Gardasil vs. Cervarix for HPV Vaccination

Can you choose which one you get?

In This Article

If you or your child is due to get the human papillomavirus (HPV) vaccine—a shot that helps to protect against a variety of HPV strains—you may have heard that there are two brands available: Gardasil and Cervarix.

Closeup of doctor hand are vaccinations to patients using the syringe.Medical concept
Manit Chaidee / Getty Images

The two vaccines protect against different strains of HPV (there are hundreds), a virus that is passed from person to person during all types of sexual contact, including intercourse, oral sex, and anal sex, and is linked to several forms of cancer. Not all strains of HPV are associated with these diseases, however, which is why HPV vaccines have been designed to target the ones that are most aggressive—HPV 16 and 18, according to the American Cancer Society.

Making the Choice

Regarding the question of choosing which shot you get, that depends. For a few years, both Gardasil, which is manufactured by the pharmaceutical company Merck, and Cervarix, made by GlaxoSmithKline (GSK), were offered in the United States.

However, Cervarix wasn't able to keep up with Gardasil in terms of sales. As a result, in late 2016, GSK stopped making it in the U.S. It's still available in other countries, including those that make up Europe, however. Cervarix is also the first and only HPV vaccine to be approved in China.

This means if you live in the U.S., Gardasil is the only option for you. It's important to note that when you hear the name Gardasil, your doctor is actually referring to Gardasil 9, the updated version.

In December 2014, the U.S. Food and Drug Administration (FDA) approved a new version of Gardasil 9 that protects against nine strains of HPV.

Since the quadrivalent form of Gardasil is no longer available, the comparisons that follow are of Gardasil-9 and Cervarix.

Gardasil-9

Strain Protection

The HPV strains it protects against include HPV 6, 11, 16, 19, 31, 33, 45, 52, and 58. The original honed in on HPV 6, 11, 16, and 18; HPV 16 and HPV 18 are the two most aggressive ones, and the only strains that Cervarix is focused on (see below).

One thing to note: There is data to suggest Gardasil-9 and Cervarix may offer cross-protection against other HPV strains; however, they do not protect against any you already may have been infected with.

Dosing Schedule

Gardasil-9 is given in three separate doses over the course of six months. The second shot is given two months after the first, and the last dose is given four months after that. 

It's important to get all three shots for the vaccine to have maximum efficacy. The HPV vaccine can be given in two doses for younger individuals but is always three doses for anyone older than 14.

Who It's For

On its website, the FDA states that Gardasil-9 is indicated for girls and women ages 9 to 45 to prevent cervical, vulvar, vaginal, and anal cancer, and genital warts caused by HPV types 6 and 11 as well as a number of precancerous lesions.

It's also indicated in boys and men ages 9 through 45 for preventing anal cancer caused by HPV types 16, 18, 31, 33, 45, 52, and 58 as well as genital warts and precancerous anal lesions.

The top public health organizations in the U.S. agree that the earlier the better when is comes to HPV vaccination. Guidelines from the U.S. Centers for Disease Control and Prevention (CDC) recommend routine vaccination at age 11 or 12 years. CDC recommends "catch-up" HPV vaccination (3 doses) for all people through age 26, and only recommends the vaccine for adults aged 27 through 45 years after shared clinical-decision making due to low chances for actual benefit.

Meanwhile, updated guidelines from the American Cancer Society recommend routine vaccination beginning at age 9 through 12, catch-up vaccination for all people through age 26, and then recommends against vaccination after age 27. The recommendation against later-in-life vaccination is based on low efficacy in this population and a vaccine shortage that is predicted to last for a while. 

Cervarix

Strain Protection

The HPV strains it protects against includes HPV 16 and 18.

Dosing Schedule

Like Gardasil-9, Cervarix is given in three doses—the second dose one month after the first, and the third dose five months after that. All three shots are necessary to get the most protection.

Who It's For

Cervarix is FDA-approved for girls and women ages 9 to 25 to prevent cervical cancer. 

Safety Issues/Side Effects

One of the issues that often comes up in discussions of any HPV vaccine is whether or not it's safe. All three vaccines can have mild to moderate side effects, such as pain and redness at the injection site as well as headaches, stomachaches, and other full-body symptoms. But otherwise, they're considered to be quite safe.

Anyone who has a serious side effect can report it to the vaccine adverse event reporting system (VAERS) through the U.S. Department of Health and Human Services. Notably, the proportion of reports to VAERS that were classified as serious (i.e., those resulting in permanent disability, hospitalization, life-threatening illnesses, or death) peaked in 2009 at 12.8% and decreased to 7.4% in 2013 (the last full year of reporting). So, in other words, just 8% were considered serious side effects and 92% were not serious.

HPV Doctor Discussion Guide

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  1. Toft L, Tolstrup M, Müller M, et al. 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;10(5):1147–1154. doi:10.4161/hv.27925

  2. American Cancer Society. HPV and cancer: What is HPV? Jul 30, 2020.

  3. American Sexual Health Association. FDA approves a new HPV vaccine.

  4. MerckVaccines.com. Dosage and administration for GARDASIL 9. Updated October 2019.

  5. Meites E, Szilagyi PG, Chesson HW, et al. Human papillomavirus vaccination for adults: Updated recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. Aug 16, 2019;68(32);698–702. doi:10.15585/mmwr.mm6832a3

  6. Saslow D, Andrews KS, Manassaram-baptiste D, et al. Human papillomavirus vaccination 2020 guideline update: American cancer society guideline adaptation. CA Cancer J Clin. Jul/Aug 2020;70(4):274-280. doi:10.3322/caac.21616

  7. Drugs.com. Cervarix dosage. Updated January 14, 2019.

  8. Centers for Disease Control and Prevention. Questions about HPV vaccine safety. Updated December 11, 2019.

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