Is HPV vaccine timing before pregnancy safe during pregnancy?

What does the evidence say about HPV vaccine timing before pregnancy during pregnancy?

1. Since the HPV vaccine is noninfectious, there is no recommended waiting period before trying to get pregnant, and pregnancy testing is not needed before getting the vaccine. 1
2. The largest available safety study followed 92,579 pregnancies and compared women who received the quadrivalent HPV vaccine during the periconceptional period or during pregnancy against a comparison group, finding no increased risk of preterm birth, major structural birth defects, or other adverse obstetric outcomes. 2
3. A meta-analysis pooling multiple studies covering over 5,000 pregnancies exposed to HPV vaccination did not find an increased chance of miscarriage overall, though it flagged one specific analysis suggesting a possible increase tied to a particular vaccine type and exposure window, underscoring that not every subgroup finding has been fully settled. 3
4. Among more than 4,000 pregnancies in which an HPV vaccine was given shortly before or during pregnancy, no increased chance of birth defects was found compared with the general population's baseline rate of about 3%. 4
5. If you find out you are pregnant before completing all three doses of the HPV vaccine series, the recommendation is to wait until after pregnancy to finish the remaining doses, a precaution rather than a response to documented harm. 1

Is HPV vaccine timing before pregnancy safe in each trimester?

• First trimester. Before you start trying to conceive, there's no need to plan around the HPV vaccine specifically. It doesn't require a waiting period or a pregnancy test beforehand, unlike some other vaccines.
• Second trimester. While you're actively trying to conceive, getting a scheduled dose does not require pausing your efforts, since the vaccine is noninfectious and large studies have not linked it to lower conception rates or early pregnancy loss.
• Third trimester. If you find out you're pregnant partway through the three-dose series, standard guidance is to hold off on the remaining doses until after delivery, more as a precaution than because of documented risk, then resume the series afterward.