title: Coadministration of a 9-Valent Human Papillomavirus Vaccine With Meningococcal and Tdap Vaccines.
abstract: BACKGROUND
  This study in 11- to 15-year-old boys and girls compared the immunogenicity and safety of GARDASIL 9 (9-valent human papillomavirus [9vHPV] vaccine) administered either concomitantly or nonconcomitantly with 2 vaccines routinely administered in this age group (Menactra [MCV4; Neisseria meningitidis serotypes A/C/Y/W-135] or Adacel [Tdap; diphtheria/tetanus/acellular pertussis]).
  
  
  METHODS
  Participants received 9vHPV vaccine at day 1 and months 2 and 6; the concomitant group (n = 621) received MCV4/Tdap concomitantly with 9vHPV vaccine at day 1; the nonconcomitant group (n = 620) received MCV4/Tdap at month 1. Antibodies to HPV-, MCV4-, and Tdap-relevant antigens were determined. Injection-site and systemic adverse events (AEs) were monitored for 15 days after any vaccination; serious AEs were monitored throughout the study.
  
  
  RESULTS
  The geometric mean titers for all HPV types in 9vHPV vaccine 4 weeks after dose 3, proportion of subjects with a fourfold rise or greater in titers for 4 N meningitidis serotypes 4 weeks after injection with MCV4, proportion of subjects with antibody titers to diphtheria and tetanus ≥0.1 IU/mL, and geometric mean titers for pertussis antigens 4 weeks after injection with Tdap were all noninferior in the concomitant group compared with the nonconcomitant group. Injection-site swelling occurred more frequently in the concomitant group. There were no vaccine-related serious AEs.
  
  
  CONCLUSIONS
  Concomitant administration of 9vHPV vaccine with MCV4/Tdap was generally well tolerated and did not interfere with the antibody response to any of these vaccines. This strategy would minimize the number of visits required to deliver each vaccine individually.
authors.affiliation: Facultad de Medicina Clinica Alemana-Universidad del Desarrollo, Santiago, Chile; dra.andrea.schilling@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schilling
authors.affiliation: Instituto Nacional de Pediatría, Mexico City, Mexico;
authors.forename: Mercedes Macias
authors.initials: MM
authors.lastname: Parra
authors.affiliation: Hospital del Niño Poblano, Puebla, Mexico;
authors.forename: Maricruz
authors.initials: M
authors.lastname: Gutierrez
authors.affiliation: Fundacion Centro de Investigacion Clinica CIC, Medellín, Colombia;
authors.forename: Jaime
authors.initials: J
authors.lastname: Restrepo
authors.affiliation: Centro de Investigaciones en Salud, Fundacion Santa Fe de Bogotá, Bogotá, Colombia;
authors.forename: Santiago
authors.initials: S
authors.lastname: Ucros
authors.affiliation: Insituto de Investigación Nutricional anexo Huáscar, Lima, Perú;
authors.forename: Teobaldo
authors.initials: T
authors.lastname: Herrera
authors.affiliation: Bayview Research Group, Valley Village, California;
authors.forename: Eli
authors.initials: E
authors.lastname: Engel
authors.affiliation: Instituto Nacional de Salud del Niño, Lima, Perú;
authors.forename: Luis
authors.initials: L
authors.lastname: Huicho
authors.affiliation: Indiana University School of Medicine/Department of Pediatrics, Indianapolis, Indiana; and.
authors.forename: Marcia
authors.initials: M
authors.lastname: Shew
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Roger
authors.initials: R
authors.lastname: Maansson
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Nicole
authors.initials: N
authors.lastname: Caldwell
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Alain
authors.initials: A
authors.lastname: Luxembourg
authors.affiliation: Merck & Co., Inc., Kenilworth, New Jersey.
authors.forename: Ajoke Sobanjo
authors.initials: AS
authors.lastname: Ter Meulen
mesh_terms: D000293:Adolescent; D002648:Child; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage*; D005260:Female; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D014481:United States; D014611:Vaccination / Q000379:methods*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D022401:Meningococcal Vaccines