeal and other head and neck cancers linked to the HPV types it covers. It also prevents genital warts caused by HPV types 6 and 11. These indications apply to both men and women.
Population-level data shows the vaccine is working. Among teen girls in the United States, infections with the HPV types that cause most cancers and genital warts have dropped 88% since vaccination programs began. More than 135 million doses have been distributed in the U.S. to date.
Who Can Get It and How Many Doses
The number of shots you need depends on your age when you start. Children and teens who begin between ages 9 and 14 typically need only two doses, spaced 6 to 12 months apart. If that second dose is given earlier than five months after the first, a third dose becomes necessary.
Anyone who starts the series at age 15 or older needs three doses. The standard schedule is the first shot, a second shot two months later, and a third shot six months after the first. People with weakened immune systems also follow the three-dose schedule regardless of age.
The FDA-approved age range extends up to 45 for both men and women. Vaccination tends to be most effective before any exposure to HPV, which is why routine recommendations focus on preteens, but adults who missed it earlier can still benefit.
Safety Profile
The most common side effects are mild: soreness, redness, or swelling at the injection site, along with headache, fatigue, nausea, fever, and muscle or joint pain. These typically resolve within a day or two.
Large-scale safety monitoring has been reassuring. An analysis of nearly 840,000 doses given at six medical centers between 2015 and 2017 found no new safety concerns. A separate review of over 7,200 reports to the national vaccine safety reporting system found that about 97% were classified as non-serious. Serious allergic reactions occur at a rate of about 3 per million doses, consistent with other vaccines.
Fainting can happen after the shot, particularly in adolescents (a reaction seen with many vaccines, not just this one). Providers are advised to give the injection while you’re seated or lying down and to observe you for 15 minutes afterward. Federal agencies have specifically investigated concerns about reproductive problems, chronic fatigue syndrome, and other conditions sometimes raised online. None of these have been linked to the vaccine.
Cost and Access
Most private insurance plans and Medicaid cover Gardasil 9 with no out-of-pocket cost, especially for children and young adults. For uninsured or underinsured adults, Merck offers a Patient Assistance Program that provides the vaccine free of charge to eligible individuals. The Merck Access Program can also help answer questions about insurance coverage and connect patients with co-pay assistance or other financial support.
For children under 19 without insurance, the federal Vaccines for Children program covers HPV vaccination at participating providers, including many community health centers and local health departments.