Tracking Gardasil 9, Cervarix & HPV Cancer Prevention Vaccines
Human Papillomavirus (HPV) causes 99% of cervical cancers and is responsible for 690,000 cases annually of cervical, throat, anal, penile, vaginal, and vulvar cancers. HPV vaccines represent one of medicine's greatest cancer prevention success stories. Three vaccines are licensed globally: Gardasil 9 (9-valent, Merck), Gardasil (4-valent, being phased out), and Cervarix (2-valent, GSK). Gardasil 9 protects against 9 HPV types (6, 11, 16, 18, 31, 33, 45, 52, 58) responsible for 90% of cervical cancers and 90% of genital warts. Global vaccination programs have reduced cervical cancer incidence by up to 87% in vaccinated cohorts. WHO aims to eliminate cervical cancer as a public health problem through 90% vaccination coverage. This tracker monitors licensed vaccines, next-generation candidates, and therapeutic vaccines for existing HPV infections.
Developer: Merck & Co.
Platform: 9-valent virus-like particle (VLP) vaccine
Coverage: HPV types 6, 11, 16, 18, 31, 33, 45, 52, 58
Protection: 90% of cervical cancers, 90% of genital warts, 95% of anal cancers, 70% of vulvar/vaginal cancers, 70% of oropharyngeal cancers
Efficacy: >97% prevention of high-grade cervical, vulvar, and vaginal disease in clinical trials
Dosing: 2 doses (6-12 months apart) for ages 9-14; 3 doses for ages 15+
Global Impact: 100+ countries approved. Real-world data shows 87% reduction in cervical cancer in vaccinated cohorts (Sweden study).
Status: Gold standard HPV vaccine. WHO prequalified. Used in most national programs globally.
Developer: GlaxoSmithKline (GSK)
Platform: 2-valent VLP vaccine with AS04 adjuvant
Coverage: HPV types 16 and 18 (cause 70% of cervical cancers)
Efficacy: 93% against HPV 16/18-related CIN2+ lesions. AS04 adjuvant provides strong, long-lasting immune response.
Cross-protection: Some protection against HPV 31, 33, 45 due to antigenic similarity
Dosing: 2 doses for ages 9-14; 3 doses for ages 15+
Status: Licensed globally but increasingly replaced by 9-valent Gardasil 9 in many programs. Still widely used in some countries.
Developer: Merck & Co.
Platform: 4-valent VLP vaccine
Coverage: HPV types 6, 11, 16, 18
Historical Impact: First HPV vaccine approved. Revolutionized cervical cancer prevention. Proved HPV vaccines were safe and effective.
Status: Being phased out globally in favor of Gardasil 9 (broader coverage). No longer manufactured in most markets.
Developer: Xiamen Innovax / Walvax Biotechnology (China)
Platform: 2-valent VLP vaccine using E. coli expression system
Coverage: HPV 16 and 18
Innovation: Lower cost production using bacterial expression (vs. yeast/insect cells)
Efficacy: 97.8% efficacy against HPV 16/18 in Phase 3 trial
Status: Approved in China, Morocco, Nepal. WHO prequalification pending. Could improve vaccine access in low-income countries.
Developer: Merck & Co.
Platform: Next-generation 15-valent VLP vaccine
Coverage: Gardasil 9's 9 types plus 6 additional oncogenic types
Goal: Prevent remaining 10% of cervical cancers not covered by Gardasil 9
Status: Phase 2 trials evaluating immunogenicity
Developer: Inovio Pharmaceuticals
Platform: DNA-based therapeutic vaccine
Target: Treat existing HPV 16/18 infections and precancerous lesions (CIN2/3)
Innovation: Uses electroporation to deliver DNA vaccine targeting infected cells
Efficacy: Phase 2 showed regression of cervical lesions in 50% of patients
Status: Phase 2 completed. Potential alternative to surgical excision of precancerous lesions.
Developer: Transgene
Platform: MVA (Modified Vaccinia Ankara) vector expressing HPV16 antigens
Target: Therapeutic vaccine for HPV16+ cancers (cervical, oropharyngeal)
Status: Phase 2 trials in combination with chemotherapy and checkpoint inhibitors
HPV vaccines are among the most successful cancer prevention interventions in history. Real-world data from countries with high vaccine coverage shows dramatic results: Scotland reported 89% reduction in cervical cancer; Australia is on track to eliminate cervical cancer as a public health problem by 2035. The vaccines are safe (400M+ doses administered), highly effective (>95% against targeted types), and provide long-lasting protection (15+ years proven, likely lifetime). Key challenges remain: achieving 90% global coverage (WHO target), reaching boys/men (prevents oropharyngeal and anal cancers), and addressing vaccine hesitancy. Future directions: broader coverage vaccines (15-valent), single-dose schedules (Phase 3 trials underway), therapeutic vaccines for existing infections, and combination vaccines (HPV + other STIs).