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Papillomavirus Res. 2017 Jun;3:105-115. doi: 10.1016/j.pvr.2017.03.002. Epub 2017 Mar 16.

Impact of baseline covariates on the immunogenicity of the 9-valent HPV vaccine - A combined analysis of five phase III clinical trials.

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Aarhus University Hospital, Department of Obstetrics and Gynecology, Aarhus, Denmark.
Fundación Centro de Investigación Clínica CIC, Medellín, Colombia.
Associação Obras Sociais Irmã Dulce and Oswaldo Cruz Foundation, Brazilian Ministry of Health, Bahia, Brazil.
Department of Clinical Science, University of Bergen and Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
Faculty of Tropical Medicine, Mahidol University, Nakhon Pathom, Thailand.
Center for the Evaluation of Vaccination, University of Antwerp, Antwerp, Belgium.
Medical University of Vienna, Comprehensive Cancer Center, Vienna, Austria.
Karolinska Institute at Danderyd Hospital, Stockholm, Sweden.
Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA, USA.
Kentucky Pediatric and Adult Research, Inc., Bardstown, KY, USA.
Moffitt Cancer Center, Tampa, FL, USA.
Catalan Institute of Oncology, Barcelona, Spain.
Wolfson Institute of Preventive Medicine, London, UK.
Royal Women's Hospital, University of Melbourne and Murdoch Childrens Research Institute, Parkville, VIC, Australia.
Division of Gynecologic Oncology, University of Alabama, Birmingham, USA.
Danish Cancer Society Research Center and Department of Gynecology, Rigshospitalet, Denmark.
Merck & Co., Inc., Kenilworth, NJ, USA.
Merck & Co., Inc., Kenilworth, NJ, USA. Electronic address:



The immunogenicity profile of the 9-valent HPV (9vHPV) vaccine was evaluated across five phase III clinical studies conducted in girls and boys 9-15 years of age and young women 16-26 years of age. The effect of baseline characteristics of subjects on vaccine-induced HPV antibody responses was assessed.


Immunogenicity data from 11,304 subjects who received ≥1 dose of 9vHPV vaccine in five Phase III studies were analyzed. Vaccine was administered as a 3-dose regimen. HPV antibody titers were assessed 1 month after dose 3 using a competitive Luminex immunoassay and summarized as geometric mean titers (GMTs). Covariates examined were age, gender, race, region of residence, and HPV serostatus and PCR status at day 1.


GMTs to all 9 vaccine HPV types decreased with age at vaccination initiation, and were otherwise generally similar among the demographic subgroups defined by gender, race and region of residence. For all subgroups defined by race or region of residence, GMTs were higher in girls and boys than in young women. Vaccination of subjects who were seropositive at day 1 to a vaccine HPV type resulted in higher GMTs to that type, compared with those in subjects who were seronegative for that type at day 1.


9vHPV vaccine immunogenicity was robust among subjects with differing baseline characteristics. It was generally comparable across subjects of different races and from different regions. Greater immunogenicity in girls and boys versus young women (the population used to establish 9vHPV vaccine efficacy in clinical studies) indicates that the anti-HPV responses generated by the vaccine in adolescents from all races or regions were sufficient to induce high-level protective efficacy. This immunogenicity profile supports a widespread 9vHPV vaccination program and early vaccination.


9v HPV vaccine; Clinical trial; Human papillomavirus; Immunogenicity; NCT00543543; NCT00943722; NCT00988884; NCT01073293; NCT01304498; V503-001; V503-002; V503-005; V503-007; V503-009/GDS01C

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