9 Human papillomavirus (HPV)

Key information

Mode of transmission Skin-to-skin contact, predominantly sexual, with a person with HPV infection.
Links to cancer HPV is linked to almost all cervical cancers and to about 69% of vulvar, 75% of vaginal, 63% of penile, 90% of anal and 70% of oropharyngeal cancers.
Incidence/ prevalence HPV infection is very common, with initial infection occurring soon after sexual debut and a lifetime risk of over 80%. Recurrent infection and co-infection with multiple types are possible.
Funded vaccines HPV9 (Gardasil 9) and HPV4 (Gardasil) are recombinant subunit vaccines containing virus-like particles.
  • HPV9 contains HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58.
  • HPV4 contains HPV types 6, 11, 16 and 18.
Dose, presentation, route 0.5 mL per dose.

Pre-filled syringe.

Intramuscular injection.
Funded indications and recommended schedules 2 doses, at 0 and 6–12 months for children aged 14 years and under.

3 doses, at 0, 2 and 6 months, for individuals:
  • aged 15–26 years inclusive
  • aged 9–26 years inclusive:
    • with confirmed HIV infection
    • who are transplant (including stem cell) patients
An additional dose for individuals aged 9–26 years post-chemotherapy.

Individuals who started with HPV4 may complete their remaining doses with HPV4 or with HPV9 when available.

Individuals who were previously fully vaccinated with HPV4 are not eligible for HPV9.
Vaccine efficacy/ effectiveness The incidence of HPV infection, precancerous lesions and genital warts is significantly reduced in immunised populations (in women and men).

There is evidence for herd immunity (reductions in HPV infection and genital warts in unimmunised populations).
Pregnancy HPV vaccines are not recommended for pregnant women; however, enquiring about the possibility of pregnancy is not necessary before vaccination.
Adverse events to vaccine Syncope (fainting) is a known injection reaction in adolescents.
Cancer prevention measures HPV immunisation.

Regular cervical screening for women.

Safer sex approaches.