Switching to Nine-Valent HPV Vaccine: Do You Need All Three Doses Again?

Change of brand for cervical cancer vaccine administration?

Hello, doctor! When I inquired about the HPV vaccine with the hospital physician, they did not mention the availability of the quadrivalent and nonavalent vaccine options and directly administered the first dose of the bivalent vaccine at my own expense.
I later learned about the quadrivalent and nonavalent vaccines.
If I want to switch to the nonavalent vaccine, do I need to restart all three doses? Thank you!

M, 30~39 year old female. Ask Date: 2021/08/18

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, it is not recommended to mix different types of HPV vaccines.
This means that from the first dose to the final dose, you should receive the same type of HPV vaccine.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2021/08/18

More Info

When considering the transition from a bivalent HPV vaccine (like Cervarix) to the nine-valent HPV vaccine (Gardasil 9), it's important to understand the vaccination protocols and the implications of switching vaccines. The nine-valent HPV vaccine protects against nine types of HPV, including those that cause the majority of cervical cancers and genital warts.
If you have already received one or more doses of the bivalent vaccine, the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommend that you complete the vaccination series with the nine-valent vaccine. However, the specific number of doses you need to receive may depend on how many doses of the bivalent vaccine you have already received.

1. If you have received only one dose of the bivalent vaccine: You will need to receive two additional doses of the nine-valent vaccine to complete the series. The recommended schedule for the nine-valent vaccine is typically two months between the first and second doses, and six months between the first and third doses.

2. If you have received two doses of the bivalent vaccine: In this case, you would only need to receive one additional dose of the nine-valent vaccine to complete your vaccination series.

3. If you have completed the three doses of the bivalent vaccine: While there is limited data on the interchangeability of HPV vaccines, it is generally recommended to complete the vaccination series with the nine-valent vaccine. This means you would need to receive three doses of the nine-valent vaccine to ensure full protection against the additional HPV types it covers.

The rationale behind this recommendation is based on the need for a robust immune response to provide adequate protection against the various HPV types. Each vaccine is designed to elicit a specific immune response, and switching between different types may not guarantee the same level of immunity.

Additional Considerations:
- Timing: If you decide to switch to the nine-valent vaccine, it is advisable to do so as soon as possible to ensure that you complete the vaccination series within the recommended timeframe. Delaying the doses may lead to a lapse in protection, especially if you are at risk for HPV-related diseases.

- Consultation with Healthcare Provider: It is crucial to discuss your vaccination history and future plans with your healthcare provider. They can provide personalized recommendations based on your health status and vaccination history.

- Effectiveness: Research indicates that the nine-valent vaccine is effective in preventing HPV-related diseases, including cervical cancer, and it is generally well-tolerated. The benefits of receiving the nine-valent vaccine, especially if you have already started the vaccination process, outweigh the risks associated with switching.

In summary, if you wish to switch to the nine-valent HPV vaccine after starting with the bivalent vaccine, you will likely need to complete the series with the nine-valent vaccine. Depending on how many doses of the bivalent vaccine you have received, you may need one or two additional doses. Always consult with your healthcare provider for the best course of action tailored to your specific situation.

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