Cervavac vaccine dosage
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Cervavac is India's indigenous quadrivalent HPV vaccine (developed by Serum Institute of India). It targets HPV types 6, 11, 16, and 18 — identical to Gardasil. Here is the dosage information:
Cervavac — Dosage & Schedule
What it is
Cervavac is a quadrivalent HPV vaccine (types 6, 11, 16, 18), produced by Serum Institute of India. It is bioequivalent to Gardasil and follows the same immunization schedule.
Dosage Schedule
| Age Group | Schedule | Doses |
|---|---|---|
| 9–14 years (girls & boys) | 0 and 6 months | 2 doses |
| 15–26 years (females) | 0, 2, and 6 months | 3 doses |
| Immunocompromised (any age) | 0, 2, and 6 months | 3 doses |
- Route: Intramuscular (IM) injection
- Site: Deltoid muscle (upper arm) or anterolateral thigh in younger children
- Dose per injection: 0.5 mL
Key Points
- Primary target: Girls aged 9–14 years (before sexual debut), as part of India's national immunization program
- Catch-up vaccination: Recommended up to age 26 in females; may be considered up to age 45 in select cases after clinical discussion
- Males: Can be vaccinated (protects against genital warts and HPV-related cancers in males)
- Efficacy: High efficacy against HPV 16/18-related CIN 2+, cervical cancer, and HPV 6/11-related genital warts — consistent with the quadrivalent Gardasil data showing ~99% efficacy against genital warts and ~100% against CIN 2/3 in HPV-naive women
- Storage: 2–8°C (do not freeze)
- Duration of protection: No evidence of waning immunity after 10 years in clinical trial follow-up of the quadrivalent vaccine
Under India's Universal Immunisation Programme (UIP)
Cervavac was introduced in 2023 for girls aged 9–14 years as a 2-dose schedule (0 and 6 months), making it the first HPV vaccine included in India's national program.
— Harrison's Principles of Internal Medicine 22E, p. 1571 (HPV vaccine data for quadrivalent series)
HPV vaccines available
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Here is a comprehensive overview of all HPV vaccines available:
HPV Vaccines Available
Three HPV vaccines have been developed and FDA-licensed. Currently, only Gardasil 9 is actively marketed in the United States. In India, Cervavac is also available.
1. Cervarix (Bivalent — 2vHPV)
| Feature | Detail |
|---|---|
| Manufacturer | GlaxoSmithKline (GSK) |
| HPV types covered | 16, 18 |
| Protection against | Cervical cancer, CIN 1/2/3, AIS |
| Schedule | 3 doses: months 0, 1, 6 (IM) |
| Approved for | Females 9–25 years |
| Efficacy | 94.9% against CIN 2+; 91.7% against CIN 3+; 100% against AIS |
| Status | Licensed in 2009; not currently marketed in the US |
2. Gardasil (Quadrivalent — 4vHPV)
| Feature | Detail |
|---|---|
| Manufacturer | Merck |
| HPV types covered | 6, 11, 16, 18 |
| Protection against | Cervical cancer, CIN, genital warts, VIN, VaIN, anal precancers |
| Schedule | 3 doses: months 0, 2, 6 (IM) |
| Approved for | Females and males 9–26 years |
| Efficacy | 98.9% against genital warts; 100% against CIN 2/3 and AIS (HPV 16/18) |
| Status | Licensed in 2006; no longer marketed in the US (replaced by Gardasil 9) |
3. Gardasil 9 (9-valent — 9vHPV) ⭐ Currently used in US
| Feature | Detail |
|---|---|
| Manufacturer | Merck |
| HPV types covered | 6, 11, 16, 18, 31, 33, 45, 52, 58 |
| Protection against | Genital warts + cervical/anal/vulvar/vaginal cancers and precancers |
| Schedule | 2 doses (ages 9–14): months 0 and 6–12; 3 doses (≥15 yrs): months 0, 2, 6 |
| Approved for | Females and males 9–45 years |
| Efficacy | 97% against disease caused by the 5 additional types (31/33/45/52/58); noninferior immunogenicity for the original 4 types |
| Status | Licensed in 2014; currently the only HPV vaccine marketed in the US |
4. Cervavac (Quadrivalent) — India-specific
| Feature | Detail |
|---|---|
| Manufacturer | Serum Institute of India |
| HPV types covered | 6, 11, 16, 18 |
| Protection against | Same as Gardasil (genital warts, cervical cancer/precancers) |
| Schedule | 2 doses (9–14 yrs): months 0 and 6; 3 doses (≥15 yrs): months 0, 2, 6 |
| Status | Launched 2023; included in India's Universal Immunisation Programme |
Key Comparisons
| Cervarix | Gardasil | Gardasil 9 | Cervavac | |
|---|---|---|---|---|
| Types covered | 2 | 4 | 9 | 4 |
| Genital warts protection | ✗ | ✓ | ✓ | ✓ |
| For males | ✗ | ✓ | ✓ | ✓ |
| Currently marketed | Limited | No (US) | ✓ (US) | ✓ (India) |
Common to All HPV Vaccines
- Mechanism: Virus-like particles (VLPs) of L1 major capsid protein — no genetic material, cannot cause infection
- Route: Intramuscular injection, 0.5 mL per dose
- Most effective when given before sexual debut (HPV-naive individuals)
- Not therapeutic — do not clear existing HPV infections
- Vaccinated women should still undergo regular cervical cancer screening (Pap smear/co-testing)
- Antibody titers are higher in adolescents (9–15 yrs) than in older age groups; protection has not waned after 8–10 years of follow-up
— Red Book 2021 (AAP), p. 717–718 | Harrison's Principles of Internal Medicine 22E, p. 1571
Cost and best HPV vaccine
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The medical textbooks in the library don't cover vaccine pricing (as prices vary by country, sector, and time). Here is a clinically accurate and up-to-date answer drawing on established knowledge:
Cost of HPV Vaccines
India (Private Market — approximate)
| Vaccine | Price per dose | Total cost (3 doses) |
|---|---|---|
| Cervavac (Serum Institute) | ₹2,000–2,500 | ~₹6,000–7,500 |
| Gardasil 9 (Merck, imported) | ₹3,500–4,500 | ~₹10,500–13,500 |
| Cervarix (GSK) | ₹2,500–3,000 | ~₹7,500–9,000 |
Under India's Universal Immunisation Programme (UIP), Cervavac is available free of cost for girls aged 9–14 years at government centres.
USA (Private Market)
| Vaccine | Price per dose (CDC list price) |
|---|---|
| Gardasil 9 |
In the US, Gardasil 9 is covered under most insurance plans and is available free for eligible children under the Vaccines for Children (VFC) program.
Which is the Best HPV Vaccine?
Globally: Gardasil 9 (9vHPV)
Gardasil 9 is the preferred and recommended vaccine by WHO, CDC (ACIP), and most national guidelines for the following reasons:
| Criterion | Gardasil 9 | Cervarix | Cervavac/Gardasil |
|---|---|---|---|
| HPV types covered | 9 (6,11,16,18,31,33,45,52,58) | 2 | 4 |
| Cervical cancer prevention | ~90% of cases | ~70% | ~70% |
| Genital wart prevention | ✓ | ✗ | ✓ |
| Male protection | ✓ | ✗ | ✓ |
| Oropharyngeal/anal cancer | ✓ (broader) | Partial | Partial |
- HPV types 31, 33, 45, 52, 58 (covered only by Gardasil 9) account for an additional ~20% of cervical cancers beyond what HPV 16/18 cause
- Gardasil 9 thus protects against ~90% of all cervical cancers, compared to ~70% for bivalent/quadrivalent vaccines
In India: Cervavac (cost-effective choice)
If Gardasil 9 is not accessible or affordable, Cervavac is the best practical option in India because:
- Significantly cheaper than imported Gardasil 9
- Same formulation as the original Gardasil (quadrivalent — 4 types)
- Manufactured locally, ensuring supply stability
- Included in India's national immunization program
- Efficacy equivalent to Gardasil for types 6, 11, 16, 18
Summary Recommendation
| Situation | Best choice |
|---|---|
| Best protection, cost not a concern | Gardasil 9 |
| India, government/free program (girls 9–14) | Cervavac (free via UIP) |
| India, private sector, budget-conscious | Cervavac |
| Available only abroad | Gardasil 9 |
Bottom line: Gardasil 9 offers the broadest protection and is the gold standard. Cervavac is the most cost-effective choice in India and provides solid core protection against the most common oncogenic HPV types.
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