GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant)

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Dosage and administration for GARDASIL 9

Patients 9 through 14 years

Regimen	Schedule
2-dose	0, 6 to 12 months^a
3-dose	0, 2, 6 months

Patients 15 through 45 years

Regimen	Schedule
3-dose	0, 2, 6 months

Observe patients for 15 minutes after administration.

GARDASIL 9 should be administered intramuscularly in the deltoid or anterolateral area of the thigh.

The number of recommended doses is based on age at the administration of the first dose.¹

Immunologic response to GARDASIL 9 may be diminished in immunocompromised individuals.

Safety and effectiveness of GARDASIL 9 have not been established in pregnant women.

^aIf the second dose is administered earlier than 5 months after the first dose, administer a third dose at least 4 months after the second dose.

Interchangeability

Studies using a mixed regimen of HPV vaccines to assess interchangeability were not performed for GARDASIL 9

Concomitant use

Concomitant administration of GARDASIL 9, at a separate injection site, did not interfere with the antibody responses to any of these vaccines when compared with nonconcomitant administration of GARDASIL 9:

Menactra [Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine]
Adacel [Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine Adsorbed (Tdap)]

The rates of injection-site adverse reactions were similar between the concomitant group and nonconcomitant group (vaccination with GARDASIL 9 separated from vaccination with Menactra and Adacel by 1 month) with the exception of an increased rate of swelling reported at the injection site for GARDASIL 9 in the concomitant group (14.4%) compared to the nonconcomitant group (9.4%). The majority of injection-site swelling adverse reactions were reported as being mild to moderate in intensity.

Menactra and Adacel are the trademarks of their respective owners and are not trademarks of Merck Sharp & Dohme LLC.

Reference:

Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2025. Centers for Disease Control and Prevention. Revised August 7, 2025. Accessed August 11, 2025. https://www.cdc.gov/vaccines/hcp/imz-schedules/downloads/child/0-18yrs-child-combined-schedule.pdf

Indication

GARDASIL^®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) is a vaccine indicated in females 9 through 45 years of age for the prevention of cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers caused by human papillomavirus (HPV) Types 16, 18, 31, 33, 45, 52, and 58; cervical, vulvar, vaginal, and anal precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts caused by HPV Types 6 and 11.

GARDASIL 9 is indicated in males 9 through 45 years of age for the prevention of anal, oropharyngeal and other head and neck cancers caused by HPV Types 16, 18, 31, 33, 45, 52, and 58; anal precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts caused by HPV Types 6 and 11.

The oropharyngeal and head and neck cancer indication is approved under accelerated approval based on effectiveness in preventing HPV-related anogenital disease. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial.

GARDASIL 9 does not eliminate the necessity for vaccine recipients to undergo screening for cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers as recommended by a health care provider.

GARDASIL 9 has not been demonstrated to provide protection against diseases caused by:

HPV types not covered by the vaccine
HPV types to which a person has previously been exposed through sexual activity

Not all vulvar, vaginal, anal, oropharyngeal and other head and neck cancers are caused by HPV, and GARDASIL 9 protects only against those vulvar, vaginal, anal, oropharyngeal and other head and neck cancers caused by HPV Types 16, 18, 31, 33, 45, 52, and 58.

GARDASIL 9 is not a treatment for external genital lesions; cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers; or cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia (VIN), vaginal intraepithelial neoplasia (VaIN), or anal intraepithelial neoplasia (AIN).

Vaccination with GARDASIL 9 may not result in protection in all vaccine recipients.

Select Safety Information

GARDASIL^®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) is contraindicated in individuals with hypersensitivity, including severe allergic reactions to yeast, or after a previous dose of GARDASIL 9 or GARDASIL^® [Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant].

Because vaccinees may develop syncope, sometimes resulting in falling with injury, observation for 15 minutes after administration is recommended. Syncope, sometimes associated with tonic-clonic movements and other seizure-like activity, has been reported following HPV vaccination. When syncope is associated with tonic-clonic movements, the activity is usually transient and typically responds to restoring cerebral perfusion.

Safety and effectiveness of GARDASIL 9 have not been established in pregnant women.

The most common (≥10%) local and systemic adverse reactions in females were injection-site pain, swelling, erythema, and headache. The most common (≥10%) local and systemic reactions in males were injection-site pain, swelling, and erythema.

The duration of immunity of a 2-dose schedule of GARDASIL 9 has not been established.