Comparison of long-term outcomes of bivalent, quadrivalent and nonavalent human papillomavirus vaccine: a systematic review

Abstract

Objective: To compare the long-term results of bivalent, tetravalent and nonavalent human papillomavirus vaccine.

Introduction: Human papillomavirus is the most frequent sexually transmitted infection in the world and can cause benign and malignant processes in both men and women. Cervical cancer is its main complication and one of the leading causes of death worldwide. The HPV vaccine is the best method of preventing lesions and other complications caused by this virus. There are three types of vaccines: bivalent, tetravalent and nonavalent that target different types of HPV, mainly HPV 16 and 18, which are considered high risk.

Methodology: A systematic review was performed applying the PRISMA 2020 criteria, original articles were collected, both in English and Spanish, in scientific databases such as Pubmed, SCOPUS and Web of Science, between the years 2017 to the present year.

Results: After applying the inclusion and exclusion criteria, six articles were obtained that responded to the research objectives. The nonavalent vaccine showed an efficacy greater than 97% in the decrease and appearance of incident infections caused by HPV 31, 33, 45, 52, 58. The bivalent and tetravalent vaccines showed an efficacy greater than 90% in preventing persistent infections. In relation to precancerous lesions, the three vaccines proved to be 100% effective in preventing the development of CIN1 and CIN3.

Conclusion: Although all three vaccines are effective and beneficial, it was shown that the nonavalent vaccine has greater efficacy compared to the tetravalent vaccine because it offers protection not only for HPV 6, 11, 16, 18 but also for HPV 31, 33, 45, 52 and 58.