Bivalent HPV vaccine recommended

About one week after the FDA approved the bivalent human papillomavirus vaccine for use in girls and women ages 10 to 25 years, the CDC’s Advisory Committee on Immunization Practices recommended the product to prevent cervical cancer in these women.

The committee recommended vaccination with either the new bivalent vaccine (Cervarix, GlaxoSmithKline) or the existing quadrivalent vaccine (Gardasil, Merck), despite some discussion about the differences between the two vaccines. The quadrivalent vaccine is indicated to prevent the types of HPV associated with genital warts, types 6 and 11, whereas the bivalent vaccine is indicated to prevent HPV types 16 and 18.

But Lauri Markowitz, MD,of the CDC, presented some data at the committee meeting today that showed additional potential benefits with the bivalent vaccine, including cross protection against other types of HPV, including type 31, another type that commonly causes cervical cancer.

Many committee members agreed that leaving the option of either vaccine to providers was important for several reasons:

Early data indicate better antibody titers in some women, and longer duration of protection with the bivalent compared with quadrivalent, but the committee members stressed long-term data are needed.
Cost considerations may lead to one vaccine being used more than the other.
In the event of a vaccine shortage, providers would have an option to administer either vaccine

The CDC currently recommends quadrivalent vaccine be offered to adolescent girls along with other vaccines that are routinely given to that age group. The ACIP harmonized the dosing schedules for both vaccines and unanimously voted to include the bivalent vaccine in the Vaccines for Children program.

The ACIP’s recommendations do not become final until they are published in Morbidity and Mortality Weekly Report. - by Colleen Zacharyczuk