One-Dose HPV Vaccine? Not All Agree

HHS’ new one-dose HPV vaccine schedule causes confusion 

By Pamela Tom | HPVANDME Founder

In January 2026, U.S. health officials at the Department of Health and Human Services (HHS) updated the immunization schedule on HPV vaccination. Instead of 2 to 3 doses for HPV cancer prevention, the schedule calls for one-dose of the HPV vaccine.

However, the one-dose HPV vaccine does not align with recommendations by the American Academy of Pediatrics and other medical organizations.

Child getting vaccination

The HPV Vaccine Evolution: 2006 to 2026

This month marks the tenth anniversary of the recommendation of the HPV vaccine for preteen girls. In 2009, the recommendation also included boys.

The American Academy of Pediatrics (AAP),  American Academy of Family Physicians (AAFP) and the American College of Obstetricians and Gynecologists (ACOG) along with hundreds of other organizations still recommend the 2 or 3 doses depending upon a person’s age at the first dose and immunocompetence,” says Dr. Robert Jacobson, pediatrician at the Mayo Clinic.

“The scientific data shows that one dose does generate antibodies that appear to persist for up to six years,” says Dr. Jacobson. “However, we do not have proof that one dose works as well as the series to prevent dysplasia and therefore cancer. The FDA held the original human papillomavirus vaccines to a much higher standard. The World Health Organization (WHO), when balancing the cost of no doses versus one dose, chose one dose but our country had higher standards and could afford the series.”

Dr. Jacobson is Medical Director, Population Health Science Program at the Mayo Clinic’s Kern Center for The Science of Health Care Delivery. 

“To its credit, CIDRAP of the University of Minnesota is pulling together the world’s literature to determine if enough evidence exists to support the one dose. I don’t believe it will find it, but I would recommend no changes for now. Mayo Clinic continues with the 2/3 dose series. My advice is to get the first dose at 9 years of age and get the second dose six months later at 9-1/2 years,” says Dr. Jacobson.

Why Parents Are Receiving Mixed Messages

  • The HHS made its decision without the ACIP’s traditional recommendation process.

  • In June 2025, the Secretary of the Health and Human Services Department removed all 17 sitting ACIP members.

  • “HHS did not follow the evidence-based process for schedule revisions, which requires sufficient new data and public scientific debate,” says Healthy Women, a nonprofit helping women make informed health choices. As a result, the AAP continues to recommend the earlier multi-dose schedule.

ESCUDDO Study: One Dose Is Highly Effective

The one-dose recommendation cites studies that show that a single dose of the HPV vaccine works as well as multiple doses. One of the biggest studies, ESCUDDO, followed over 20,000 girls ages 12–16 in Costa Rica. The study compared one and two doses of Cervarix and Gardasil. Both schedules gave strong protection against HPV types that can cause cancer.

Merck Responds with Caution

Gardasil 9, the HPV vaccine used in the U.S., protects against nine HPV types most commonly linked to oropharyngeal, cervical, anal, vulvar, vaginal, and penile cancers. Merck, the pharmaceutical company that produces Gardasil 9, has called for more studies to support the one-dose schedule.

“Clear, evidence-based recommendations remain essential to support informed decisions and ensure children receive reliable protection against preventable diseases,” Merck said, noting that declining vaccination rates can have serious consequences amid recent outbreaks. (Reuters)

Financial analysts also note that reducing the vaccine schedule to one dose could lower Merck’s annual revenue by up to $630 million, as other countries develop their own HPV vaccines.

Global Picture

Currently, 164 countries have introduced the HPV vaccine into their national or subnational immunization programs, marking a significant rise in global access. This includes major recent introductions in countries like Nigeria, China, and Indonesia. More than half of these countries (89 as of January 2026) have adopted a single-dose schedule to improve coverage. The WHO has also prequalified additional HPV vaccines.

  • Cecolin® – Prequalified in October 2021, protects against HPV 16 and 18 (2-valent, China).

  • Walrinvax® – Prequalified in August 2024, protects against HPV 16 and 18 (2-valent, China, 2-dose schedule).

Talk to Your Pediatrician

At the time of publication, the CDC’s recommendation remains at two doses for children ages 9 to 14 and three doses at age 15 to 45.

Parents are encouraged to talk with their child’s healthcare provider about dosage.

HPV vaccination is cancer prevention.

What this Means for Families

  • Safety: The CDC and National Institutes of Health (NIH) confirm that the HPV vaccine is safe and effective. The update is about how many doses are needed.

  • Coverage: Insurance, Medicaid, and the Vaccines for Children program are expected to cover the vaccine, though a second dose may not be required or covered in the future.

  • Global alignment: The change, if approved by the ACIP would align with the World Health Organization (WHO), which in 2022 recommended a single-dose HPV schedule for children ages 9–20.