Human papillomavirus vaccine trials and tribulations : Vaccine efficacy - 15/10/15

Doi : 10.1016/j.jaad.2015.05.041

Nancy S. Handler, BA ^a,^f, Marc Z. Handler, MD ^a, Slawomir Majewski, MD ^g, Robert A. Schwartz, MD, MPH, DSc (Hon), FRCP (Edin) ^a,^b,^c,^d,^e,^⁎
^a Dermatology, Rutgers University New Jersey Medical School, Newark, New Jersey
^b Pathology, Rutgers University New Jersey Medical School, Newark, New Jersey
^c Pediatrics, Rutgers University New Jersey Medical School, Newark, New Jersey
^d Medicine, Rutgers University New Jersey Medical School, Newark, New Jersey
^e Preventive Medicine and Community Health, Rutgers University New Jersey Medical School, Newark, New Jersey
^f University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska
^g Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland

^∗Reprint requests: Robert A. Schwartz, MD, MPH, DSc (Hon), FRCP (Edin), Professor & Head, Dermatology, Rutgers University New Jersey Medical School, 185 S Orange Ave, Newark, NJ 07103-2714.

Abstract

As of December 2014, there were 3 approved vaccines for human papillomavirus (HPV): bivalent Cervarix (GlaxoSmithKline, New York, NY), quadrivalent Gardasil (Merck and Co, Kenilworth, NJ), and 9-valent Gardasil-9 (Merck and Co). The average cost per dose is $120, with a recommended 3-dose course. The quadrivalent vaccine is the most widely administered worldwide. As with the bivalent and 9-valent vaccines, the vaccine is considered safe, although concerns have been raised. In addition to immunization against the targeted HPV types, there is evidence that there is cross protection against other types of HPV. This continuing medical education review evaluates the differences in vaccines that are currently on the market; part II focuses on the cost-effectiveness of vaccination, the HPV vaccination programs currently instituted around the globe, efficacy, and safety.

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Key words : anal cancer, Cervarix, cervical cancer, condylomas, Gardasil, human papillomavirus, vaccine

Abbreviations used : ACA, ACIP, AIN, CDC, CHMP, CIN, FDA, HPV, ICER, MSM, MSW, OPSCC, QALY, VLP