Almost everyone who has sex picks up human papillomavirus at some point, usually with no symptoms at all, since in most cases the immune system clears the virus on its own (WHO, cervical cancer fact sheet, 2026). A positive HPV result therefore says nothing about how many partners someone has had or how careful they are with safer sex.
HPV only becomes relevant where an infection settles into the tissue and stays for years. That is the gap the HPV vaccine closes, with the version in use today covering nine viral types.
What HPV does in the body
Human papillomaviruses are a large family of more than 200 types, around 40 of which colonise the mucous membranes of the genitals, the rectum and the throat (Robert Koch Institute, HPV guidance for clinicians). They pass from person to person through skin and mucosal contact, so during vaginal, oral and anal sex, during fingering or heavy petting and through shared sex toys. Condoms lower the risk considerably, although some uncertainty remains with HPV, because the virus can also sit on skin that a condom leaves uncovered.
Two groups within that family matter in everyday life. The low-risk types 6 and 11 cause genital warts, which stay medically benign and respond well to treatment. The high-risk types, above all 16 and 18, can take up long-term residence in the cells. Clinicians then speak of a persistent infection, meaning one the immune system no longer clears. Out of that, cell changes can develop that take 15 to 20 years to turn into cancer (WHO, cervical cancer fact sheet, 2026). That long runway is what makes screening so effective for HPV, because there is plenty of time to find changes while they are still straightforward to treat.
Why HPV so rarely comes up
An HPV infection does not hurt, does not itch and does not show up in any of the tests people tend to order after a night with a question mark over it, so most people never learn they had one. In conversations about sexual health HPV falls behind chlamydia, gonorrhoea and HIV, even though it is the most common sexually transmitted infection there is.
Then there is the history of the vaccine. Germany's standing committee on vaccination, the STIKO, recommended it for girls from 2007 and only added boys explicitly in 2018, which is why plenty of people still file it under women's health. Coverage shows the effect: among 15-year-olds in Germany in 2024, around 55 per cent of girls were fully vaccinated, compared with 36 per cent of boys (Nationale Lenkungsgruppe Impfen, 2024). The elimination target is 90 per cent of girls fully vaccinated by their 15th birthday (WHO, 90-70-90 elimination strategy).
What the HPV vaccine protects against
The nine-valent vaccine in use today covers nine HPV types, including 16 and 18 as the most important high-risk types and 6 and 11, which account for most genital warts. That prevents cancers of the cervix, vulva, vagina, penis, anus and the oropharynx, meaning the back of the mouth and throat.
German cancer registry data put the scale of it at 10,000 to 11,000 cancer diagnoses a year attributable to HPV, around 3,000 of them in men (Zentrum für Krebsregisterdaten, Germany's national cancer registry data centre, reference year 2021). For cervical cancer the HPV-attributable share is 90 to 95 per cent, for oropharyngeal cancer about 50 per cent (Zentrum für Krebsregisterdaten, reference year 2021). On top of that come about 25,000 conisations a year in Germany, procedures in which abnormal tissue is removed from the cervix (Nationale Lenkungsgruppe Impfen, 2025).
The effect of vaccination comes through clearly in a Swedish registry study of almost 1.7 million girls and women: those vaccinated before their 17th birthday had an 88 per cent lower risk of invasive cervical cancer, while for vaccination between 17 and 30 the reduction was 53 per cent (Lei et al., New England Journal of Medicine 2020). In Scotland, where a two-type vaccine was used initially, not a single case of invasive cervical cancer had been found by 2024 among women vaccinated at age 12 or 13 (Palmer et al., Journal of the National Cancer Institute 2024).
Why it matters just as much for boys
Two things come together for men. Their immune system produces antibodies after a cleared infection less often than women's does, which makes natural protection after a first encounter with HPV less dependable. There is also no screening programme for them comparable to the cervical smear, so HPV-related changes in men often come to light only once symptoms appear.
Oropharyngeal cancer, the most common HPV-related cancer in men, has become more frequent over recent decades, while anal cancer, penile cancer and genital warts come on top of that and affect everyone regardless of gender. Anyone vaccinated also passes the covered types on less often, which benefits every partner they have.
Which ages the HPV vaccine is recommended for
The STIKO recommends HPV vaccination for all children between 9 and 14 regardless of gender, with two doses at least five months apart being enough at that age. Anyone who misses it by their 15th birthday can catch up until they turn 18, with three doses spread over about six months in that case (STIKO recommendation, 2025). Up to that point statutory health insurance in Germany covers the full cost.
There are two reasons for the early slot. The immune system responds particularly strongly to the vaccine at that age, which is why two doses suffice. Protection also builds best while the first contact with the virus is still ahead, so the timing follows the biologically best moment, long before sex becomes a topic for the children themselves.
Is the HPV vaccine still worth it at 30?
The nine-valent vaccine is licensed from the age of nine with no upper age limit, so being 28, 40 or 55 is no obstacle. German S3 guidance recommends catch-up vaccination for vaccine-naive adults between 18 and 26, while advising against recommending it as a matter of course from 27 onwards (S3 guideline on vaccine prevention of HPV-associated neoplasia, AWMF 2020). From 27 it becomes an individual decision made with a clinician.
How much you get out of it depends on how many of the nine types your immune system has already met, which rises with the number of sexual partners. Very few people have met all nine, so for every type still missing the vaccine keeps building protection. The Swedish data put that at a 53 per cent risk reduction for vaccination between 17 and 30 (Lei et al., New England Journal of Medicine 2020).
If you are between 18 and 26, it is worth raising at your next appointment. If you are older, the conversation is still worth having, because the weighing-up depends on your situation: whether a new relationship is starting, how many changing partners there are or whether a smear has ever come back abnormal.
If you already know you have had HPV
The vaccine works preventively by building antibodies against types your immune system has not met yet. It cannot end an infection that is already running, which is why abnormal results belong in clinical care, usually with a gynaecology practice or a dysplasia clinic, a specialist service for cell changes on the cervix.
The evidence on vaccination after a conisation is still open. A Cochrane review of 13 studies covering 21,453 women found that vaccination in that context may make recurrent cell changes less likely, while rating the certainty of the evidence as low to very low (Kapp et al., Cochrane Database of Systematic Reviews 2025). The picture is therefore contradictory, which makes it one to work through with the clinic treating you.
Who pays for it
In Germany, HPV vaccination is covered by statutory insurance up to the 18th birthday. After that it depends on your insurer, since many statutory funds cover it to 26 or 27 and some have no age limit at all, usually as a voluntary extra benefit. A quick call or a message through your insurer's app settles it in minutes, ideally before you book. If you are paying yourself, the cost per dose runs into low three figures, with the practice able to give you the exact amount in advance.
Can you get tested for HPV?
For people with a cervix, the HPV test is part of statutory screening in Germany. Between 20 and 34 there is an annual cytology smear, the Pap test, in which cells from the cervix are assessed under the microscope. From 35 the check runs every three years as a combination of Pap test and HPV test, known as co-testing, for which insurers send written invitations (Gemeinsamer Bundesausschuss, organised cervical screening programme, Germany).
For men there is no comparable routine check so far. HPV gets investigated when something shows up, so with warts or changes on the penis, scrotum or anus, for which urology or dermatology practices are the right address.
Our Reality Check covers chlamydia, gonorrhoea, syphilis, HIV and hepatitis C. HPV is not part of it, because an HPV result only becomes meaningful alongside an assessment of the cells on the cervix. For HPV, vaccination and screening are what work together. If you are weighing up a home test against an appointment for the other pathogens, our piece on home STI tests and clinic visits goes through the differences.
Genital warts, the other side of HPV
Genital warts are among the most common sexually transmitted conditions there are. They appear weeks to months after contact as small soft bumps on the penis, vulva, perineum or around the anus, staying medically benign throughout. They are still unpleasant, physically and emotionally, because they are visible.
Treatment works well, either with prescription topical preparations or with minor procedures at a clinic, although some patience helps, since warts can come back. The nine-valent vaccine covers the two types behind around 90 per cent of genital warts (RKI, HPV vaccination fact sheet, 2024).
Why screening continues after vaccination
The nine covered types account for most HPV-related cancers, while other high-risk types exist alongside them, which is why screening stays part of the routine for vaccinated people too. The vaccine lowers the chance of cell changes developing in the first place, while screening catches the cases where something grows anyway. Together they give you the best protection medicine currently has to offer against HPV.
Where to get vaccinated
GP surgeries, gynaecology, urology, dermatology and paediatric practices all vaccinate, as do many occupational health doctors and some public health offices in Germany. You need no backstory and no justification, so a sentence like "I would like to catch up on the HPV vaccine" is plenty. If a smear has ever come back abnormal or you have had genital warts, bring it up in the conversation, because it helps work out what the vaccine does for you specifically.
Having let a few opportunities for this vaccine go by is extremely common and nothing to make up for, since the large majority of adults in Germany are unvaccinated. The course can be started at any point, with a single conversation usually enough to work out what makes sense in your situation.
