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The Quadrivalent Human Papillomavirus Vaccine: Potential Factors in Effectiveness


  • Nancy J. Zonfrillo MSN, APRN-BC, RNC,

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    • Nancy J. Zonfrillo, MSN, APRN-BC, RNC, is a 2007 graduate of Yale University School of Nursing.

  • Barbara Hackley CNM, MSN

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    • Barbara Hackley, CNM, MSN, is on faculty at Yale University School of Nursing and is in clinical practice at the Women's Health Service at Montefiore South Bronx Health Center for Children and Families.

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Cervical cancer, caused by human papillomavirus (HPV) infection, is the second most common female cancer in the world, causing over a quarter of a million deaths worldwide every year. The quadrivalent HPV vaccine (Gardasil) has the potential to significantly reduce morbidity and mortality associated with cervical disease. However, a variety of factors affect the vaccine's success, including exposure to HPV prior to vaccination, duration of protection provided by the vaccine, the in vivo interaction between HPV serotypes, and variation in HPV serotype prevalence worldwide. This article describes the pathophysiology of HPV infection, efficacy and safety of the quadrivalent HPV vaccine, factors that may influence the vaccine's effectiveness in reducing cervical cancer rates, and recommendations for maximizing this effectiveness.