Vaccine Info

Gardasil 9 HPV Vaccine

Last Reviewed
January 25, 2021

Gardasil 9 HPV Vaccine Description

Gardasil 9 vaccine consists of human papillomavirus (HPV) proteins, Types 6, 11, 16, 18, 31, 33, 45, 52, and 58, amorphous aluminum hydroxyphosphate sulfate, yeast protein, sodium chloride, L-histidine, Polysorbate 80, sodium borate, and water for injection.

Approximately 100 types of HPV have been identified, at least 40 of which can infect the genital area, says the US CDC.

HPV infections can lead to certain cervical cancers. Many females with cervical cancer were probably exposed to cancer-causing HPV types in their teens and early 20s. Unlike some other cancers, cervical cancer is not thought to be passed down through family genes.

Additionally, males can get HPV, causing anal and throat cancers and genital warts, says the CDC. Most HPV infections are self-limited and are asymptomatic or unrecognized. Most sexually active persons become infected with HPV at least once in their lifetime.

Although the HPV vaccine holds promise to nearly eliminating cervical cancer with complete population coverage, U.S. vaccination rates remain far below those in other high-income countries: 57% of U.S. adolescent females are up-to-date vs.>80% in Australia and >90% in the U.K, reported the American Cancer Society on January 12, 2021.

Merck Sharp & Dohme Corp., a Merck & Co., Inc. subsidiary, produces the Gardasil 9 vaccine.

Gardasil 9 HPV Vaccine Indication

Gardasil 9 helps protect girls and women ages 9 to 45 against cervical, vaginal, vulvar, and anal cancers and genital warts caused by 9 types of HPV. It is also indicated to help protect boys and men ages 9 to 45 against anal cancer and genital warts caused by HPV types.

The U.S. FDA approved an expanded indication for GARDASIL 9 to prevent oropharyngeal cancers caused by HPV types 16, 18, 31, 33, 45, 52, and 58. The oropharyngeal and head and neck cancer indication are approved under accelerated approval based on effectiveness in preventing HPV-related anogenital disease. Continued approval for this indication may be contingent upon verification and clinical benefit description in a confirmatory trial, which is currently underway.

GARDASIL 9 may not fully protect everyone, nor will it protect against diseases caused by other HPV types or against diseases not caused by HPV. GARDASIL 9 does not prevent all types of cervical, vulvar, vaginal, anal, or head and neck cancers

Gardasil 9 HPV Vaccine Dosage

The CDC now recommends 11 to 12-year-olds get 2-doses of the HPV vaccine—rather than the previously recommended 3-doses—to protect against cancers caused by HPV. The second dose should be given 6-12 months after the first dose. Each dose of Gardasil 9 is 0.5-mL and is administered intramuscularly only. The Age Recommended Regimen Schedule: 9 through 14 years 2-dose 0, 6 to 12 months; 15 through 45 years 3-dose 0, 2, 6 months.

Gardasil 9 HPV Vaccine Adverse Events

Anyone who is allergic to the ingredients of Gardasil 9, including those severely allergic to yeast, should not receive the vaccine. And Gardasil9 was not studied in women who knew they were pregnant.

Gardasil 9 HPV Vaccine Side Effects

Gardasil 9 side effects include pain, swelling, redness, itching, bruising, bleeding, and a lump where your child got the shot, headache, fever, nausea, and dizziness.

Fainting can happen after getting Gardasil 9. Sometimes people who faint can fall and hurt themselves. For this reason, your health care professional may ask your child to sit or lie down for 15 minutes after your child gets Gardasil 9. Some people who faint might shake or become stiff.

Gardasil 9 HPV Vaccine News

January 12, 2021 - The report estimates that in the U.S. in 2021, almost 1.9 million (1,898,160) new cancer cases will be diagnosed, and 608,570 Americans will die from cancer. These projections are based on currently available incidence and mortality data through 2017 and 2018, respectively, and thus do not account for the impact of the COVID-19 pandemic on cancer diagnoses or deaths.

January 5, 2021 - The human papillomavirus infection, or HPV, is the most common sexually transmitted infection in the U.S., according to the Centers for Disease Control and Prevention. HPV is associated with health problems, including genital warts and cancers, but a vaccine has been available since 2006 to stop the virus. The CDC reports more than 12 years of data supports the HPV vaccine is safe and effective, yet HPV vaccination rates across the U.S. remain low. Social media has a history of being a popular place for sexual health discussions, and the HPV vaccine is one of the most discussed vaccines on the internet. Monique Luisi, an assistant professor in the University of Missouri School of Journalism, has studied more than 6,500 public HPV vaccine-related posts on Facebook from 2006 to 2016.

December 25, 2020 - Washington D.C. - Minor Consent for Vaccinations Amendment Act of 2019. As introduced, this bill permits a minor of any age to consent to receive a vaccine where the vaccination is recommended by the CDC's Advisory Committee on Immunization Practices. It also establishes that if a minor can comprehend the need for, the nature of, and any significant risks inherent in medical care, informed consent is established.

December 6, 2020 - The Urban Public Health Network is joining forces with the University of Saskatchewan for a project that seeks to eliminate cervical cancer. The project is funded by the Canadian Partnership Against Cancer totaling $1.6 million. The goal is to eliminate cervical cancer in Canada by 2040. “Current immunization rates for HPV range from 57% to 92% in various provinces and we need to reach above 90% across Canada, in all populations,” said Neudorf.

November 17, 2020 - The WHO‘s Global Strategy to Accelerate the Elimination of Cervical Cancer outlines three key steps: vaccination, screening, and treatment that could reduce more than 40% of new disease cases and 5 million related deaths by 2050.

November 16, 2020 - AAP study: Cost-effectiveness of Interventions to Increase HPV Vaccine Uptake. Three interventions for increasing HPV vaccine coverage were cost-effective and offered substantial health benefits. Policymakers seeking to increase HPV vaccination should, at minimum, dedicate additional funding for QI visits, which are consistently effective at low cost and may additionally consider more resource-intensive interventions (reminder and recall or school-located vaccination).

November 14, 2020 - College students from minority communities and communities of color are less likely to receive the human papillomavirus (HPV) vaccine compared with individuals in the White community, with Black women significantly less likely than Black men to plan to receive the vaccination, according to results from a small study presented at the Association of Nurses in AIDS Care Virtual Conference.

November 3, 2020 - A new analysis published in the British Journal of Clinical Pharmacology shows that HPV vaccines are safe and well-tolerated in the male population. The side effects that may occur after immunization are similar in both sexes. "To the best of our knowledge, this is one of the first studies focused on the evaluation of the safety profile of HPV vaccines in males," the authors wrote.

October 27, 2020 -  Merck EVP and chief commercial officer Frank Clyburn said during the new earnings call that Gardasil sales fell by 10% in Q3'2020, largely due to lower demand in the U.S. and Hong Kong, SAR, PRC attributable to the COVID-19 pandemic, partially offset by higher volumes in China and Europe.

October 8, 2020 - A new study led by Jeanine Guidry, Ph.D., assistant professor at the Robertson School of Media and Culture and a member of the Cancer Prevention and Control research program at the VCU Massey Cancer Center, compared how HPV vaccination was portrayed on Pinterest before and after the social media platform began moderating vaccine-related content. Findings may help public health officials utilize social media to tackle potentially harmful rhetoric and disseminate trustworthy health information. “Vaccine misinformation is immensely prevalent online and particularly on social media,” said Guidry, who is also director of the Media+Health Lab at VCU. “Although the specific influence of social media on medical decision-making remains understudied, research supports an association between online health information searches and medical decisions.”

October 2, 2020 - Area-Level Variation and Human Papillomavirus Vaccination among Adolescents and Young Adults in the United States: A Systematic Review. Results demonstrate the need to move beyond existing multilevel methods and toward adopting geospatial approaches that allow for the mapping and detection of geographic areas with low HPV vaccination coverage.

September 16, 2020 - U.S. Pharmacist - Human Papillomavirus Vaccine Update.

September 3, 2020 - CDC report: HPV-Associated Cancers Rates by Race and Ethnicity. This study used cancer registry data to estimate the amount of HPV-associated cancer in the United States by examining cancer in parts of the body and cancer cell types that are more likely to be caused by HPV.

August 27, 2020 - Health Canada announced the extension of Gardasil 9 to include men between the ages of 27 and 45.

June 12, 2020 - Merck announced that the U.S. FDA had approved an expanded indication for GARDASIL9 to prevent oropharyngeal and other head and neck cancers caused by HPV types 16, 18, 31, 33, 45, 52, and 58. "Oropharyngeal cancer is the most common cancer caused by HPV in the U.S., and men are five times more likely to be diagnosed than women," said Dr. Alessandro Villa, Ph.D., chief of the Sol Silverman Oral Medicine Clinic at the University of California, San Francisco, and a consultant to the American Dental Association Council on Scientific Affairs who has worked with the ADA on HPV and oral cancer initiatives. "Prophylactic HPV vaccination represents a safe and effective tool for the prevention of oropharyngeal cancers."

May 28, 2020 - Prophylactic, quadrivalent HPV vaccination can prevent genital warts in healthy women and men; therefore, it should be included in routine immunization programs.

April 18, 2020 – During 2007–2016, cancers of the oral cavity and pharynx increased, despite decreases in several anatomic sites, including the nasopharynx, hypopharynx, and lip floor the mouth.

February 12, 2020 – New cancer prevention research published by researchers at The University of Texas Medical Branch (UTMB) at Galveston indicates that just 1-dose of a human papillomavirus (HPV) vaccine is effective as multiple vaccinations for preventing pre-invasive cervical disease.

October 5, 2018 - FDA approved your request dated April 6, 2018, to supplement your Biologics License Application (BLA) submitted under section 351(a) of the Public Health Service Act (42 U.S.C. 262) for Human Papillomavirus 9-valent Vaccine, Recombinant (GARDASIL® 9) to extend the age range for the use of the vaccine to include women and men from 27 to 45 years of age.

February 9, 2018 - FDA approved your request dated August 11, 2017, to supplement your Biologics License Application (BLA) submitted under section 351(a) of the Public Health Service Act (42 U.S.C. 262) for Human Papillomavirus 9-valent Vaccine, Recombinant (Gardasil 9®), to revise Sections 2.3 and 14.4 of the Gardasil 9® package insert to clarify information regarding the study conducted to assess the safety and immunogenicity of Gardasil 9® in individuals who were previously vaccinated with Gardasil®.

December 16, 2016 - This CDC report includes new recommendations for using a 2-dose schedule for girls and boys who initiate the vaccination series at ages 9 through 14. Three doses remain recommended for persons who initiate the vaccination series at ages 15 through 26 years and immunocompromised persons.

Gardasil 9 HPV Vaccine Clinical Trials

Phase 4 study - NCT03943875 - Sponsor: The University of Texas Medical Branch, Galveston; Collaborator: Cancer Prevention Research Institute of Texas

We evaluate whether 15-26-year-old males and females need a 3rd dose of the HPV vaccine or whether 2 doses provide similar protection as 3 doses from the 9 types of HPV that it protects against. Estimated Primary Completion Date: February 28, 2022.