Which HPV Vaccine to use?

This post was originally written in 2010, the best vaccine now is clearly the Gardasil 9 and all the current questions on HPV vaccination are nicely summarized by the CDC at this link.

When deciding which HPV vaccine to get, be sure to use the one that will offer you the most protection. That is the Gardasil. Vaccine for Cervical Cancer the Cervarix by GSK was approved for use in the US in October of 2009. Thus joining the  more than 100 countries worldwide that already had this vaccine in use. It is a vaccine only for Cervical Cancer protection and it is known as a bivalent vaccine active against HPV viruses 16 and 18. About 30 to 40 types of HPV affect the genital tissues, so complete protection from either of these shots is not possible. Some cross protection for other viral types has been shown, mostly 31, 33 and 45.
HPV types 16 and 18, which together are thought to be responsible for about 70% to 80% of all cervical cancer cases, and also responsible for a similar percentage of cervical dysplasias. Women can expect the duration of immunity to last at least 6.4 years, according to a recent HPV study in Lancet
Women can also note that antibody levels from vaccination are much better than the antibody levels from natural infection.
Gardasil is a quadrivalent vaccine with activity against 4 HPV types: HPV types 16 and 18, which cause cervical cancer, and HPV types 6 and 11, which cause genital warts. This extra activity means that this vaccine is also indicated for the prevention of genital warts in girls and women, and it has now been recommended for that same indication for boys and men (up to age 26 is the data submitted so far to the FDA). However, the current data on Gardasil in males extends only out 2 to 3 years, and in women extends only out 5 years.
Would Cervarix or Gardasil be Better at Protecting Against Cervical Cancer?
In the USA we prevent cancer by regular pap smears and then the treatment of precancerous disease. The main purpose behind the development of these HPV vaccines was to prevent ever getting the infection, therefore even impact on pre-invasive disease before it should ever reach cervical cancer. Gardasil has published more information on protection regarding the various infections: cervical, vaginal, vulvar and their preinvasive disease. And protection has been shown to start as soon as you get your first shot. However some physicans have proposed, just for cervical cancer protection, Cervarix is the better of the 2 vaccines. Cervarix might have better cross protection and one of the viruses that Cervarix protects against is one of the causes of adenocarcinoma of the cervix a very difficult cancer to detect. As for antibodies, although some studies say you might form better antibody response against Cervarix, not all those antibodies are important for disease fighting. No one knows if either vaccine will offer permanent protection or need boosters over time, but current evidence is that Gardasil is working with fewer cases of abnormal paps and fewer cases of genital warts in young women and young men

. Other vaccines are in development right now. So it is important for patients and their Gynos to keep up on this important topic.


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