title: Comparison of the immunogenicity and safety of Cervarix and Gardasil human papillomavirus (HPV) cervical cancer vaccines in healthy women aged 18-45 years.
abstract: This observer-blind study compared the prophylactic human papillomavirus (HPV) vaccines, Cervarix (GlaxoSmithKline) and Gardasil (Merck), by assessing immunogenicity and safety through one month after completion of the three-dose vaccination course. Women (n = 1106) were stratified by age (18-26, 27-35, 36-45 years) and randomized (1:1) to receive Cervarix (Months 0, 1, 6) or Gardasil (Months 0, 2, 6). At Month 7 after first vaccination, all women in the according-to-protocol cohort who were seronegative/DNA negative before vaccination for the HPV type analyzed had seroconverted for HPV-16 and HPV-18 serum neutralizing antibodies, as measured by pseudovirion-based neutralization assay (PBNA), except for two women aged 27-35 years in the Gardasil group who did not seroconvert for HPV-18 (98%). Geometric mean titers of serum neutralizing antibodies ranged from 2.3-4.8-fold higher for HPV-16 and 6.8-9.1-fold higher for HPV-18 after vaccination with Cervarix compared with Gardasil, across all age strata. In the total vaccinated cohort (all women who received at least one vaccine dose, regardless of their serological and DNA status prior to vaccination), Cervarix induced significantly higher serum neutralizing antibody titers in all age strata (p < 0.0001). Positivity rates for anti-HPV-16 and -18 neutralizing antibodies in cervicovaginal secretions and circulating HPV-16 and -18 specific memory B-cell frequencies were also higher after vaccination with Cervarix compared with Gardasil. Both vaccines were generally well tolerated. The incidence of unsolicited adverse events was comparable between vaccinated groups. The incidence of solicited symptoms was generally higher after Cervarix, injection site reactions being most common. However, compliance rates with the three-dose schedules were similarly high (>or= 84%) for both vaccines. Although the importance of differences in magnitude of immune response between these vaccines is unknown, they may represent determinants of duration of protection against HPV-16/18. Long-term studies evaluating duration of efficacy after vaccination are needed for both vaccines.
authors.affiliation: Montefiore Medical Center, Albert Einstein College of Medicine, Department of Obstetrics & Gynecology and Women's Health, Division of Gynecologic Oncology, Bronx, NY, USA. meinstei@montefiore.org
authors.forename: Mark H
authors.initials: MH
authors.lastname: Einstein
authors.forename: Mira
authors.initials: M
authors.lastname: Baron
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Levin
authors.forename: Archana
authors.initials: A
authors.lastname: Chatterjee
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
authors.forename: Fred
authors.initials: F
authors.lastname: Zepp
authors.forename: Isabelle
authors.initials: I
authors.lastname: Carletti
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Dessy
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Trofa
authors.forename: Anne
authors.initials: A
authors.lastname: Schuind
authors.forename: Gary
authors.initials: G
authors.lastname: Dubin
mesh_terms: D000293:Adolescent; D000328:Adult; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D019496:Cancer Vaccines / Q000009:adverse effects / Q000276:immunology; D005260:Female; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D008875:Middle Aged; D009500:Neutralization Tests; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000009:adverse effects* / Q000276:immunology*; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D019496:Cancer Vaccines; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines; C510352:human papillomavirus vaccine, L1 type 16, 18