[Question #7574] HPV Vaccine and COVID-19 Vaccine

1 months ago
Hi and thank you for your service. I work on the frontline and am being offered the COVID vaccine. However, I am in the process of being HPV vaccinated (received my first two shots and will receive the 3rd in March). My question is, is it safe to receive the COVID vaccine before the 3rd dose of the HPV vaccine? Do vaccines interact with each other and cause problems, or have they historically? Are there other people in this predicament? Thanks again.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Welcome back to the forum. Thanks for an important and interesting question.

Bottom line:  I suggest you go ahead with COVID immunization as scheduled. As an option, you could delay your third HPV vaccine dose, but I'm not sure it's necessary. Here are the reasons:

In general, vaccines do not interfere with one another. We give influenza and pneumococcal vaccines at the same visit; same for many childhood vaccines; and of course some vaccines combine protection of more than one infection simultaneously, including MMR (measles-mumps-rubella) for kids, Twinrix vaccine for both hepatitis A and B, and others. There is no reason to suppose the COVID vaccine would be any different, i.e. the HPV and COVID vaccines are unlikely to interfere with one another or increase the risk of side effects. 

That said, the official advice of the manufacturers and the FDA for the currently available COVID vaccines (Moderna, Pfizer) is that other vaccines be avoided for 2 weeks before and a few weeks (4 weeks?) afterward. That's not because interference is known, only because it hasn't yet been studied -- it's basically a legally based (CYA) recommendation. In any case, the usual HPV vaccine schedule is 0, 1 and 6 months -- so if your third HPV dose is due in March, your first two doses must have been last fall, i.e. 3-4 months ago -- right? And your March dose likely will be more than 4 weeks beyond your planned COVID shots. As suggested above, for extra caution you could consider delaying your third HPV dose; your HPV protection will be equally good. (In fact, it's now known that just the first 2 HPV doses give nearly 100% protection, and the timing of the third dose doesn't matter very much. Many people get the third dose a year later or more.)

In summary, I see no problem with this schedule. However, I would urge other users considering HPV immunization to space the individual doses of COVID and HPV vaccines at least 2 weeks apart. But this is just a very conservative precaution:  I doubt here would be any problem, either in side effects or effectiveness of either vaccine, if they were given at the same time. When your workplace COVID vaccine clinic gives you the first dose, they'll probably ask you if you've had any other vaccine in the preceding two weeks; you can honestly answer no, with no need to mention your HPV immunization.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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1 months ago
Thank you for the detailed response.

My follow up question is what is the difference between say someone who received an HPV vaccine a year ago getting a COVID vaccine vs someone who received the vaccine 4 weeks prior. Do the antibodies from the vaccine reduce over time? 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
With most vaccines, the vaccine-generated antibody levels tend to decline over time. For the HPV vaccine, antibody levels often are lower at one year than at, say, 3-4 months after the last dose. However, for most vaccines protection against infection doesn't require high antibody levels; any detectable antibody correlates well with protection, even if the level becomes low. Protection may even continue long often after no antibody at all can be detected. This is the case for hepatitis B vaccine, for example. That said, there have been a few hep B infections in this situation, so a booster dose often is given for people at continued high risk, if antibody can't be detected. And as we all know, people with serious wounds usually are re-vaccinated against tetanus if more than 10 years have passed since the last dose. Usually these measures probably aren't necessary, but it's sometimes done just to be on the safe side. But not (so far) after HPV vaccine, which appears to offer lifelong protection.

The duration of antibody and protection are not yet known for the COVID vaccines. Even the very first recipients of vaccine in the earliest research were immunized only a few months ago, so no way to yet know the answers. However, most experts believe protection and detectable antibody will be quite long, especially in people who receive both doses, as recommended.
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1 months ago
Thank you, I guess my last question is what is the difference between someone who has a newly acquired HPV infection and someone who has just received the HPV vaccine in terms of antibodies. Thanks!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
To my knowledge there is no dfference in HPV vaccine response or antibody level in people who recently acquired HPV. That said, vaccination produces higher antibody levels than natural HPV infection does, so conceivably vaccination could have a booster effect. It used to be believed that immunization has no effect on preestablished infection -- but more recent research suggests there may be some benefit in reducing reactivation of past HPV. However, that's not a strong effect -- and in itself isn't a strong reason to be vaccinated.

My final thought goes back to your original question. You are at far higher risk of a serious health outcome, including death, from COVID-19 than from HPV. Don't let your HPV immunizatio or other HPV delay or otherwise interfere wih COVID vaccination.

I hope the discusion has been helpufl. Best wishes and stay safe.


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