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Gardasil 9

Phase 3

Cervical Cancer | Monoclonal antibody | Oncology |Merck & Company, Inc.|Last Updated: Sep 10, 2026

Target and mechanism

ModalityMonoclonal antibody

Also known as GARDASIL®9, GARDASIL9, 9vHPV Vaccine, 9vHPV vaccine, V503, Gardasil, Comparator: Gardasil, GARDASIL

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials3
Total Enrollment28,219

FDA Designations

No designations recorded

Clinical trial landscape

Gardasil 9 · 28 trials · 28 indications

Phase 3 25Phase 2 1Phase 1 2
NCT07785843A Clinical Study of V503 in Chinese Females Who Have Previously Received a Bivalent Human Papillomavirus (HPV) Vaccine (V503-108)Papillomavirus Infections
NOT YET_RECRUITING930 Analytics
NCT05450705V503 in Chinese Girls 9-14 Years Old Versus Chinese Women 20-26 Years Old (V503-071)Papillomavirus Infections
ACTIVE NOT_RECRUITING1,500 Analytics
NCT05314023Immunogenicity and Safety of V503 in Chinese Males 9 Through 19 Years Old (V503-053)Genital Warts
ACTIVE NOT_RECRUITING1,590 Analytics
NCT05119855Safety and Immunogenicity of 9-valent Human Papillomavirus (9vHPV) Vaccine Coadministered With Messenger Ribonucleic Acid (mRNA)-1273 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (COVID-19) Vaccine (V503-076)Papillomavirus Infections
COMPLETED165 Analytics
NCT05285826Efficacy, Immunogenicity, and Safety of V503 in Chinese Males (V503-052)Papillomavirus Infections
ACTIVE NOT_RECRUITING8,100 Analytics
NCT04772534Immunogenicity and Safety of the 9-valent Human Papillomavirus (9vHPV) Vaccine in Japanese Boys and Girls (V503-066)Papillomavirus Infections
COMPLETED314 Analytics
NCT04708041Safety and Immunogenicity of Extended 2-dose Regimens of 9-valent Human Papillomavirus (9vHPV) Vaccine (V503-069)Papillomavirus Infections
ACTIVE NOT_RECRUITING700 Analytics
NCT04635423Efficacy, Immunogenicity, and Safety Study of V503 (9-valent Human Papillomavirus [9vHPV] Vaccine) in Japanese Males (V503-064)Warts, Genital
COMPLETED1,059 Analytics
NCT04199689Efficacy Against Oral Persistent Infection, Immunogenicity and Safety of the 9-valent Human Papillomavirus Vaccine (9vHPV) in Men Aged 20-45 Years (V503-049)Papillomavirus Infections
ACTIVE NOT_RECRUITING6,033 Analytics
NCT03998254Efficacy, Immunogenicity and Safety of V503 in Chinese Women Aged 20-45 Years (V503-023)Papillomavirus Infections
ACTIVE NOT_RECRUITING6,000 Analytics
PHASE3NOT YET_RECRUITING
A Clinical Study of V503 in Chinese Females Who Have Previously Received a Bivalent Human Papillomavirus (HPV) Vaccine (V503-108)
Papillomavirus InfectionsUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
V503 in Chinese Girls 9-14 Years Old Versus Chinese Women 20-26 Years Old (V503-071)
Papillomavirus InfectionsUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Immunogenicity and Safety of V503 in Chinese Males 9 Through 19 Years Old (V503-053)
Genital WartsUnlock trial analytics
PHASE3COMPLETED
Safety and Immunogenicity of 9-valent Human Papillomavirus (9vHPV) Vaccine Coadministered With Messenger Ribonucleic Acid (mRNA)-1273 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (COVID-19) Vaccine (V503-076)
Papillomavirus InfectionsUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Efficacy, Immunogenicity, and Safety of V503 in Chinese Males (V503-052)
Papillomavirus InfectionsUnlock trial analytics
PHASE3COMPLETED
Immunogenicity and Safety of the 9-valent Human Papillomavirus (9vHPV) Vaccine in Japanese Boys and Girls (V503-066)
Papillomavirus InfectionsUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Safety and Immunogenicity of Extended 2-dose Regimens of 9-valent Human Papillomavirus (9vHPV) Vaccine (V503-069)
Papillomavirus InfectionsUnlock trial analytics
PHASE3COMPLETED
Efficacy, Immunogenicity, and Safety Study of V503 (9-valent Human Papillomavirus [9vHPV] Vaccine) in Japanese Males (V503-064)
Warts, GenitalUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Efficacy Against Oral Persistent Infection, Immunogenicity and Safety of the 9-valent Human Papillomavirus Vaccine (9vHPV) in Men Aged 20-45 Years (V503-049)
Papillomavirus InfectionsUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Efficacy, Immunogenicity and Safety of V503 in Chinese Women Aged 20-45 Years (V503-023)
Papillomavirus InfectionsUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants Who Are Seropositive by Competitive Luminex Immunoassay (cLIA) to HPV Types 6, 11, 31, 33, 45, 52, and 58 (Month 7)
Up to approximately 1 month post vaccination 3 (Up to approximately Month 7)

The percentage of participants who are seropositive for HPV types 6, 11, 31, 33, 45, 52, and 58 in the Prior 2vHPV Vaccine Recipients Receiving V503 group will be determined using cLIA. Seropositivity is defined as having a titer at or above the prespecified seropositivity cutoff for a given HPV type.

Percentage of Participants Who Experience at Least 1 Solicited Injection-site Adverse Event (AE)
Up to approximately Day 8 post any vaccination

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. AEs such as redness/erythema, swelling, pain, and induration at the injection site are recorded. The percentage of participants who experience 1 or more injection-site AE will be reported.

Percentage of Participants Who Experience at Least 1 Solicited Systemic AE
Up to approximately Day 8 post any vaccination

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. Systemic AEs are those not categorized as injection-site AEs. The percentage of participants who experience 1 or more systemic AE will be reported.

Percentage of Participants Who Experience at Least 1 Serious AE (SAE)
Up to approximately Month 12

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. An SAE is an AE that results in death, is life threatening, results in a persistent or significant disability or incapacity, results in or prolongs an existing hospitalization, is a congenital anomaly or birth defect, or is another important medical event. The percentage of participants who experience 1 or more SAEs will be reported.

Stage I: Competitive Luminex immunoassay (cLIA) Geometric Mean Titers (GMTs) to 9 vaccine types of 9vHPV vaccine
One month after last dose (Up to Month 13)

cLIA GMT to each of 9 vaccine types of 9vHPV vaccine. The GMT for each HPV type will be reported in mMU/mL.

Stage II: cLIA GMTs to 9 vaccine types of 9vHPV vaccine in girls 9 through 14 years of age
Up to Month 84

cLIA GMT to each of 9 vaccine types of 9vHPV vaccine in girls 9 through 14 years of age. The GMT for each HPV type will be reported in mMU/mL.

Stage II: cLIA seropositivity percentages to 9 vaccine types of 9vHPV vaccine in girls 9 through 14 years of age
Up to Month 84

cLIA seropositivity to each of 9 vaccine types of 9vHPV vaccine in girls 9 through 14 years of age. The percentage of participants who are seropositive for each HPV type will be summarized.

Competitive Luminex immunoassay (cLIA) GMTs to 9 vaccine types of 9vHPV vaccine at one month post last dose
Up to Month 13

cLIA GMT to each of 9 vaccine types of 9vHPV vaccine at one month post last dose. The GMT for each HPV type will be reported in mMU/mL.

cLIA GMTs to 9 vaccine types of 9vHPV vaccine up to 60 months post last dose
Up to 72 months

cLIA GMT to each of 9 vaccine types of 9vHPV vaccine at up to 60 months post last dose. The GMT for each HPV type will be reported in mMU/mL.

cLIA seropositivity percentages to 9 vaccine types of 9vHPV vaccine
Up to 72 months

cLIA seropositivity to each of 9 vaccine types of 9vHPV vaccine. The percentage of participants who are seropositive for each HPV type will be summarized.

Geometric Mean Titers of Anti-Human Papillomavirus Vaccine Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 (9vHPV)
Up approximately 4 weeks post vaccination with 9vHPV Dose 2

Antibodies to HPV types 6/11/16/18/31/33/45/52/58 were measured using a competitive Luminex immunoassay (cLIA). Per protocol, antibody titers were expressed as milli Merck units/milliliter (mMU/mL). Geometric Mean Titers (GMTs) are reported for both arms for all randomized participants included in the per-protocol immunogenicity (PPI) population. The PPI population is HPV-type specific.

Geometric Mean Concentrations of SARS-CoV-2 Spike Protein-Specific Binding Antibodies
Up approximately 4 weeks post vaccination with mRNA-1273 Dose 2

The geometric mean concentration (GMC) of serum-derived antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike protein was determined using an electrochemiluminescence (ECL) assay. GMCs are reported for both arms for all randomized participants included in the mRNA-1273 per-protocol (mRNA-1273-PP) population.

Percentage of Participants With ≥1 Solicited Injection-site Adverse Event (AE)
Up to approximately Day 7 post vaccination with any study vaccine

An AE was any untoward medical occurrence in a participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Solicited AEs are predefined local AEs (at the injection site) for which the participant was specifically questioned, and noted by the participant in their vaccine report card (VRC). Per protocol, the percentage of participants with ≥1 solicited injection site AE has been reported separately based on injection site for participants in the Concomitant Group (Day 1 mRNA-1273 Dose 1 right arm; Day 1 9vHPV Dose 1 left arm; Month 1 mRNA-1273 Dose 2 right arm; Month 6 9vHPV Dose 2 left arm) and Non-Concomitant Group (Day 1 mRNA-1273 Dose 1 right arm; Month 1 mRNA-1273 Dose 2 right arm; Month 2 9vHPV Dose 1 left arm; Month 8 9vHPV Dose 2 left arm). Per protocol, reporting for Concomitant Group Day 1 Dose 1 separated by injection site is specific to this outcome only and does not apply to other safety outcomes.

Percentage of Participants With ≥1 Solicited Systemic AE
Up to approximately Day 7 post vaccination with any study vaccine

An AE was any untoward medical occurrence in a participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. Solicited AEs are predefined systemic events for which the participant is specifically questioned, and which are noted by the participant in their VRC. Per protocol the percentage of participants who experienced ≥1 solicited systemic (affecting the whole body) AE are reported here for participants in the Concomitant (Day 1 mRNA-1273 Dose 1 right arm + 9vHPV Dose 1 left arm; Month 1 mRNA-1273 Dose 2 right arm; Month 6 9vHPV Dose 2 left arm) and Non-Concomitant Groups (Day 1 mRNA-1273 Dose 1 right arm; Month 1 mRNA-1273 Dose 2 right arm; Month 2 9vHPV Dose 1 left arm; Month 8 9vHPV Dose 2 left arm). Per protocol, reporting is based on time of injection; as 9vHPV Dose 1 AND mRNA-1273 Dose 1 were both given on Day 1 of the Concomitant Group they have been combined below.

Percentage of Participants With ≥1 Serious Adverse Event (SAE)
Up to approximately Day 28 post vaccination with any study vaccine

A serious adverse event (SAE) was defined as one that results in death, is life threatening, or requires hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly or birth defect, or other important medical event that may require medical intervention. Per protocol the percentage of participants who experienced ≥1 SAE are reported here for participants in the Concomitant (Day 1 mRNA-1273 Dose 1 right arm + 9vHPV Dose 1 left arm; Month 1 mRNA-1273 Dose 2 right arm; Month 6 9vHPV Dose 2 left arm) and Non-Concomitant Groups (Day 1 mRNA-1273 Dose 1 right arm; Month 1 mRNA-1273 Dose 2 right arm; Month 2 9vHPV Dose 1 left arm; Month 8 9vHPV Dose 2 left arm). Per protocol, reporting is based on time of injection; as 9vHPV Dose 1 AND mRNA-1273 Dose 1 were both given on Day 1 of the Concomitant Group they have been combined below.

Percentage of Participants With ≥1 Vaccine-Related SAE
Up to approximately 9 Months

A SAE was defined as one that results in death, is life threatening, or requires hospitalization/prolongation of existing hospitalization, results in persistent/significant disability/incapacity, is a congenital anomaly/birth defect, or other important medical event that may require medical intervention. An SAE judged by the investigator to be related to the study vaccine is a vaccine-related SAE. Per protocol the percentage of participants who experienced ≥1 vaccine-related SAE are reported here for participants in Concomitant (Day 1 mRNA-1273 Dose 1 right arm + 9vHPV Dose 1 left arm; Month 1 mRNA-1273 Dose 2 right arm; Month 6 9vHPV Dose 2 left arm) and Non-Concomitant Groups (Day 1 mRNA-1273 Dose 1 right arm; Month 1 mRNA-1273 Dose 2 right arm; Month 2 9vHPV Dose 1 left arm; Month 8 9vHPV Dose 2 left arm). Per protocol, reporting is based on time of injection; as 9vHPV Dose 1 AND mRNA-1273 Dose 1 were both given on Day 1 of the Concomitant Group they have been combined below.

Stage I: Combined Incidence of HPV 6-, 11-, 16-, 18-, 31-, 33-, 45-, 52-, and 58-related External Genital and Intra-anal 12-month Persistent Infection
Up to approximately 30 months

This endpoint is defined as having occurred if a participant is positive for the same HPV type by the HPV PCR assay in the penile, scrotum, perineal, perianal and intra-anal swabs, biopsy, or excised samples obtained in 3 or more consecutive visits over a period of at least 12 months.

Stages I and II: Combined Incidence of HPV 6-, 11-, 16-, 18-, 31-, 33-, 45-, 52-, and 58-related Genital Warts, PIN, or Penile/Perianal/Perineal Cancer
Up to approximately 78 months

This endpoint is defined as having occurred if on a single biopsy or excised tissue from a participant, there is: (a) a pathology panel consensus diagnosis of genital warts, PIN of any grade, or penile/perianal/perineal cancer; and (b) detection of at least 1 of HPV types 6, 11, 16, 18, 31, 33, 45, 52 or 58 by Thinsection PCR in an adjacent section from the same tissue block.

Seroconversion Percentages for the HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58
1 month after final dose (Month 7)

The percentage of seropositive participants is reported. Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using competitive Luminex Immunoassay (cLIA). Seroconversion was defined as changing serostatus from seronegative at Day 1 to seropositive at 4 weeks post last vaccination.

Number of Participants With at Least 1 Injection-site Adverse Event (AE)
Up to 5 days after each vaccination (up to ~6 months)

The number of participants with injection-site AEs (erythema/redness, pain and swelling) is reported. An AE any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.

Number of Participants With at Least 1 Systemic Adverse Event
Up to 15 days after each vaccination (up to ~6.5 months)

The number of participants with a systemic AE is reported. An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.

Number of Participants With at Least 1 Serious Adverse Event (SAE)
Up to ~Month 30

The number of participants with an SAE is reported. An SAE is defined as one that results in death, is life threatening, or requires hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly or birth defect, or other important medical event that may require medical intervention.

Geometric Mean Titers of Anti-Human Papilloma Virus Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 as Measured by Competitive Luminex Immunoassay
4 weeks post last vaccination (Up to ~Month 61)

Serum antibody titers for human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 45, 52 and 58 will be determined using competitive luminex immunoassay (cLIA). The geometric mean titer (GMT) for each HPV type will be reported in milli Merck units/mL (mMU/mL).

Percentage of Participants With at Least 1 Solicited Injection-site Adverse Event
Up to 5 days post vaccination

An adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants with injection-site AEs (erythema/redness, pain and swelling) will be assessed.

Percentage of Participants With at Least 1 Systemic Adverse Event
Up to 15 days post vaccination

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. The percentage of participants with a systemic AE will be assessed.

Percentage of Participants With at Least 1 Serious Vaccine-Related Adverse Event
Entire study period (Up to ~Month 96)

A serious adverse event (SAE) is defined as one that results in death, is life threatening, or requires hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly or birth defect, or other important medical event that may require medical intervention. An SAE that is judged by the investigator to be related to the study vaccine is defined as a vaccine-related SAE.

Base Study: Combined Incidence of Human Papillomavirus (HPV) 6/11/16/18-related Anogenital Persistent Infection
Up to approximately 36 Months

Combined incidence of HPV type(s) 6/11/16/18-related anogenital persistent infection was defined to have occurred in a participant; 1) who is polymerase chain reaction (PCR) positive to at least one applicable HPV type(s) in 2 consecutive anogenital or biopsy samples from at least 2 consecutive visits 6 months (±1 month visit) or longer apart, or 2) who has a pathology diagnosis of condyloma, penile/perineal/perianal intraepithelial neoplasia, or penile, perineal or perianal cancer and PCR detection of at least one applicable HPV type(s) in an adjacent section and PCR positive for the same HPV type at a separate adjacent visit with regardless of visit interval, prior to or following the biopsy showing HPV disease. Incidence was defined as the number of cases per 100 person-years of follow-up in both V503 and placebo arms. Per protocol, cases per 100 person-years is reported for applicable HPV type eligible participants with data available in the per-protocol efficacy population (PPE).

Base Study: Percentage of Participants With Solicited Injection-site Adverse Events (AEs)
Up to 5 days after any vaccination

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The participant recorded the presence of any vaccination report card (VRC)-prompted injection-site AEs that occurred in the 5 days after any vaccination. The percentage of participants with an injection-site AE prompted on the VRC (redness/erythema, tenderness/pain, and swelling) is reported here for all randomized participants in the All Participants as Treated (APaT) population.

Base Study: Percentage of Participants With ≥1 Systemic AE
Up to 15 days after any vaccination

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who experienced at least 1 systemic AE is reported here for all randomized participants in the All Participants as Treated (APaT) population.

Base Study: Percentage of Participants With ≥1 Serious Adverse Events (SAEs)
Up to approximately 37 months

An SAE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention, that results in death, is life-threatening, requires hospitalization or prolongs existing hospitalization, results in persistent/significant disability/incapacity, is a congenital birth defect, or is another important medical event. The percentage of participants who experienced at least 1 SAE is reported here for all randomized participants in the All Participants as Treated (APaT) population.

Base Study: Number of Participants With Elevated Oral Body Temperature
Up to 5 days after any vaccination

Participants collected their oral body temperature in the evening of their vaccination day and at the same time each day thereafter for 4 days. The maximum body temperature obtained within 5 days of any of the 3 vaccinations was recorded using the vaccination report card (VRC). Per protocol, fever was defined as an oral temperature of ≥99.5°F(37.5°C). The number of participants who had at least 1 oral body temperature reading that was, \<99.5°F (\<37.5ºC), ≥99.5°F (≥37.5ºC) and \<100.4°F (38.0°C), or ≥100.4°F (38.0°C) and \<101.3°F(38.5°C), or ≥101.3°F(38.5°C) is reported here for all randomized participants in the APaT population with temperature data available.

Incidence of HPV 16/18/31/33/45/52/58-related 6-month Persistent Oral Infection
Up to Month 90

A 6-month persistent infection is defined to have occurred if a participant, after completion of the Month 7 visit, is positive for the same HPV type by the HPV polymerase chain reaction (PCR) assay to at least 1 common gene in Oral Rinse and Gargle (ORG) samples obtained at 2 or more consecutive visits at 6 months (+/-1 month visit window) apart.

Stage I: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related 12-month Persistent Infection
1 month post vaccination 3 (Month 7) up to Month 30

A 12-month persistent infection This endpoint is defined to have occurred if a participant who is positive for the same HPV type by the HPV PCR assay in the LVPP/EEC swabs, biopsy, ECC or definitive therapy samples obtained in 3 or more consecutive visits over a period of at least 12 months. Incidence is defined as the number of cases of persistent infection per 10,000 person-years of follow-up in a treatment arm.

Stage I: Geometric Mean Titers to HPV Types 6, 11, 16, and 18 Antibodies
1-month post vaccination 3 (Month 7)

Serum antibodies to HPV types 6/11/16/18 are measured with a Competitive Luminex Immunoassay (cLIA). Titers are reported in milli Merck Units/mL.

Stage I: Percentage of Participants Who Report at Least 1 Solicited Injection-site Adverse Event
up to 8 days post any vaccination

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. AEs such as redness, swelling, and pain/tenderness/soreness at the injection site are recorded.

Stage I: Percentage of Participants Who Report at Least 1 Solicited Systemic Adverse Event
up to 30 days post any vaccination

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. Systemic AEs are those not categorized as injection-site AEs.

Stage I: Percentage of Participants Who Experience at Least 1 Serious Adverse Event (SAE)
Day 1 up to approximately Month 30

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. An SAE is an AE that results in death, is life threatening, results in a persistent or significant disability or incapacity, results in or prolongs an existing hospitalization, is a congenital anomaly or birth defect, or is another important medical event.

Stage II: Combined Incidence of HPV 31-, 33-, 45-, 52-, and 58-related CIN 2/3, AIS, and cervical cancer
Month 7 up to Month 90

This endpoint is defined to have occurred if on a single cervical biopsy, ECC, LEEP or Conization (cold knife/laser) specimen, there is: (a) a HPV Pathology Panel consensus diagnosis of CIN (grade 2 or 3), AIS, or cervical cancer; AND (b) detection of at least 1 of HPV types 31, 33, 45, 52 or 58 by Thinsection PCR in an adjacent section from the same tissue block. Disease incidence is defined as the number cases per 10,000 person-years of follow-up in a treatment arm.

Stages I/II: Percentage of Participants Who Experience at Least 1 Serious Adverse Event (SAE)
Day 1 up to approximately Month 90

An AE is defined as any untoward medical occurrence in a participant which does not necessarily have a causal relationship with study vaccine. An AE can therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of study vaccine or a protocol-specified procedure, whether or not considered related to the study vaccine or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the study vaccine or protocol-specified procedure is also an AE. An SAE is an AE that results in death, is life threatening, results in a persistent or significant disability or incapacity, results in or prolongs an existing hospitalization, is a congenital anomaly or birth defect, or is another important medical event.

Stage I: Competitive Luminex Immunoassay (cLIA) Geometric Mean Titers (GMTs) for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age and 20 to 26 Years of Age: Month 7
1 month post vaccination 3 (Month 7)

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using cLIA. The HPV-9 cLIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as milli Merck units/mL (mMU/mL).

Stage I: Percentage of Participants 27 to 45 Years of Age and 20 to 26 Years of Age Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 7
1 month post vaccination 3 (Month 7)

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using cLIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥50, 29, 41, 59, 29, 22, 15, 20, and 15 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: cLIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 12
Month 12

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using cLIA. The HPV-9 cLIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: cLIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 24
Month 24

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using cLIA. The HPV-9 cLIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: cLIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 36
Month 36

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using cLIA. The HPV-9 cLIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: cLIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 48
Month 48

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using cLIA. The HPV-9 cLIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: cLIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 60
Month 60

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using cLIA. The HPV-9 cLIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 12
Month 12

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using cLIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥50, 29, 41, 59, 29, 22, 15, 20, and 15 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 24
Month 24

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using cLIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥50, 29, 41, 59, 29, 22, 15, 20, and 15 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 36
Month 36

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using cLIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥65, 37, 79, 85, 46, 26, 21, 30 and 31 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 48
Month 48

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using cLIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥34, 25, 32, 26, 15, 10, 10, 14 and 10 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 60
Month 60

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using cLIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥34, 25, 32, 26, 15, 10, 10, 14 and 10 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Immunoglobulin G Luminex Immunoassay (IgG LIA) GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 12
Month 12

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using IgG LIA. The HPV-9 IgG LIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL. Although the same name (mMU/mL) is used for the unit of measurement in both cLIA and IgG LIA, the 'cLIA mMU/mL' and the 'IgG LIA mMU/mL' are actually different units of measurement and cannot be directly compared.

Stage II: IgG LIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 24
Month 24

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using IgG LIA. The HPV-9 IgG LIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: IgG LIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 36
Month 36

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using IgG LIA. The HPV-9 IgG LIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: IgG LIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 48
Month 48

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using IgG LIA. The HPV-9 IgG LIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: IgG LIA GMTs for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 in Participants 9 to 19 Years of Age: Month 60
Month 60

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined using IgG LIA. The HPV-9 IgG LIA assay was used to quantify the antibodies. This assay evaluated the serological response before and after 9vHPV vaccination and measured HPV infection-induced antibodies. The GMT for each HPV type was expressed as mMU/mL.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by IgG LIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 12
Month 12

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using IgG LIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥9, 6, 5, 5, 3, 4, 3, 5 and 5 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by IgG LIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 24
Month 24

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using IgG LIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥9, 6, 5, 5, 3, 4, 3, 5 and 5 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by IgG LIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 36
Month 36

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using IgG LIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥9, 6, 5, 5, 3, 4, 3, 5 and 5 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by IgG LIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 48
Month 48

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using IgG LIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥9, 6, 5, 5, 3, 4, 3, 5 and 5 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Stage II: Percentage of Participants 9 to 19 Years of Age Who Are Seropositive by IgG LIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58: Month 60
Month 60

The percentage of participants who are seropositive for HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined using IgG LIA. Seroconversion was defined as changing serostatus from seronegative at baseline (Day 1) to seropositive at 1 month after last dose. Cutoff values for HPV seropositivity are ≥9, 6, 5, 5, 3, 4, 3, 5 and 5 mMU/mL for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, respectively.

Seroconversion Percentages to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 at Month 7
4 weeks postdose 3 (Month 7)

Seroconversion was defined as a participant who was anti-HPV seronegative at Day 1 and became seropositive at 4 weeks postdose 3 (Month 7). Anti-HPV antibodies were measured using a Competitive Luminex Immunoassay.

Anti-HPV Geometric Mean Titers (GMTs) for Each Anti-HPV Type
4 weeks post vaccination 3 (Month 7)

Antibodies to the HPV types contained in V503 were measured using a competitive luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL). Statistical comparisons between arms was performed for the HPV types considered oncogenic (HPV Types 16/18/31/33/45/52/58).

Geometric Mean Titers (GMTs) to HPV Types 6/11/16/18
4 weeks postdose 3 (Month 7)

Serum antibodies to HPV types 6, 11, 16, and 18 were measured with a Competitive Luminex Immunoassay. Titers are reported in milli Merck Units/mL.

Geometric Mean Titers to Human Papillomavirus (HPV) Type 6 After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV virus-like particles (VLP) type 6 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 11 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 11 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 16 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 16 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 18 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 18 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 31 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 31 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 33 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 33 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 45 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 45 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 52 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 52 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers to HPV Type 58 at Four Weeks After the Last Dose of V503 in the Planned Regimen
4 weeks after the last dose of V503 in the planned regimen (Month 7 or Month 13)

Antibodies to HPV VLP type 58 were measured using a competitive Luminex immunoassay. Antibody titers were expressed as milli Merck units/mL (mMU/mL).

Geometric Mean Titers (GMTs) to the HPV Types Contained in the 9vHPV Vaccine
Four weeks post vaccination 3 (Month 7)

Serum antibodies to HPV types 6/11/16/18/31/33/45/52/58 were measured with a Competitive Luminex Immunoassay. Titers are reported in milli Merck Units/mL

Percentage of Participants With One or More Injection-site Adverse Experiences Prompted on the Vaccination Report Card
Up to 5 days after any vaccination

An adverse experience (AE) is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Injection-site AEs prompted on the Vaccination Report Card (VRC) were erythema, pain, and swelling. Participants were instructed to use the Vaccination Report Card to record AEs daily after each study vaccination.

Percentage of Participants With Elevated Oral Body Temperature (>=37.8° C, >=100° F)
Up to 5 days after any vaccination

Participants were instructed by the investigator to use the Vaccination Report Card to document evening oral temperature daily after each study vaccination

Percentage of Participants With an Adverse Event
Up to Month 12

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE.

Percentage of Participants Who Had Study Vaccine Discontinued Due to an Adverse Event
Up to Month 12

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE.

Geometric Mean Titers (GMTs) to HPV Types 16 and 18
4 weeks postdose 3 (Month 7)

Serum antibodies to HPV types 16 and 18 were measured with a Competitive Luminex Immunoassay.

Percentage of Participants Who Seroconvert to Each of the HPV Types Contained in the Vaccine
4 weeks post-vaccination 3 (Month 7)

Serum antibody titers for HPV virus-like particles (VLPs), Types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined 4 weeks post-vaccination 3 using competitive luminex immunoassay (cLIA). The serostatus cutoffs (milli Merck U/mL) for HPV types were as follows: HPV Type 6: ≥30, HPV Type 11: ≥16; HPV Type 16: ≥20, HPV Type 18: ≥24, HPV Type 31: ≥10, HPV Type 33: ≥8, HPV Type 45: ≥8, HPV Type 52: ≥8, and HPV Type 58: ≥8.

Percentage of Participants With an Injection-site Adverse Event (AE)
up to 5 days after any vaccination

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. AEs such as redness, swelling, and pain/tenderness/soreness at the injection site were recorded.

Percentage of Participants With a Non-Injection Site (Systemic) AE
up to 15 days after any vaccination

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Systemic AEs were those not categorized as injection-site AEs.

Percentage of Participants With a Vaccine-related AE
up to 15 days after any vaccination

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Adverse experience that is judged by the Investigator to be "definitely related," "probably related," or "possibly related" to the study drug is defined as a vaccine-related AE.

Geometric Mean Titers (GMTs) of the Antibody Response to Each of the Human Papillomavirus (HPV) Types Contained in V503
4 weeks following Month 6 vaccination

Serum antibody titers for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 were measured using a competitive Luminex immunoassay. Titers are reported in milli Merck Units/mL.

Percentage of Participants With a V503 Injection-site Adverse Experience
Day 1 through Day 5 following Day 1 vaccination

An adverse experience (AE) is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the vaccine is also an AE. Only injection-site AEs in the arm that received V503 vaccination were reported for this endpoint.

Percentage of Participants With a Repevax™ Injection-site Adverse Experience
Day 1 through Day 5 following Day 1 (Concomitant) or Month 1 (Non-concomitant) vaccination

For the Concomitant Vaccination group, injection-site AEs are reported following Day 1 vaccination; for the Non-concomitant Vaccination group, injection-site AEs are reported following Month 1 vaccination. An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the vaccine is also an AE. Only injection-site AEs in the arm that received Repevax™ vaccination were reported for this endpoint.

Percentage of Participants With Maximum Temperature >=37.8 °C (>=100.0 °F) (Oral or Oral Equivalent)
Up to 5 days following the Day 1 and Month 1 vaccination / visit

For the Concomitant Vaccination group, temperatures were collected after the Day 1 vaccination and the Month 1 visit; for the Non-concomitant Vaccination group, temperatures were collected after the Day 1 vaccination and the Month 1 vaccination.

Percentage of Participants With a Systemic Adverse Experience
Up to 15 days following the Day 1 and Month 1 vaccination / visit

For the Concomitant Vaccination group, systemic AEs were collected after the Day 1 vaccination and the Month 1 visit; for the Non-concomitant Vaccination group, systemic AEs were collected after the Day 1 vaccination and the Month 1 vaccination. An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body that is temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the vaccine is also an adverse experience. A systemic AE was an AE that was not associated with the injection site.

Percentage of Participants Who Achieve Acceptable Titers of Anti-Diphtheria and Anti-Tetanus Antibody
4 weeks following Day 1 (Concomitant) or Month 1 (Non-concomitant) vaccination

For the Concomitant Vaccination group, serum samples were collected 4 weeks after the Day 1 vaccination; for the Non-concomitant Vaccination group, serum samples were collected 4 weeks after the Month 1 vaccination. Titers of neutralizing antibody to diphtheria toxin were measured using a cell-based Diphtheria Micrometabolic Inhibition assay. Serum titers of neutralizing antibody to tetanus toxin were measured using an enzyme immunoassay. The lower limits of quantitation of the assays was 0.01 International Units (IU)/mL and 0.04 IU/mL, respectively. Acceptable titers refer to the World Health Organization-defined protective titer of \>=0.1 IU/mL.

Geometric Mean Titers of Pertussis Antibody Responses
4 weeks following Day 1 (Concomitant) or Month 1 (Non-concomitant) vaccination

For the Concomitant Vaccination group, serum samples were collected 4 weeks after the Day 1 vaccination; for the Non-concomitant Vaccination group, serum samples were collected 4 weeks after the Month 1 vaccination. Titers of anti-pertussis toxin (PT), anti-filamentous hemagglutinin (FHA), anti-pertactin (PRN), and anti-fimbriae 2/3 (FM 2/3) antibodies were measured using enzyme-linked immunosorbent assays. Titers are expressed as enzyme-linked immunoassay units/mL (ELU/mL).

Percentage of Participants Who Achieve Acceptable Titers of Anti-Poliovirus Antibody
4 weeks following Day 1 (Concomitant) or Month 1 (Non-concomitant) vaccination

For the Concomitant Vaccination group, serum samples were collected 4 weeks after the Day 1 vaccination; for the Non-concomitant Vaccination group, serum samples were collected 4 weeks after the Month 1 vaccination. Titers of neutralizing antibody to poliovirus type 1, 2, and 3 were measured using a microneutralization assay. Serial dilutions of sera were incubated with type-specific standard poliovirus and sensitive cells. Neutralization of the virus was measured by cell staining. Acceptable titers were defined as neutralization at \>=1:8 dilution of serum.

Percentage of Participants Who Experience an Injection-site Adverse Event (AE) - Base Study
up to 5 days after any vaccination - Base Study

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. The percentage of participants who reported an AE that was associated with the injection site such as redness, swelling, and pain/tenderness/soreness was summarized.

Percentage of Participants With Body Temperature ≥100.0°F (≥37.8ºC) - Base Study
up to 5 days after any vaccination - Base Study

Participants collected their oral body temperature in the evening of their vaccination day and at the same time each day thereafter for 4 days. The maximum body temperature obtained within 5 days of any of the 3 vaccinations was recorded.

Percentage of Participants Who Experience a Systemic AE - Base Study
up to 14 days after any vaccination - Base Study

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Systemic AEs were those not categorized as injection-site AEs.

Percentage of Participants Who Experience a Serious Adverse Event (SAE) Within 15 Days of Any Vaccination - Base Study
up to 14 days after any vaccination - Base Study

An SAE is one that results in death, disability/incapacity, or hospitalization or is life threatening, a congenital anomaly or birth defect, cancer, an overdose, or otherwise jeopardizes the participant and may require medical intervention.

Percentage of Participants Who Experience a Vaccine-related SAE Any Time During Study- Base Study
Up to 7 months - Base Study

An SAE is one that results in death, disability/incapacity, or hospitalization or is life threatening, a congenital anomaly or birth defect, cancer, an overdose, or otherwise jeopardizes the participant and may require medical intervention. An SAE that is judged by the Investigator to be "definitely related," "probably related," or "possibly related" is defined as a vaccine-related SAE.

Percentage of Participants Who Experience a Severe Injection-site AE - Base Study
up to 5 days after any vaccination - Base Study

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Participants were instructed to estimate the severity of AEs such as pain at injection site as mild (awareness of symptom, but easily tolerated), moderate (discomfort enough to cause interference with usual activities), or severe (incapacitating with inability to work or do usual activity). Additionally, participants were instructed to measure any swelling and/or erythema at its greatest width. Swelling or erythema with diameter \>2 inches (\>5 cm) was recorded as severe. All AEs associated with the injection site and reported as severe were summarized.

Percentage of Participants With >=4-fold Increase in Antibody Titers to Neisseria Meningitidis Serogroups
Baseline and 4 weeks following Day 1 (Concomitant) or Month 1 (Non-concomitant) vaccination

For the Concomitant Vaccination group, serum samples were collected at Day 1 (baseline) and 4 weeks after the Day 1 vaccination; for the Non-concomitant Vaccination group, serum samples were collected at Month 1 (baseline) and 4 weeks after the Month 1 vaccination. Bactericidal antibodies to Neisseria meningitidis serogroups A, C, Y, and W-135 were measured by incubating serial dilutions of serum with target N. meningitidis strains and complement, and enumerating the surviving bacteria after overnight incubation on blood agar plates. The serum bactericidal titer is reported as the reciprocal of the final serum dilution giving \>50% killing in 60 minutes.

Percentage of Participants With a Menactra™ or Adacel™ Injection-site Adverse Experience
Day 1 through Day 5 following Day 1 or Month 1 vaccination

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Only injection-site AEs in the arm that received Menactra™ and Adacel™ vaccination were reported for this endpoint. For the Concomitant Vaccination group, injection-site AEs are reported following Day 1 vaccination; for the Non-concomitant Vaccination group, injection-site AEs are reported following Month 1 vaccination.

Base Study: Geometric Mean Titers (GMTs) for Each of the HPV Types Contained in the Vaccine (9- to 15-Year-Old Females [Lot 1] and 16- to 26-Year-Old Females [Lot 1])
4 weeks post-vaccination 3 (Month 7)

Serum antibody titers for HPV virus-like particles (VLPs), Types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined 4 weeks post-vaccination 3 using a competitive luminex immunoassay (cLIA). Titers were reported in milli Merck Units/mL.

Base Study: GMTs for Each of the HPV Types Contained in the Vaccine (9- to 15-Year-Old Males [Lot 1] and 16- to 26-Year-Old Females [Lot 1])
4 weeks post-vaccination 3 (Month 7)

Serum antibody titers for HPV VLPs, Types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined 4 weeks post-vaccination 3 using a competitive luminex immunoassay (cLIA). Titers were reported in milli Merck Units/mL.

Base Study: GMTs for Each of the HPV Types Contained in the Vaccine (Lot Consistency Study)
4 weeks post-vaccination 3 (Month 7)

Serum antibody titers for HPV VLPs, Types 6, 11, 16, 18, 31, 33, 45, 52 and 58 were determined 4 weeks post-vaccination 3 using cLIA. Titers were reported in milli Merck Units/mL.

Base Study: Percentage of Participants With Injection Site Adverse Experiences (AEs)
Up to 5 days after any vaccination

An AE was defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine was also an AE. AEs such as redness, swelling, and pain/tenderness/soreness at the injection site were recorded.

Base Study: Percentage of Participants With Systemic AEs
Up to 15 days after any vaccination

An AE was defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the vaccine. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine was also an AE. Systemic AEs were those not categorized as injection-site AEs.

Base Study: Percentage of Participants With Body Temperature ≥100.0°F (≥37.8ºC)
Up to 5 days after any vaccination

Participants collected their oral body temperature in the evening of their vaccination day and at the same time each day thereafter for 4 days. The maximum body temperature obtained within 5 days of any of the 3 vaccinations was recorded. The percentage of participants who had at least 1 oral body temperature reading that was ≥100.0°F (≥37.8ºC) was summarized.

Extension Study: GMTs For Each of the HPV Types Contained in the Vaccine
Up to ~Month 126

Serum antibody titers (milli Merck Units/mL) measured by cLIA to each of the 9vHPV types were assessed. Per protocol, the extension study included data from 9- to 15-year-old females regardless of lot administered.

Extension Study: Percentage of Participants Who Are Seropositive to Each of the HPV Types Contained in the Vaccine
Up to ~Month 126

Serum antibody titers for HPV VLPs Types 6, 11, 16, 18, 31, 33, 45, 52 and 58 was determined and reported in milli Merck Units/mL. The percentage of participants seropositive to each HPV type was reported. Per protocol, the extension study included data from 9- to 15-year-old females regardless of lot administered.

Base Study: Combined Incidence of HPV Type 31/33/45/52/58-related Disease (Test of Hypothesis)
From Day 1 until >=30 cases accumulate, up to Month 54 in the base study

HPV Type 31/33/45/52/58-related high-grade Cervical Intraepithelial Neoplasia (CIN 2/3), Adenocarcinoma in Situ (AIS), Invasive Cervical Carcinoma, high-grade Vulvar Intraepithelial Neoplasia (VIN 2/3), high-grade Vaginal Intraepithelial Neoplasia (VaIN 2/3), vulvar cancer, or vaginal cancer were determined by clinical/pathologic criteria and positive Polymerase Chain Reaction (PCR) assay for virus subtype. This outcome measure reports data based on the protocol-specified plan of conducting hypothesis testing when at least 30 cases had accumulated. The cutoff date for this analysis was 10 April 2013. Disease incidence was defined as the number of primary efficacy cases per 10,000 person-years of follow-up in a treatment arm.

Base Study: Combined Incidence of HPV Type 31/33/45/52/58-related Disease (End-of-study Update)
Up to Month 54 in the base study

HPV Type 31/33/45/52/58-related high-grade Cervical Intraepithelial Neoplasia (CIN 2/3), Adenocarcinoma in Situ (AIS), Invasive Cervical Carcinoma, high-grade Vulvar Intraepithelial Neoplasia (VIN 2/3), high-grade Vaginal Intraepithelial Neoplasia (VaIN 2/3), vulvar cancer, or vaginal cancer were determined by clinical/pathologic criteria and positive Polymerase Chain Reaction (PCR) assay for virus subtype. This outcome measure reports cumulative study data through 10 March 2014. Disease incidence was defined as the number of primary efficacy cases per 10,000 person-years of follow-up in a treatment arm.

Base Study: Geometric Mean Titers (GMTs) to HPV Types 6/11/16/18/31/33/45/52/58
4 weeks postdose 3 in the base study

Serum antibodies to HPV types 6/11/16/18/31/33/45/52/58 were measured with a Competitive Luminex Immunoassay. Titers are reported in milli Merck Units/mL. Statistical analysis was performed only for HPV types contained in both vaccines.

Base Study: Percentage of Participants With One or More Adverse Event
Up to Month 7 (low- and high-dose V503) or up to Month 54 (mid-dose V503 and Gardasil)

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE.

Base Study: Percentage of Participants With One or More Injection-site Adverse Event
Up to Day 5 after any vaccination

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. AEs such as redness, swelling, and pain/tenderness/soreness at the injection site were recorded.

Base Study: Percentage of Participants With One or More Non-injection-site (Systemic) Adverse Event
Up to Day 15 after any vaccination

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. Systemic AEs were those not categorized as injection-site AEs.

Base Study: Percentage of Participants With One or More Vaccine-related Adverse Event
Up to Month 7 (low- and high-dose V503) or up to Month 54 (mid-dose V503 and Gardasil)

An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an AE. An AE that is judged by the investigator to be "definitely related," "probably related," or "possibly related" to the study drug is defined as a vaccine-related AE.

Base Study: Percentage of Participants With Study Medication Withdrawn Due to an Adverse Event
Up to Month 6

An adverse event is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study vaccine, whether or not considered related to the use of the product. Any worsening of a preexisting condition which is temporally associated with the use of the study vaccine is also an adverse event.

Number of Participants Who Seroconvert to HPV 6.
Week 4 Postdose 3

Vaccine-induced anti-HPV 6 seroconversion following administration of a 3-dose regimen of GARDASIL® in females 9 to 23 years of age in Korea. Seroconversion for HPV 6 was defined as achieving an anti-HPV cLIA (Competitive Luminex immunoassay) level of at least 20 mMU/mL.

Number of Participants Who Seroconvert to HPV 11.
Week 4 Postdose 3

Vaccine-induced anti-HPV 11 seroconversion following administration of a 3-dose regimen of GARDASIL® in females 9 to 23 years of age in Korea. Seroconversion for HPV 11 was defined as achieving an anti-HPV cLIA (Competitive Luminex immunoassay) level of at least 16 mMU/mL.

Number of Participants Who Seroconvert to HPV 16.
Week 4 Postdose 3

Vaccine-induced anti-HPV 16 seroconversion following administration of a 3-dose regimen of GARDASIL® in females 9 to 23 years of age in Korea. Seroconversion for HPV 16 was defined as achieving an anti-HPV cLIA (Competitive Luminex immunoassay) level of at least 20 mMU/mL.

Number of Participants Who Seroconvert to HPV 18.
Week 4 Postdose 3

Vaccine-induced anti-HPV 18 seroconversion following administration of a 3-dose regimen of GARDASIL® in females 9 to 23 years of age in Korea. Seroconversion for HPV 18 was defined as achieving an anti-HPV cLIA (Competitive Luminex immunoassay) level of at least 24 mMU/mL.

Incidence of the Composite Endpoint of Human Papillomavirus (HPV) 16/18-related Cervical Intraepithelial Neoplasia (CIN) 2 or Worse in the Base Study
Up to 4 years

This measure is defined to have occurred when, on a single cervical biopsy, endocervical curettage (ECC), loop electrosurgical excision procedure (LEEP), or conization specimen, there was HPV Vaccine consensus diagnosis of CIN 2 or worse up to 4 years after the first vaccination. For this measure, CIN 2 or worse includes CIN 2, CIN 3, adenocarcinoma in situ (AIS) or cervical cancer related to HPV 16 or 18.

Incidence of the Composite Endpoint of Human Papillomavirus (HPV) 16/18-related Cervical Intraepithelial Neoplasia (CIN) 2 or Worse in the Long-term Follow-up (LTFU) Study
Up to 14 years since Vaccine Dose 1

This measure is defined to have occurred when, on a single cervical biopsy, endocervical curettage (ECC), loop electrosurgical excision procedure (LEEP), or conization specimen, there was HPV Vaccine Nordic pathology panel (NPP) consensus diagnosis of CIN 2 or worse up to 14 years after the first vaccination. For this measure, CIN 2 or worse includes CIN 2, CIN 3, AIS or cervical cancer related to HPV 16 or 18. Only participants who received qHPV vaccine during the Base Study vaccination period and consented for inclusion in the LTFU are included. Because the objective was to demonstrate qHPV vaccine prophylactic efficacy at 14 years, Cohort 2 was not included in the analysis.

Incidence of the Composite Endpoint of HPV16/18-related CIN 2 or Worse in the Long-term Follow-up (LTFU) Study
up to 22 years post Vaccination Dose 1

This measure is defined to have occurred when, on a single cervical biopsy, ECC, LEEP, or conization specimen, there was HPV Vaccine NPP consensus diagnosis of CIN 2 or worse up to 22 years after the first vaccination. For this measure, CIN 2 or worse includes CIN 2, CIN 3, AIS or cervical cancer related to HPV 16 or 18. Only participants who received qHPV vaccine during the Base Study vaccination period and consented for inclusion in the LTFU will be included.

The octavalent HPV VLP vaccine, when administered in a 3-dose regimen, induces acceptable responses for specific HPV types at 4 weeks Post dose 3. Immune responses measured by an HPV competitive Luminex immunoassay.
4 weeks post dose 3 injection
Number of Participants Who Experience a Solicited Injection-Site Adverse Event (AE)
Up to approximately 6 months

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

Number of Participants Who Experience a Solicited Systemic AE
Up to approximately 6 months

Solicited systemic AEs include headache, fatigue, nausea, dizziness, muscle aches, joint pain.

Immediate Reactions Occurring Within 30 Minutes After Any Vaccination
Up to approximately 6 months

An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.

Number of Participants Who Experienced Unsolicited AEs
Up to approximately 7 months

An unsolicited AE is an AE that was not solicited using a vaccine report card (VRC) and that is communicated by a participant (or their legally acceptable representative, if applicable). Unsolicited AEs include serious and nonserious AEs.

Number of Participants Who Experienced a Serious Adverse Event
Up to approximately 18 months

Serious adverse events (SAEs) include adverse events that result in any of the following outcomes: death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, a persistent or significant incapacity or substantial disruption of the ability to conduct normal functions, or a congenital anomaly/birth defect.

Number of Participants Who Experienced a Medically-Attended AE
Up to approximately 18 months

AEs in which medical attention is received during an unscheduled, non-routine outpatient visit, such as an emergency department visit, office visit, or an urgent care visit with any medical personnel for any reason. Routine visits are not considered medically-attended adverse events (MAAEs). Examples of routine visits include physical examination, wellness visits, or vaccinations.

Number of Participants Who Experienced an Event of Clinical Interest
Up to approximately 18 months

Events of clinical interest (ECIs) are defined as an overdose of Sponsor's product, drug-induced liver injury events, or potential immune-mediated diseases (pIMDs).

Frequency of Participants With Adverse Events
1,61,66,181,186,211,330 days

Frequency of participants with Vaccine site reactions, Frequency of participants with Non Vaccine Adverse Events,

Number of Non Vaccine Adverse Events
1,61,66,181,186,211,330 days

the number of non vaccine adverse events

Secondary Endpoints

Percentage of Participants Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58
Up to approximately 1 month post vaccination (Up to approximately 7 months)
cLIA Geometric Mean Titers (GMTs) for HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58
Up to approximately 1 month post vaccination (Up to approximately 7 months)
Difference in Percentage of Participants Who Are Seropositive by cLIA to HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58 Between Prior 2vHPV Vaccine Recipients and HPV Vaccine-Naïve Participants
Up to approximately 1 month post vaccination (Up to approximately 7 months)
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposePREVENTION

Treatment Arms

ArmTypeDescription
Prior 2vHPV Vaccine Recipients Receiving V503EXPERIMENTALParticipants will receive V503 at Day 1, Month 2, and Month 6
Prior 2vHPV Vaccine Recipients Receiving PlaceboPLACEBO_COMPARATORParticipants will receive Placebo at Day 1, Month 2, and Month 6
HPV Vaccine-Naïve Participants Receiving V503EXPERIMENTALParticipants will receive V503 at Day 1, Month 2, and Month 6
HPV Vaccine-Naïve Participants Receiving PlaceboPLACEBO_COMPARATORParticipants will receive Placebo at Day 1, Month 2, and Month 6
9 to 14 Years Old: Day 1 and Month 6EXPERIMENTALChinese females 9 to 14 years old will receive a 0.5 mL intramuscular (IM) injection of 9-valent HPV (9vHPV) vaccine on Day 1 and Month 6
9 to 14 Years Old: Day 1 and Month 12EXPERIMENTALChinese females 9 to 14 years old will receive a 0.5 mL iIM injection of 9-valent HPV (9vHPV) vaccine on Day 1 and Month 12
20 to 26 Years Old: Day 1, Month 2 and Month 6EXPERIMENTALChinese females 20 to 26 years old will receive a 0.5 mL IM injection of 9-valent HPV (9vHPV) vaccine on Day 1, Month 2 and Month 6
9 to 19 Years Old: Day 1, Months 2 and 6EXPERIMENTALChinese males 9 to 19 years old will receive a 0.5 mL intramuscular (IM) injection of 9-valent HPV (9vHPV) vaccine on Day 1, Month 2 and Month 6
9 to 14 Years Old: Day 1, and Month 6EXPERIMENTALChinese males 9 to 14 years old will receive a 0.5 mL IM injection of 9vHPV vaccine on Day 1 and Month 6
Concomitant GroupEXPERIMENTALParticipants will receive Dose 1 of 9-valent human papillomavirus \[Types 6, 11, 16, 18, 31, 33, 45, 52, 58\] (9vHPV) vaccine administered into the left arm as an intramuscular (IM) injection, AND Dose 1 of the messenger ribonucleic acid (mRNA)-1273 vaccine administered into the right arm as an IM injection on Day 1; participants will then receive Dose 2 of the mRNA-1273 vaccine administered into the right arm as an IM injection at Month 1 and Dose 2 of the 9vHPV vaccine administered into the left arm as an IM injection at Month 6.
Non-concomitant GroupEXPERIMENTALParticipants will receive Dose 1 of the mRNA-1273 vaccine administered into the right arm as an IM injection on Day 1 and Dose 2 of the mRNA-1273 vaccine administered into the right arm as an IM injection at Month 1. Participants will then receive Dose 1 of the 9vHPV vaccine administered into the left arm as an IM injection at Month 2 and Dose 2 of the 9vHPV vaccine administered into the left arm as an IM injection at Month 8.
V503EXPERIMENTALParticipants will receive a single 0.5 mL intramuscular (IM) injection of V503 at Day 1, Month 2, and Month 6.
PlaceboPLACEBO_COMPARATORParticipants will receive a single 0.5 mL IM injection of placebo at Day 1, Month 2, and Month 6.
3-dose in 9 to 15 year old boysEXPERIMENTAL9 to 15 year old boys will receive a 3-dose regimen of 9vHPV vaccine (Day 1, Month 2 and Month 6).
2-dose in 9 to 14 year old boysEXPERIMENTAL9 to 14 year old boys receive a 2-dose regimen of 9vHPV vaccine (Day 1 and Month 6).
2-dose in 9 to 14 year old girlsEXPERIMENTAL9 to 14 year old girls receive a 2-dose regimen of 9vHPV vaccine (Day 1 and Month 6).
Cohort 0: 1 Dose of 9vHPV Vaccine (previous 1-dose recipients)EXPERIMENTAL10 to 15 year old girls and boys (who previously received 1 dose of 9vHPV vaccine) receive a second dose of 9vHPV vaccine at Day 1.
Cohort 1: 2 Doses of 9vHPV Vaccine Given 12 Months ApartEXPERIMENTAL9 to 14 year old girls and boys receive a 2-dose regimen of 9vHPV vaccine at Day 1 and Month 12.
Cohort 2: 2 Doses of 9vHPV Vaccine Given 24 Months ApartEXPERIMENTAL9 to 13 year old girls and boys receive a 2-dose regimen of 9vHPV vaccine at Day 1 and Months 24.
Cohort 3: 2 Doses of 9vHPV Vaccine Given 36 Months ApartEXPERIMENTAL9 to 12 year old girls and boys receive a 2-dose regimen of 9vHPV vaccine at Day 1 and Month 36.
Cohort 4: 2 Doses of 9vHPV Vaccine Given 60 Months ApartEXPERIMENTAL9 to 10 year old girls and boys receive a 2-dose regimen of 9vHPV vaccine at Day 1 and Month 60.
Cohort 5: 3 Doses of 9vHPV Vaccine Given Over a 6-Month PeriodACTIVE_COMPARATOR16 to 26 year old young women receive 3 dose regimen of 9vHPV vaccine at Day 1, Month 2 and Month 6.
V503 → Open Label V503 Extension StudyEXPERIMENTALParticipants from V503 arm of the base study who do not complete the 3-dose series receive 1 or 2 doses of V503, on Day 1, or Day 1 and Month 4 of the open label extension study.
Placebo → Open Label V503 Extension StudyEXPERIMENTALParticipants from the placebo arm of the base study receive 3 doses of V503 on Day 1, Month 2 and Month 6 of the open label extension study.
9vHPV vaccineEXPERIMENTALSingle 0.5-mL intramuscular injection at Day 1, Month 2, and Month 6
GardasilACTIVE_COMPARATORSingle 0.5-mL intramuscular injection at Day 1, Month 2, and Month 6
Adult Women 27- to 45-years OldEXPERIMENTALAdult women 27- to 45-years old will receive V503 vaccination, 0.5 mL in a 3-dose regimen administered on Day 1, Month 2, and Month 6.
Young Adult Women 16- to 26-years OldACTIVE_COMPARATORYoung adult women 16- to 26-years old will receive V503 vaccination, 0.5 mL in a 3-dose regimen administered on Day 1, Month 2, and Month 6.
Girls 9 to 14 Years V503 at Months 0 and 6EXPERIMENTALGirls aged 9 to 14 years received a 2-dose regimen of V503 0.5 mL intramuscular (IM) injection at Months 0 and 6. An additional dose of V503 0.5 mL IM was administered at Month 36.
Boys 9 to 14 Years V503 at Months 0 and 6EXPERIMENTALBoys aged 9 to 14 years received a 2-dose regimen of V503 0.5 mL IM injection at Months 0 and 6. An additional dose of V503 0.5 mL IM was administered at Month 36.
Girls and Boys 9 to 14 Years V503 at Months 0 and 12EXPERIMENTALGirls and boys aged 9 to 14 years received a 2-dose regimen of V503 0.5 mL IM injection at Months 0 and 12. An additional dose of V503 0.5 mL IM was administered at Month 36.
Girls 9 to 14 Years V503 at Months 0, 2, and 6EXPERIMENTALGirls aged 9 to 14 years received a 3-dose regimen of V503 0.5 mL IM injection at Months 0, 2, and 6. An additional dose of V503 0.5 mL IM was administered at Month 36 for a subset of participants.
Young Women 16 to 26 Years V503 at Months 0, 2, and 6ACTIVE_COMPARATORYoung Women aged 16 to 26 years received a 3-dose regimen of V503 0.5 mL IM injection at Months 0, 2, and 6. An additional dose of V503 0.5 mL IM was administered at Month 36 for a subset of participants.
FemalesACTIVE_COMPARATORHealthy females 16 to 26 years of age received 9vHPV vaccine 0.5 mL intramuscular injection on Day 1, Month 2, and Month 6
Heterosexual MalesEXPERIMENTALHealthy heterosexual males 16 to 26 years of age received 9vHPV 0.5 mL intramuscular injection on Day 1, Month 2, and Month 6
Men who have Sex with MenEXPERIMENTALHealthy MSM 16 to 26 years of age received 9vHPV 0.5 mL intramuscular injection on Day 1, Month 2, and Month 6
All EnrolledEXPERIMENTAL9-valent human papillomavirus (9vHPV) L1 VLP vaccine (V503), 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6.
Concomitant VaccinationEXPERIMENTALV503 given as a 0.5 mL intramuscular injection in the deltoid muscle of the non-dominant arm on Day 1, Month 2, and Month 6, and Repevax™ given as a 0.5 mL intramuscular injection in the deltoid muscle of the dominant arm on Day 1
Non-concomitant VaccinationEXPERIMENTALV503 given as a 0.5 mL intramuscular injection in the deltoid muscle of the non-dominant arm on Day 1, Month 2, and Month 6, and Repevax™ given as a 0.5 mL intramuscular injection in the deltoid muscle of the dominant arm at Month 1
9- to 15-Year-Old Females (Lot 1)EXPERIMENTAL9-valent human papillomavirus (9vHPV) L1 VLP vaccine, 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6. Vaccine dose administered is obtained from manufacturing Lot 1.
9- to 15-Year-Old Females (Lot 2)EXPERIMENTAL9-valent human papillomavirus (9vHPV) L1 VLP vaccine, 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6. Vaccine dose administered is obtained from manufacturing Lot 2.
9- to 15-Year-Old Females (Lot 3)EXPERIMENTAL9-valent human papillomavirus (9vHPV) L1 VLP vaccine, 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6. Vaccine dose administered is obtained from manufacturing Lot 3.
9- to 15-Year-Old Males (Lot 1)EXPERIMENTAL9-valent human papillomavirus (9vHPV) L1 VLP vaccine, 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6. Vaccine dose administered is obtained from manufacturing Lot 1.
16- to 26-Year-Old Females (Lot 1)EXPERIMENTAL9-valent human papillomavirus (9vHPV) L1 VLP vaccine, 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6. Vaccine dose administered is obtained from manufacturing Lot 1.
Low-dose V503EXPERIMENTALV503 (9-Valent Human Papillomavirus \[HPV\] Vaccine) low-dose 0.5 mL injection in a 3-dose regimen in the base study.
Mid-dose V503EXPERIMENTALV503 (9-Valent HPV Vaccine) mid-dose 0.5 mL injection in a 3-dose regimen in the base study. A subset of participants (Cohort 1) received a fourth V503 mid-dose vaccination in the extension study.
High-dose V503EXPERIMENTALV503 (9-Valent HPV Vaccine) high-dose 0.5 mL injection in a 3-dose regimen in the base study.
Gardasil™EXPERIMENTALGardasil™ 3 dose regimen
Quadrivalent Human Papillomavirus (HPV) VaccineEXPERIMENTALThe Vaccination Period for the base study encompassed Day 1 through Month 7, during which time study subjects in Group 1 were vaccinated (at Day 1, Month 2 and Month 6) with the Quadrivalent HPV vaccine.
1ACTIVE_COMPARATORGardasil
2EXPERIMENTALHPV VLP vaccine -Dose regimen 1
3EXPERIMENTALHPV VLP vaccine -Dose regimen 2
4EXPERIMENTALHPV VLP vaccine -Dose regimen 3
GARDASIL®9 (G9)ACTIVE_COMPARATORParticipants will receive vaccinations with G9.
V540BEXPERIMENTALParticipants will receive vaccinations with V540B.

Interventions

NameTypeDescription
V503BIOLOGICALV503 (9-vHPV vaccine \[Types 6, 11, 16, 18, 31, 33, 45, 52, and 58\]) administered as a 0.5-mL intramuscular (IM) injection on Day 1, Month 2, and Month 6
PlaceboBIOLOGICALSaline administered as a 0.5-mL IM injection on Day 1, Month 2, and Month 6
9vHPV vaccineBIOLOGICALA 9-valent HPV vaccine (Types 6, 11, 16, 18, 31, 33, 45, 52, and 58) will be administered as a 0.5 mL IM injection.
mRNA-1273 VaccineBIOLOGICALmRNA-1273 50 mcg dose administered as a 0.25-mL IM injection
Placebo (Saline for Injection)OTHER0.9% sodium chloride given as a 0.5-mL intramuscular injection
GardasilDRUGqHPV \[Types 6, 11, 16, and 18\] L1 virus-like particle vaccine
V503 (9-valent Human Papillomavirus [HPV] L1 Virus-Like Particle [VLP] vaccine)BIOLOGICALV503, a 9-valent HPV (Types 6, 11, 16, 18, 31, 33, 45, 52, 58) administered as a 0.5-mL intramuscular injection
V503 VaccineBIOLOGICALV503 (Multivalent HPV L1 VLP vaccine) given as a 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6
REPEVAX™ (Concomitant)BIOLOGICALREPEVAX™ given as a single 0.5 mL intramuscular injection at Day 1
REPEVAX™ (Non-concomitant)BIOLOGICALREPEVAX™ given as a single 0.5 mL intramuscular injection at Month 1
Placebo to V503BIOLOGICALPlacebo to V503 (saline) given as a 0.5 mL intramuscular injection at Day 1, Month 2, and Month 6 of the Base Study
Comparator: Menactra™ (Concomitant)BIOLOGICALMenactra™ given as a single 0.5 mL intramuscular injection in the deltoid muscle of the dominant arm on Day 1.
Comparator: Adacel™ (Concomitant)BIOLOGICALAdacel™ given as a single 0.5 mL intramuscular injection in the deltoid muscle of the dominant arm on Day 1.
Comparator: Menactra™ (Non-Concomitant)BIOLOGICALMenactra™ given as a single 0.5 mL intramuscular injection in the deltoid muscle of the dominant arm at Month 1.
Comparator: Adacel™ (Non-concomitant)BIOLOGICALAdacel™ given as a single 0.5 mL intramuscular injection in the deltoid muscle of the dominant arm at Month 1.
Comparator: GARDASILBIOLOGICALGARDASIL (quadrivalent HPV \[Types 6, 11, 16, and 18\] L1 virus-like particle vaccine), 0.5 mL injection in 3 dose regimen
Experimental: V503BIOLOGICALV503 (9-valent HPV \[Types 6, 11, 16, 18, 31, 33, 45, 52, and 58\] L1 virus-like particle vaccine), 0.5 mL injection in 3 dose regimen (and a fourth injection for Cohort 1 only).
Gardasil™BIOLOGICALGardasil™ 3 dose regimen (Day 1, Month 2 and Month 6)
Gardasil, human papillomavirus (type 6, 11, 16, 18) recombinant vaccineBIOLOGICALA 0.5 mL intramuscular injection in the deltoid muscle at Day 1, Month 2, and Month 6 in the Base Study.
Matching PlaceboBIOLOGICALA placebo 0.5 mL intramuscular injection in the deltoid muscle at Day 1, Month 2, and Month 6 in the Base Study.
Comparator: octavalent HPV Vaccine - dose formulation 1BIOLOGICAL0.5 mL octavalent HPV vaccine - intramuscular injection administered at Day 1, Month 2 and Month 6
Comparator: octavalent HPV Vaccine - dose formulation 2BIOLOGICAL0.5 mL octavalent HPV vaccine - intramuscular injection administered at Day 1, Month 2 and Month 6
Comparator: octavalent HPV Vaccine - dose formulation 3BIOLOGICAL0.5 mL octavalent HPV vaccine - intramuscular injection administered at Day 1, Month 2 and Month 6
GARDASIL®9 (G9)BIOLOGICALSuspension administered via intramuscular (IM) injection
V540BBIOLOGICALExperimental vaccine and adjuvant administered via IM injection
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Eligibility Criteria

Age Range10 Years to 45 Years
SexFEMALE
Healthy VolunteersYes

Inclusion Criteria: The main inclusion criteria include but are not limited to the following: * For participants to be enrolled in prior 2vHPV (bivalent human papillomavirus \[HPV\] vaccine) vaccine groups: has received at least one dose of any one of the three currently marketed 2vHPV vaccines, w...

Countries:ChinaUnited StatesJapanColombiaMexicoPolandSouth AfricaTaiwanBelgiumBrazilCzechiaFranceGermanyIsraelItalyPeruSouth KoreaSpainThailandVietnamAustriaFinlandNetherlands
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Competitive Landscape -Cervical Cancer 64 trials

Recent Changes (Last 90 Days)

LOWSep 10, 2026NCT06623409lastUpdatePostDate: changed
LOWSep 10, 2026NCT06623409lastUpdatePostDate: changed
LOWSep 4, 2026NCT07785843startDate: changed
LOWSep 4, 2026NCT07785843startDate: changed
LOWSep 2, 2026NCT06623409Status: ACTIVE_NOT_RECRUITING → RECRUITING
LOWSep 2, 2026NCT06623409Status: ACTIVE_NOT_RECRUITING → RECRUITING
LOWSep 2, 2026NCT06623409Status: ACTIVE_NOT_RECRUITING → RECRUITING
LOWSep 1, 2026NCT03998254lastUpdatePostDate: changed
MEDIUMSep 1, 2026NCT06623409primaryCompletionDate: changed
LOWSep 1, 2026NCT03998254lastUpdatePostDate: changed
MEDIUMSep 1, 2026NCT06623409primaryCompletionDate: changed
LOWAug 25, 2026NCT07785843NEW_TRIAL: changed
LOWAug 25, 2026NCT07785843NEW_TRIAL: changed
MEDIUMJul 12, 2026NCT04635423TRIAL_REMOVED: changed
MEDIUMJul 12, 2026NCT04635423TRIAL_REMOVED: changed
MEDIUMJul 12, 2026NCT04635423TRIAL_REMOVED: changed
MEDIUMJul 12, 2026NCT04635423TRIAL_REMOVED: changed

Frequently asked questions about Gardasil 9

What is GARDASIL used for?

GARDASIL is a vaccine used to prevent human papillomavirus (HPV) infections and related conditions, including cervical cancer, vulvar cancer, vaginal cancer, and genital warts. It is also studied in healthy individuals for safety and immunogenicity. The vaccine is developed by Merck & Company, Inc. and is in Phase 3 clinical development.

What does GARDASIL target?

GARDASIL is a vaccine that targets human papillomavirus (HPV) types to prevent infections and associated cancers. It is designed to elicit an immune response against HPV, thereby reducing the risk of cervical cancer, vulvar cancer, vaginal cancer, and genital warts. The vaccine is being studied in clinical trials for its efficacy and safety.

Who makes GARDASIL?

GARDASIL is developed by Merck & Company, Inc., a pharmaceutical company traded on the New York Stock Exchange under the ticker symbol MRK. The vaccine is being studied in clinical trials for the prevention of HPV infections and related cancers.

What phase is GARDASIL in?

GARDASIL is in Phase 3 clinical development. It is being studied in a Phase 3 trial (NCT00157950) for papillomavirus infections and a Phase 3 trial (NCT00543543) for cervical cancer and other HPV-related conditions. The vaccine is investigational and not yet approved.

What clinical trials is GARDASIL in?

GARDASIL is being studied in several clinical trials, including NCT00157950 (Phase 3, completed) for papillomavirus infections, NCT00260039 (Phase 2, completed) for HPV and cervical cancer, NCT00543543 (Phase 3, completed) for cervical cancer and genital warts, and NCT06623409 (Phase 1, active) for safety in healthy adults.

Is GARDASIL the same as GARDASIL 9?

GARDASIL is also known as GARDASIL 9, GARDASIL9, and GARDASIL 9 (G9). These names refer to the same vaccine product developed by Merck & Company, Inc. for the prevention of HPV infections and related cancers.