Human Papilloma Virus (HPV) Vaccine

Two HPV vaccines have been licensed globally; a quadrivalent vaccine marketed as Gardasil™ and the other a bivalent vaccine marketed as Cervarix™.

Both vaccines are manufactured by recombinant DNA technology that produces non-infectious virus like particles (VLP) comprising of the HPV L1 protein, the major capsid protein of HPV. Both have efficacy against cervical intraepithelial neoplasia (CIN) 2/3 and adenocarcinoma in situ (AIS) caused by human papilloma virus (HPV) strains contained in the concerned vaccine as primary end points. Both vaccines do not protect against the serotype against which infection has already occurred before vaccination.

Gardasil™ now available in India is a mixture of L1 proteins of HPV serotypes 16, 18, 6 and 11with aluminium containing adjuvant. It has additional efficacy against vaccine type related genital warts, vaginal intraepithelial neoplasia (VaIN) and vulvar intraepithelial neoplasia (VIN).

Cervarix™ is a mixture of L1 proteins of HPV serotypes 16 & 18 with ASO4 as an adjuvant.

The HPV vaccine is recommended for 11 and 12 years old girls (can also be given to girls 9 or 10 years of age). It is also recommended for girls and women age 13 through 26 years of age who have not yet been vaccinated or completed the vaccine series.

Since protection is seen only when the vaccine is given before infection with HPV, the vaccine should preferably be given prior to sexual debut.

Vaccines are not 100% protective against cervical cancer hence, is not a replacement for periodic screening.

Dose and schedule:

Dose – 0.5 ml IM in deltoid

Schedule - Gardasil™ 3 doses at 0, 2 and 6 months

                 Cervarix™ 3 doses at 0, 1 and 6 months

Both vaccines are contraindicated in those with history of previous hypersensitivity to any vaccine component and should be avoided in pregnancy.