Human Papillomavirus (HPV) Vaccines to Prevent Cervical Cancer

This Evidence Report updates and supersedes the Evidence Report “HPV Vaccines to Prevent Cervical Cancer” published by ECRI Institute in November 2007. We updated the literature searches for clinical trials to January 29, 2009. No relevant new clinical trials were identified, and the primary conclusions of the updated report are identical to those of the original report. The adverse events section of the updated report has been substantially revised to include updated Vaccine Adverse Event Reporting System (VAERS) reports, and information obtained from Australian vaccination programs. However, the conclusion that HPV vaccines are generally safe did not change. The Regulatory Status and Reimbursement sections of the report have also been updated to reflect ongoing marketing approval and changes in reimbursement policies for the HPV vaccines by various regulatory and payer organizations around the world.

This report provides a systematic review of the currently available information on two vaccines to prevent cervical cancer, Gardasil and Cervarix. This report does not address the following: vaccine acceptance by the public or the effect of HPV vaccines on other sexually transmitted diseases. Other vaccines and interventions intended to prevent or treat cervical cancer are beyond the scope of this report.

Development of cervical cancer requires infection with certain types of human papillomavirus (HPV). Vaccination of women against these viruses may prevent HPV infection and reduce the incidence of cervical lesions and cervical cancer. Gardasil® is a vaccine directed against HPV types 6, 11, 16, and 18. Cervarix® is a vaccine directed against HPV types 16 and 18. HPV types 16 and 18 cause approximately 70% of cases of cervical cancer. HPV types 6 and 11 cause approximately...