The legal framework
Vaccination is recommended routinely at 11 or 12, with catch-up to 26 and shared decision-making between 27 and 45. Coverage varies widely by state because there is no national school programme. Cervical screening combines cytology and HPV testing depending on age, and self-collection of samples in healthcare settings was authorised in 2024, an important step for people who avoid pelvic examinations.
Key points
| Routine age | 11 or 12, with vaccination possible from 9 |
|---|---|
| Catch-up | Recommended to 26; shared decision-making from 27 to 45 |
| Coverage | Varies widely by state; there is no national school programme |
| Vaccines for Children | Provides free vaccine for eligible uninsured and underinsured children |
| Screening 21-29 | Cytology every three years |
| Screening 30-65 | HPV testing or co-testing every five years, or cytology every three |
| Self-collection | Authorised in 2024 for use in healthcare settings |
In practice
- If your child is uninsured, ask about the Vaccines for Children programme: the vaccine is free.
- Preventive services rules mean most insurance must cover both vaccination and screening without cost sharing.
- Ask about self-collection if a pelvic examination is a barrier for you.
- Vaccination does not replace screening.
Cost and coverage
Most insurance must cover vaccination and screening without cost sharing; free programmes exist for uninsured children.
Recent changes
Authorisation of self-collection in 2024 opened screening to people who had avoided it because of the examination itself.
Where to go
- Pediatricians, family doctors and pharmacies.
- Federally qualified health centres and Title X clinics.
- State and local health department immunisation programmes.
Worth knowing
Because there is no national school programme, coverage depends heavily on where you live and on your insurance. Do not assume the vaccine will be offered — ask for it.
Official sources and links
- CDC — STI — clinical and prevention guidance
- HIV.gov — testing locator and treatment programmes
- USA.gov — official guide to government services
- Congress.gov — federal legislation