New Gardasil Vaccine Reduces HPV-Related Cancer Incidence

The new 9-valent human papillomavirus (HPV) vaccine may be able to reduce a woman’s risk of developing cervical cancer.

In a recent study published in theProceedings of the National Academy of Sciences, researchers from the Yale School of Public Health examined the benefits of Merck’s HPV 9-valent recombinant vaccine (Gardasil 9). Launched in 2015, the vaccine is designed to protect patients against 9 different types of HPV, including 5 types that have been linked to elevated cancer risks but weren’t prevented by older HPV vaccines.

After developing a model to evaluate the vaccine’s potential effect on cervical cancer, the research team determined that the use of Gardasil 9 could decrease cervical cancer incidence by 73%, compared with the 63% decrease associated with the older vaccines. Additionally, Gardasil 9 was estimated to reduce mortality by 49%, while older vaccines were linked to a 43% decrease.

The researchers also discovered that these benefits could be achieved at the same or even lower cost of older drugs, even after taking into account the higher per-dose price of Gardasil 9.

“Adopting the new vaccine is always cost-effective relative to the old vaccines,” said study author David Durham, PhD, in a press release.

The study authors concluded that expanding HPV vaccination could potentially prevent a significant number of deaths due to cervical cancer, especially if vaccination policies are coordinated across different states. They also noted that increasing funding would likely have a positive effect on HPV vaccination, but cautioned against overinvesting in areas with higher vaccination rates.

“In terms of number of cancers averted per vaccine, there are decreasing marginal returns in states that already have high coverage,” Dr. Durham explained. “You get more bang for your buck by focusing first on states with lower coverage.”

The CDC currently recommends that all children aged 11 years and older receive the HPV vaccine, which is administered in a 3-dose series.

However, a number of children fail to complete the series after receiving the first or second dose. Aseparate studypublished inHuman Vaccines and Immunotherapeuticsfound that this is often because of miscommunication and mismatched expectations between parents and health care providers.

Given that parents areincreasinglytaking their children to retail clinics instead of pediatricians, the nurse practitioners and physician assistants who work in these settings can play an important role in improving communication about vaccines and ensuring that children are fully vaccinated against HPV.

“What we’ve learned is that there is a great opportunity to close the non-completion gap by improving education and dialogue between providers and parents about scheduling future visits to finish the 3-dose vaccination series,” said the study’s lead author, Rebecca Perkins, MD, MSc, in a press release.

For example, Dr. Perkin and her colleagues suggested that clinics implement an electronic health record system that delivers electronic reminders to parents. They also encouraged clinicians to schedule follow-up appointments as soon as a child receives the first dose of the HPV vaccine.

“By implementing a reminder system, we hope that more children will complete the vaccination series, which can help improve the overall health of our next generation,” Dr. Perkins said.