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By switching to the latest version of the Gardasil vaccine, which can thwart a virus that leads to cervical cancer, the nation’s health care bill could drop by an estimated $2.7 billion over the next 35 years, according to a new study published on Monday.

How so? The newer vaccine is expected to lower the incidence of cervical cancer and death. The current vaccines used to tackle the human papillomavirus reduce the onset of cervical cancer by 63 percent and deaths by 43 percent. But by using Gardasil 9, as the newest version is called, the incidence of cervical cancer would decrease by 73 percent and death by 49 percent, the analysis found.

“There’s a potentially large societal cost that can be lowered over time” by using the newest version, said David Durham, an associate research scientist in epidemiology at the Yale University School of Public Health and lead author of the study, which was published by the Proceedings of the National Academy of Sciences.


The study also found that targeting increased use of the vaccine in states where vaccination rates are currently lowest would provide the greatest health gains. The cost of the newer Gardasil, which is made by Merck, is approximately $126 per dose for a three-dose regiment, roughly $13 more than the older version and $18 more than another vaccine called Cervarix.

Durham explained that there may be barriers, at least for now, to widespread adoption of the newest Gardasil vaccine. For instance, he noted that the higher cost may seem minimal on a per dose basis, but there may be concern that the added expense can add up over the long run. Moreover, some physicians and government health agencies may have stockpiled large amounts of the older, cheaper vaccines.


“The main policy message is that the new vaccine is cost effective and that focusing on states with lower coverage gives you more bang for your buck,” Durham told us. We should note that Durham and another study author have done consulting work for Merck, which, of course, benefits from this comparison. (Yet another study author has consulted for, and received research funding, from GlaxoSmithKline, which sells Cervarix).

The findings come amid ongoing concern among public health officials that HPV vaccination remains at unacceptably low rates. Barely 40 percent of girls between the ages of 13 and 17 received the full three-dose regimen in 2014, according to the US Centers for Disease Control and Prevention. And for boys in the same age range, less than 22 percent were administered all three doses that year.

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The initial version of Gardasil was approved by regulators a decade ago for treating HPV, which is a sexually transmitted virus, in girls and women between 9 and 26 years old. The vaccine was also approved to prevent genital warts caused by some HPV strains in boys and men in the same age range. The Cervarix vaccine, by the way, is not used as widely as Gardasil.

The newer Gardasil 9, which was approved by the US Food and Drug Administration in late 2014, can protect against an additional group of HPV strains. Whereas the older vaccine can combat strains that cause about 66 percent of cervical cancer cases, the newest version can thwart strains believed to be responsible for about 80 percent of such cancers.

From the start, though, Gardasil has been dogged by controversy.

For one thing, some parents have been concerned that vaccination may lead their teenage girls to engage in casual sexual behavior. In late 2014, however, a study found that vaccination was not associated with risky sexual behavior. And a study published in 2012 found that HPV vaccines did not lead to an increased risk of pregnancy, sexually transmitted infections, or contraceptive counseling.

At the same time, Gardasil has been plagued by broader safety concerns that have plagued many vaccines. Specifically, some families have complained that the vaccine caused chronic pain or dizziness. Last year, however, the European Medicines Agency conducted an extensive review and found there was no link, and no change was needed to vaccination.

We asked SaneVax, an advocacy group that has maintained Gardasil safety is questionable, for comment about the study findings and will update you accordingly.

  • Gardasils hpv no study is out their…. Mercks HPV this vaccine is a theory…..
    without others proving same experiments results……. the hpv in Gardasils’ is an unproven theory. MERCK DOES NOT EMPLOY A FACT DATA

  • My 16 year old granddaughter has started the series twice but not completed the last 2 injections, it has been 2 years since the last injection…does she need to start over with the first and complete the other or does she just need the last two?

  • HPV and immunity
    their has been no seen or documented cases of immunity to HPV “wart”
    Their has been no proven establishment of creating an immunity without
    seen or documented cases of immunity
    Dead particle in laymen terms means dormant
    strains of unidentified HPV from where are these strains from, rude,anal,cervix,throat, penis
    think hpv inside the body cavity by injection ,that’s criminal with intent
    Who was intelligent in throwing vaccine science in another picture,driving your thinking or worse
    mafia style but not mafia

  • Japan withdrew its recommendation for the HV vaccine in 2013 and has not reversed it as far as I know. Ireland is headed that way.

    When the risk of cervical cancer, depending on the study you read, is somewhere in the 1 in 40,000 range or 2 in 100,000 range, and then see the high numbers of girls with permanent debilitating disorders after this vaccine, you have to say is it effective at all, or even necessary?

    This vaccine was fast tracked, it skipped any real testing or safety study, and is basically being ‘live tested’ on our teens.

    ANd if I am not mistaken there are over 70 types of hpv virus, which most resolve all on their own, and the vaccine, the new one, covers 9?

    So, how do we justify pushing an untested vaccine for the masses, for a non epidemic disease, that effects 1 in 40,000, and create a youth base with ovarian failure, blood disorders, and early menopause?

    Is it saving money, or actually making money, lots of money.

    I don’t believe there are people who are vaccine deniers, I do however believe there are a whole lot of people with very legitimate questions that are routinely dismissed .

  • The European Medicines Agency stated ‘reviews of the reports did not show a consistent pattern regarding time-to-onset following vaccination, they appear to have totally ignored the evidence provided by the UK Association of HPV Injured Daughters (AHVID) which reported that a questionnaire completed by 94 member families indicated that:
    • 27 girls (31% ) had adverse reactions on the same day as the vaccination, many of them suffrering immediately, within minutes.
    • 12 girls (14%) had adverse reactions after just 1 dose
    • 19 girls (22%) had adverse reactions after just 2 doses (some of these had reactions also to the 1st dose
    • 14 girls had adverse reactions after the 3rd dose (and some of these had earlier reactions)
    • At least 4 girls (4%) had adverse reactions after each of 3 doses. Health professionals had indicated that the vaccine is safe and the adverse reactions suffered were not recognised as side effects of the vaccine. Initial symptoms were often ‘generally unwell, flu-like, tired, aches and pains’. With each dose the severity increased and day-by-day the severity increased. With some it was eventually several weeks before these symptoms developed into collapse with total fatigue and sleeping up to 23 hours each day.

    • The EMA “extensive review” only included cases where POTS/CRPS were diagnosed in the material used to generate the “Report from the Danish Health and Medicines Authority for consideration by EMA and rapporteurs in relation to the assessment of the safety profile of HPV-vaccines” sent to the EMA. The doctor, Louise Brinth, MD PhD, and her Chief of research at the Syncope Unit at Bispebjerg and Frederiksberg Hospital, Jesper Mehlsen, had collaborated with the DHMA(Danish Health and Medicines Authorities) to generate this report. The response of Dr Brith to the EMA conclusion can be read here and shows the severe deficiencies of the review :

  • Thank you for the article about the HPV vaccine. However, I can’t understand why you’d consider the opinion of “SaneVax”, an antivax group that quotes “Natural News”, and that presents unverified, unscientific points of view about vaccine safety.

    • …and in an attempt to respond to the incorrect and scare-tactic anti-vaccination propaganda that will no doubt be posted here, I recommend this post as a place to find accurate information about Gardasil: This post includes links to multiple studies and verifiable information about the safety and efficacy of Gardasil, from many different sources.

    • Hi Lisa,
      I understand your point and generally agree. I’ve been running Pharmalot for nearly a decade, most recently at The Wall Street Journal, and have covered Gardasil since before it was approved. I’ve heard and read many reasons for – and against – vaccination during that time. SaneVax agitates against vaccination but, in this case, never offered me a response concerning this particular point – cost effectiveness. I was curious to know if they had an argument on that score. That’s the only reason.

    • Hi Lisa,
      Thanks for your note. I reached out to them simply because they have that different view of the vaccine and wondered if they had anything to say, specifically, about the cost effectiveness issue.

    • Thanks for your response. I guess I understand that you were looking for different views, but as a science and medicine focused publication, I am very confused as to why you would consult a group of vaccine deniers. My opinion on this is supported by many in the community; here is a great piece that illustrates this issue:

      The bottom line is this: “There’s a term to describe giving more time to opposing view points than the evidence actually supports – false balance.”

      And, this: “A recent study reports that stories about vaccines that include false balance are actually more dangerous than those that are purely anti-vaccine. Yes, you read that correctly. Stories that offer both sides of the coin can have a greater negative influence on people’s decision to not vaccinate than those that are purely anti-vaccine.” – the study is here:, and it’s titled: “The effect of falsely balanced reporting of the autism-vaccine controversy on vaccine safety perceptions and behavioral intentions.”

      By perpetuating this idea of a false balance, and giving time and a platform to people with a scientifically, medically and factually incorrect view on vaccines, you are contributing to the public perception that vaccines are unsafe and ineffective, which is false.

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