Three recombinant HPV vaccines are currently available for the prevention of HPV infection, which is known to cause cancers of the cervix, vagina and anogenital region: Gardasil (Merck), Gardasil 9 (Merck) and Cervarix (GlaxoSmithKline). Gardasil and Cervarix are administered as three-dose intramuscular injections, and Gardasil 9 is administered as either a two-dose or three-dose injection. This section discusses the commonly reported adverse reactions, warning and precautions, and other contraindications associated with HPV vaccines.
Common adverse reactions
Warnings and precautions
Drug interactions and other contraindications
Recombinant HPV vaccines common adverse reactions
The most commonly reported adverse reactions included injection site reactions (pain, redness and swelling) and headache for all three HPV vaccines. Other systemic reactions reported included fatigue, myalgia, arthralgia and GI symptoms for Cervarix, and fever, nausea and dizziness for Gardasil.
Recombinant HPV vaccines warnings and precautions
Patients should be monitored for signs of syncope and possible tonic-clonic or other seizure-like activity for 15 minutes after receiving an injection. If a patient exhibits jerking or stiffening of the muscles, then he or she should be placed in a supine (lying face-up on the back) or Trendelenburg position (feet elevated above head) until the symptoms dissipate.
Recombinant HPV vaccines drug interactions and other contraindications
All three vaccines protect against the two most common virulent types of HPV, 16 and 18; Gardasil also protects against infection with types 6 and 11, which are known to cause most genital warts, and Gardasil 9 protects against types 31, 33, 45, 52 and 58. The vaccines do not protect against infection from any other HPV type, and they are not effective in those who are already infected with HPV.
Regarding contraindications, patients with hypersensitivity and/or severe allergic reactions to yeast should not receive Gardasil or Gardasil 9, as these vaccines contain a yeast component. Patients who are allergic to any component of Cervarix should not receive the vaccine.