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Gardasil 9
human papillomavirus 9-valent vaccine (recombinant) (HPV)
Adult Dosing .
Dosage forms: INJ
HPV-related cancer, dysplastic lesion, and genital wart prevention
- [18-45 yo]
- Dose: 0.5 mL IM x1 at mo 0, mo 1-2, and mo 6 for 3 total doses; Info: give to pts 27-45 yo based on shared clinical decision-making; repeat dose if <4wk between 1st and 2nd dose, <12wk between 2nd and 3rd dose, or <5mo between 1st and 3rd dose; search 'immunization' for epocrates Adult Immunization decision tool incl. links to CDC/ACIP schedules
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ
HPV-related cancer, dysplastic lesion, and genital wart prevention
- [9-14 yo, immunocompetent pts]
- Dose: 0.5 mL IM x1 at mo 0 and mo 6-12 for 2 total doses; Info: give a 3rd dose at least 4mo after 2nd dose if 2nd dose given <5mo after 1st dose; start series at 9 yo if sexual abuse or assault hx; search 'immunization' for epocrates Child/Adolescent Immunization decision tool incl. links to CDC/ACIP schedules
- [9-14 yo, immunocompromised pts]
- Dose: 0.5 mL IM x1 at mo 0, mo 1-2, and mo 6 for 3 total doses; Info: repeat dose if <4wk between 1st and 2nd dose, <12wk between 2nd and 3rd dose, or <5mo between 1st and 3rd dose; start series at 9 yo if sexual abuse or assault hx; search 'immunization' for epocrates Child/Adolescent Immunization decision tool incl. links to CDC/ACIP schedules
- [15-17 yo]
- Dose: 0.5 mL IM x1 at mo 0, mo 1-2, and mo 6 for 3 total doses; Info: repeat dose if <4wk between 1st and 2nd dose, <12wk between 2nd and 3rd dose, or <5mo between 1st and 3rd dose; search 'immunization' for epocrates Child/Adolescent Immunization decision tool incl. links to CDC/ACIP schedules
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to yeast
- caution: pregnancy
- caution: immunocompromised patients
- caution: illness, acute moderate-severe
Drug Interactions .
Overview
human papillomavirus vaccine
vaccine
- non-live vaccine
Avoid/Use Alternative
- elivaldogene autotemcel
- interferon gamma 1b
Monitor/Modify Tx
- abatacept
- abemaciclib
- abrocitinib
- acalabrutinib
- adalimumab
- ado-trastuzumab emtansine
- afamitresgene autoleucel
- aldesleukin
- alemtuzumab
- anakinra
- anifrolumab
- anti-thymocyte globulin
- atezolizumab
- atidarsagene autotemcel
- avelumab
- avutometinib
- axicabtagene ciloleucel
- azacitidine
- azathioprine
- baricitinib
- basiliximab
- belatacept
- belimumab
- belinostat
- belzutifan
- bendamustine
- betamethasone
- bimekizumab
- blinatumomab
- bortezomib
- brentuximab vedotin
- brexucabtagene autoleucel
- brodalumab
- budesonide
- budesonide rectal
- busulfan
- cabazitaxel
- canakinumab
- capecitabine
- capmatinib
- carboplatin
- carfilzomib
- carmustine
- cemiplimab
- certolizumab pegol
- chlorambucil
- ciltacabtagene autoleucel
- cisplatin
- cladribine injection
- cladribine oral
- clofarabine
- copanlisib
- corticotropin
- cortisone
- cosibelimab
- cyclophosphamide
- cyclosporine
- cytarabine
- dactinomycin
- daratumumab
- dasatinib
- daunorubicin
- decitabine
- defactinib
- deflazacort
- delgocitinib topical
- deucravacitinib
- deuruxolitinib
- dexamethasone
- dimethyl fumarate
- dinutuximab
- diroximel fumarate
- docetaxel
- dordaviprone
- dostarlimab
- doxorubicin
- dupilumab
- durvalumab
- duvelisib
- efgartigimod alfa
- elotuzumab
- elranatamab
- emapalumab
- epcoritamab
- epirubicin
- eribulin
- etanercept
- etoposide
- etrasimod
- everolimus
- fam-trastuzumab deruxtecan
- fingolimod
- floxuridine
- fludarabine
- fludrocortisone
- fluorouracil
- fruquintinib
- gemcitabine
- gemtuzumab ozogamicin
- glofitamab
- golimumab
- guselkumab
- hydrocortisone
- hydroxyurea
- ibritumomab tiuxetan
- ibrutinib
- idarubicin
- idecabtagene vicleucel
- idelalisib
- ifosfamide
- imatinib
- inebilizumab
- infliximab
- inotuzumab ozogamicin
- ipilimumab
- irinotecan
- isatuximab
- ixabepilone
- ixekizumab
- lebrikizumab
- leflunomide
- lenalidomide
- linvoseltamab
- lisocabtagene maraleucel
- lomustine
- loncastuximab tesirine
- lurbinectedin
- lymphocyte immune globulin, anti-thymocyte globulin
- margetuximab
- melphalan
- mercaptopurine
- methotrexate
- methylprednisolone
- mirikizumab
- mitoxantrone
- mogamulizumab
- momelotinib
- monomethyl fumarate
- mosunetuzumab
- mycophenolate mofetil
- mycophenolic acid
- natalizumab
- nelarabine
- nemolizumab
- nilotinib
- nipocalimab
- nivolumab
- obecabtagene autoleucel
- obinutuzumab
- ocrelizumab
- ofatumumab
- oxaliplatin
- ozanimod
- paclitaxel
- palbociclib
- panobinostat
- peginterferon alfa 2a
- pembrolizumab
- pentostatin
- pertuzumab
- pirtobrutinib
- polatuzumab vedotin
- pomalidomide
- ponatinib
- ponesimod
- prednisolone
- prednisone
- procarbazine
- regorafenib
- retifanlimab
- rilonacept
- ripretinib
- risankizumab
- ritlecitinib
- rituximab
- romidepsin
- ropeginterferon alfa-2b
- rozanolixizumab
- ruxolitinib
- sarilumab
- satralizumab
- secukinumab
- selinexor
- siltuximab
- siponimod
- sirolimus
- sirolimus albumin-bound
- sirolimus topical
- spesolimab
- sunitinib
- sunvozertinib
- tacrolimus
- tafasitamab
- talquetamab
- tarlatamab
- teclistamab
- temozolomide
- temsirolimus
- teplizumab
- teriflunomide
- thioguanine
- thiotepa
- tildrakizumab
- tisagenlecleucel
- tislelizumab
- tocilizumab
- tofacitinib
- topotecan
- toripalimab
- tralokinumab
- tremelimumab
- triamcinolone
- ublituximab
- upadacitinib
- ustekinumab
- vamorolone
- vandetanib
- vedolizumab
- venetoclax
- vinblastine
- vincristine
- vinorelbine
- voclosporin
- zanidatamab
- zanubrutinib
- zenocutuzumab
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylactoid rxn
- anaphylaxis
Common Reactions
- injection site rxn
- headache
- fever
- nausea
- dizziness
- diarrhea
- pharyngolaryngeal pain
- vomiting
- cough
- fatigue
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
delay vaccination until pregnancy completed; no known risk of fetal harm based on limited human data; no known risk of fetal harm based on animal data at 240x recommended human dose
Pregnancy Registry and Reporting
enroll patients or encourage patients to enroll in Gardasil 9 Pregnancy Registry at 1-800-986-8999; report any suspected fetal exposure to VAERS at 1-800-822-7967
Lactation
Clinical Summary
may use while breastfeeding; no human data available, though risk of infant harm not expected based on human data w/ quadrivalent HPV vaccine; no human data available to assess effects on milk production
Pharmacology .
Metabolism: other; CYP450: unknown
Excretion: unknown; Half-life: unknown
Subclass: Human Papillomavirus (HPV) Vaccines ; Routine Adult Vaccines ; Routine Pediatric Vaccines
Mechanism of Action
exact mechanism of action unknown; induces antibody formation
Formulary .
No Formulary Selected
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