title: Update on the new 9-valent vaccine for human papillomavirus prevention.
abstract: OBJECTIVE
  To provide family physicians with information on the efficacy, safety, public health effects, and cost-effectiveness of the 9-valent human papillomavirus (HPV) vaccine.
  
  
  METHODS
  Relevant publications in PubMed up to May 2015 were reviewed and analyzed. Most evidence cited is level I (randomized controlled trials and meta-analyses) or level II (cross-sectional, case-control, and epidemiologic studies). Government reports and recommendations are also referenced.
  
  
  RESULTS
  The 9-valent HPV vaccine, which protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, is safe and effective and will further reduce the incidence of HPV infection, as well as HPV-related cancers. It can also indirectly protect unvaccinated individuals through herd immunity. With an effective vaccination program, most cervical cancers can be prevented. Analyses show that the cost-effectiveness of the 9-valent HPV vaccine in female patients is comparable to the original quadrivalent HPV vaccine (which protects against HPV types 6, 11, 16, and 18) currently in use. However, the usefulness of vaccinating male patients with the 9-valent HPV vaccine needs further investigation.
  
  
  CONCLUSIONS
  The 9-valent HPV vaccine offers more protection against HPV than the quadrivalent HPV vaccine does and is as safe. Analysis of cost-effectiveness favours its use, at least in adolescent girls. Therefore, physicians should recommend the 9-valent HPV vaccine to patients instead of the quadrivalent HPV vaccine.
authors.affiliation: Medical student at the Michael G. DeGroote School of Medicine at McMaster University in Hamilton, Ont. david.yang@medportal.ca.
authors.forename: David Yi
authors.initials: DY
authors.lastname: Yang
authors.affiliation: Associate Professor in the Department of Family Medicine at McMaster University.
authors.forename: Keyna
authors.initials: K
authors.lastname: Bracken
mesh_terms: D003362:Cost-Benefit Analysis; D005194:Family Practice / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D032521:Immunity, Herd; D008297:Male; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000191:economics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines