Is Cervarix a Good HPV Vaccine Choice?

Cervical Cancer Cells
Coloured scanning electron micrograph (SEM) of two cervical cancer cells forming during division from one cell. They are still joined (at centre). These large rounded cells have an uneven surface with many cytoplasmic projections which may enable them to be motile. Typically, cancer cells are large and they divide rapidly in a chaotic manner. STEVE GSCHMEISSNER/Science Photo Library/Getty Images

Although at first glance Cervarix may not seem to be as good an option for protecting against sexually transmitted HPV infections as either Gardasil or Gardasil 9, it is actually quite a reasonable vaccine choice. Despite having been designed to protect against only the two strains of high risk HPV (16 and 18) that are most often associated with cervical cancer (at least in Caucasian women), in comparison to the other vaccines which target 4 or 9 strains, several studies have provided evidence suggesting that Cervarix is actually capable of providing protection against a broad range of oncogenic HPV strains, including, potentially, HPV 31, 33, 35, 45, 52, and 58. However, unlike Garadsil, it is unlikely to protect against any of the lower risk strains that are associated with genital warts.

Cervarix isn't alone in its ability to provide cross-protection against other HPV strains. Gardasil also appears to have some ability to provide cross-protection against a variety of types of HPV, but evidence to date, although inconsistent, suggests that the extent of cross-protection may not be as great as it is for Cervarix. In addition, some of the researchers comparing the ability of the two vaccines to protect against a variety of HPV strains have found evidence suggesting that protection by Cervarix may last longer than protection induced by Gardasil.

In short, the sum total of the evidence suggests that either HPV vaccine option is a good one... and that the two vaccines are likely similarly cost effective. The main advantage of Gardasil is its ability to protect against genital warts as well as various types of cancer. The main advantage of Cervarix is that it may offer stronger and longer protection against a variety of cancerous strains.

Oh, and there is one other potential advantage of Cervarix over Gardasil, at least for a small population of the population. In late 2013, the European Commission approved a reduced dosing schedule of two injections, instead of three, for girls aged 9 to 14. The 2-dose schedule has not yet been approved in the United States, but if and when it is, that could be a powerful motivator for some people to choose vaccination with Cervarix over vaccination with either Gardasil shot. If you're someone who hates injections, or if you have financial or other logistic concerns about vaccination, being finished after two shots could be a lot more attractive than needing to come back for shot number three.

View Article Sources
  • Bissett SL, Draper E, Myers RE, Godi A, Beddows S. Cross-neutralizing antibodies elicited by the Cervarix® human papillomavirus vaccine display a range of Alpha-9 inter-type specificities. Vaccine. 2014 Feb 26;32(10):1139-46. doi:10.1016/j.vaccine.2014.01.008.
  • Einstein MH, Takacs P, Chatterjee A, Sperling RS, Chakhtoura N, Blatter MM, Lalezari J, David MP, Lin L, Struyf F, Dubin G. Comparison of long-term immunogenicity and safety of human  papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and HPV-6/11/16/18 vaccine in healthy women aged 18-45 years: End-of-study analysis of a Phase III randomized trial. Hum Vaccin Immunother. 2014;10(12):3435-45. doi: 10.4161/hv.36121.
  • Kohli M, Lawrence D, Haig J, Anonychuk A, Demarteau N. Modeling the impact of the difference in cross-protection data between a human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and a human papillomavirus (HPV)-6/11/16/18 vaccine in Canada. BMC Public Health. 2012 Oct 13;12:872. doi: 10.1186/1471-2458-12-872.
  • Malagón T, Drolet M, Boily MC, Franco EL, Jit M, Brisson J, Brisson M. Cross-protective efficacy of two human papillomavirus vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012 Oct;12(10):781-9.
  • Nakalembe M, Banura C, Namujju PB, Mirembe FM. The levels of anti-HPV16/18 and anti-HPV31/33/35/45/52/58 antibodies among AS04-adjuvanted HPV16/18 vaccinated and non-vaccinated Ugandan girls aged 10-16 years. Infect Agent Cancer. 2014 Sep 1;9:29. doi: 10.1186/1750-9378-9-29.
  • Toft L, Tolstrup M, Müller M, Sehr P, Bonde J, Storgaard M, Østergaard L, Søgaard OS. Comparison of the immunogenicity of Cervarix® and Gardasil® human papillomavirus vaccines for oncogenic non-vaccine serotypes HPV-31, HPV-33, and HPV-45 in HIV-infected adults. Hum Vaccin Immunother. 2014 May;10(5):1147-54. doi: 10.4161/hv.27925.