Can My Child Get Gardasil 9 as a Second HPV Vaccine in Taiwan?

Received one dose of the HPV vaccine in another country?

Hello, Director: This year, I plan to take my child back to Taiwan to receive the HPV vaccine, but I found it difficult to locate a similar vaccine.
My child received the HPV vaccine once at the end of last year, and the hospital's record indicates it was a bivalent vaccine (produced using E.
coli).
They mentioned that a second dose is needed for better protection.
However, I found that the bivalent vaccines available are Cervarix, Cecolin, and Walrinvax, none of which are currently offered in Taiwan.
The hospital mentioned that the available HPV vaccine is the nine-valent Gardasil 9, but it is not produced using E.
coli.
If my child can receive a vaccine in Taiwan, would it be advisable to administer Gardasil 9 as the second dose to enhance protection, or does the physician have a better recommendation? Thank you!

Miss He, 30~39 year old female. Ask Date: 2023/10/19

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the World Health Organization's report published in April 2009 indicates that it is not recommended to interchange different brands of cervical cancer (HPV) vaccines.
This means that if the first dose is from a specific brand, the subsequent second and third doses should continue with the same vaccine.
If a change is necessary, it is advised to restart the vaccination series.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2023/10/19

More Info

When considering whether your child can receive the Gardasil 9 vaccine as a second dose after having received a bivalent HPV vaccine, it's important to understand the implications of switching between different types of HPV vaccines. The World Health Organization (WHO) and various health authorities recommend that individuals complete their vaccination series with the same brand of vaccine to ensure optimal efficacy and safety.
In your case, your child has already received one dose of a bivalent HPV vaccine, which is designed to protect against two strains of HPV, specifically types 16 and 18, which are known to cause the majority of cervical cancer cases. Gardasil 9, on the other hand, provides broader protection against nine HPV types, including the two covered by the bivalent vaccine, as well as types 6, 11, 31, 33, 45, 52, and 58, which are associated with various cancers and genital warts.

Given the guidelines that discourage mixing different brands of HPV vaccines, it is generally recommended that if a child has started their vaccination series with a specific brand, they should continue with that same brand for the subsequent doses. If the bivalent vaccines you mentioned (Cervarix, Cecolin, Walrinvax) are not available in Taiwan and your child needs a second dose, the best course of action would be to consult with a healthcare provider. They may suggest restarting the vaccination series with Gardasil 9, which would involve administering three doses of the Gardasil 9 vaccine to ensure adequate protection.

It is also important to consider the timing of the vaccinations. The recommended schedule for Gardasil 9 is typically two months between the first and second doses, and then four months between the second and third doses. If your child is due for their second dose soon, it would be advisable to follow the recommended intervals to maximize the vaccine's effectiveness.

In summary, while it is technically possible to switch to Gardasil 9 after receiving a bivalent vaccine, it is not the preferred approach due to the potential for reduced efficacy. The best practice would be to consult with a healthcare professional who can provide personalized advice based on your child's vaccination history and the availability of vaccines in Taiwan. They can help determine whether to continue with the bivalent vaccine series or to start anew with Gardasil 9, ensuring that your child receives the best possible protection against HPV-related diseases.

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