Are the Two Human Papillomavirus Vaccines Really Similar? A Systematic Review of Available Evidence: Efficacy of the Two Vaccines against HPV

Table 1

Characteristics of bivalent and quadrivalent HPV vaccine.

	Quadrivalent vaccine	Bivalent vaccine
Commercial name	Gardasil/Silgard	Cervarix
Manufacturer	Sanofi Pasteur MSD SNC	GlaxoSmithKline Biologicals S.A.
HPV types	HPV 6 L1 protein 20 μg	HPV 16 L1 protein 20 μg
	HPV 11 L1 protein 40 μg	HPV18 L1 protein 20 μg
	HPV 16 L1 protein 40 μg
	HPV 18 L1 protein 20 μg
Common characteristics	L1 protein in the form of noninfectious virus-like particles produced by recombinant DNA technology
Differences in cellular culture	Yeast cells (Saccharomyces cerevisiae CANADE 3C-5 (strain 1895))	Hi-5 Rix4446 cells derived from Trichoplusia ni using a Baculovirus expression system
Differences in adjuvant	Amorphous aluminium hydroxyphosphate sulfate adjuvant, 225 μg	AS04 adjuvant system composed of aluminium hydroxide and 3-O-desacyl-4′-monophosphoryl lipid A, 50 μg
Therapeutic indications	Gardasil is a vaccine for use from the age of 9 years for the prevention of; (i) premalignant genital lesions (cervical, vulvar, and vaginal) and cervical cancer causally related to certain oncogenic human papillomavirus (HPV) types; (ii) genital warts (condyloma acuminata) causally related to specific HPV types.	Cervarix is a vaccine for use from the age of 9 years for the prevention of; (i) premalignant cervical lesions and cervical cancer causally related to certain oncogenic human papillomavirus (HPV) types.
Efficacy data leading to registration	95.2% (87.2, 98.7)^1	90.4% (53.4, 99.3)
Efficacy data in the latest publication	43% (13, 63)^3	93% (79, 99)^4
Mean follow-up of phase III trials	3.6 years^1	4 years^2

Vaccine efficacy against CIN/AIS associated with vaccine related HPV in the TVC-naïve from EMA registration data [19].
²Vaccine efficacy against CIN2+ associated with vaccine related HPV in the TVC-naïve from EMA registration data [20].
³Vaccine efficacy against any CIN3 in the TVC-naïve from Muñoz et al. 2010 [26].
⁴Vaccine efficacy against any CIN3+ in the TVC-naïve from Lehtinen et al. 2012 [27].