My teenager missed the school HPV vaccine — can they still get it?

Yes. Gardasil 9 is free under Australia's National Immunisation Program for people aged up to 19 who missed the school programme. Doses can be given by a GP or community immunisation service. For ages 20 and above, the vaccine is available on prescription but is not subsidised under the NIP for that age group; a GP can advise on whether it is likely to be beneficial based on prior exposure history.

Why does the 80% HPV vaccine coverage threshold matter?

At high coverage levels, widespread vaccination reduces overall HPV circulation in the community — including among people who are unvaccinated. When coverage falls below approximately 80%, this community-level protection weakens. Australia's national target is 80% coverage by age 15. Both girls (78.7%) and boys (75.6%) now sit below that threshold, which experts describe as concerning.

Gardasil turns 20 — and HPV vaccine coverage is falling

What just happened

This week marks 20 years since Australia launched Gardasil — in August 2006, Australia became the first country in the world to introduce a publicly funded human papillomavirus vaccination programme. The occasion is genuinely worth marking. What the anniversary data reveals, however, is a concerning trend running counter to the programme’s two-decade record.

HPV vaccine coverage among Australian girls at age 15 has declined from 86.6% in 2020 to 78.7% in 2025. Among boys, the drop is from 84.9% to 75.6% over the same period. Both figures now sit below the 80% threshold that experts consider important for community-level protection. Immunisation register data confirms what clinicians in general practice have been observing: uptake is falling, and the decline is not trivial.

The both-and

What 20 years of Gardasil has achieved

Australia’s HPV vaccination programme has been one of the most consequential public health investments in the country’s recent history. The vaccine targets the human papillomavirus strains responsible for approximately 70% of cervical cancers, along with strains linked to vulvar, vaginal, anal, penile, and oropharyngeal cancers. Coverage at the levels Australia achieved in the years after the programme launched translated into measurable reductions in HPV infection rates, precancerous cervical lesions, and — with the natural history lag — in cancer rates themselves.

Professor Nigel McMillan has described cervical cancer as a disease that will become rare enough to be “a thing of the past” for vaccinated cohorts. That trajectory depends on coverage remaining high. Australia has been on track to become one of the first countries in the world to effectively eliminate cervical cancer as a public health problem. That achievement is not locked in — it depends on each successive cohort of adolescents completing the schedule.

The vaccine now used is Gardasil 9, which covers nine HPV strains compared to the original four-valent formulation. Under the National Immunisation Program, it is delivered through school-based programmes for students in Year 7 or 8 (depending on the state) and is free for those aged up to 19 who missed the school programme. Scheduling has moved to a single dose for most recipients — a deliberate change from the earlier two-dose schedule, intended to reduce barriers to completion.

Why the coverage decline should be taken seriously

Professor Julia Brotherton described the drop below 80% as “really concerning.” That framing is appropriate. The 80% threshold is not an arbitrary administrative target. It reflects the coverage level at which the vaccinated majority provides meaningful protection to the non-vaccinated minority — what is broadly described as community immunity. When coverage falls below that threshold, HPV strains can circulate more freely, reaching individuals who are unvaccinated or who have not developed immunity to those particular strains.

The timing of this decline is important context. The years 2020 to 2025 include the COVID-19 pandemic, during which school-based immunisation programmes across most states were disrupted or paused. Catch-up vaccination after school programme disruption is notoriously difficult to complete at the same rate as the programme itself — students age out of the school setting, and the infrastructure for systematic catch-up is less robust than the school delivery mechanism.

Whether the decline represents a structural shift in vaccine hesitancy or a pandemic-era disruption that has not yet been recovered matters for how to respond. If it is the former, the response requires sustained community engagement. If the latter, targeted catch-up outreach to specific birth cohorts may be sufficient. The data does not clearly distinguish between these explanations, but the directional trend warrants action regardless.

It is also worth noting the decline includes boys. The HPV programme was extended to boys in 2013, partly to reduce overall HPV circulation and partly because males are also at risk of HPV-related cancers — oropharyngeal cancer rates in particular have been rising in Australia. A declining coverage rate among boys directly affects the cancer prevention goal for both sexes.

The Australian Immunisation Handbook remains clear on the evidence base: HPV vaccination is safe, effective, and reduces cancer risk. The question is not the vaccine — it is uptake.

My two cents

If you have a teenager who went through Years 7–8 between 2020 and 2023, it is worth checking their immunisation record. The Australian Immunisation Register is accessible through myGov; your GP can pull the record in a consultation. If doses are outstanding, the vaccine is free through a GP or community immunisation clinic for anyone aged up to 19.

For parents of children who have not yet reached the school programme: HPV vaccination is part of the standard immunisation schedule for a reason. It prevents cancer. That is a clear and documented benefit in a single dose.

For adults who were adolescents before the Gardasil era — roughly those who completed secondary school before 2007 — HPV vaccination may still be relevant but is not publicly funded for that age group in most circumstances. A GP can advise based on individual circumstances and prior sexual health history.

The 20-year mark is a moment worth pausing on. The question now is whether Australia holds onto the gains it spent two decades building — and whether the cohorts who missed the school programme during the pandemic receive the catch-up attention they need.

Verdict: yes — worth knowing about.

Sources cited

“Twenty years on from Gardasil cancer vaccine” — ABC News, 28 August 2026. https://www.abc.net.au/news/2026-08-28/gardasil-vaccine-20-years-on/107079282
Human papillomavirus (HPV) — Australian Immunisation Handbook. https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/human-papillomavirus-hpv
National Immunisation Program Schedule — Australian Government. https://www.health.gov.au/topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule