Gardasil and Gardasil 9 are both HPV vaccines, but they cover different numbers of strains. The original Gardasil protected against four HPV types (6, 11, 16, 18). Gardasil 9 adds five more cancer-causing types (31, 33, 45, 52, 58), widening cancer protection. Since 2016, only Gardasil 9 is distributed in the US ACS.
of HPV-attributable cancers
| Item | Value |
|---|---|
| Currently infected | ~42 million |
| New infections / yr | ~13 million |
| Clear within 2 years | ~90% |
| Vaccine prevents | >90% — of HPV-attributable cancers |
What each vaccine actually means
HPV is the most common STI, and not all strains do the same thing. Low-risk types like 6 and 11 cause genital warts; high-risk types like 16 and 18 drive cancers. The warts strains and the cancer strains are separate problems people often blur together CDC. An HPV vaccine works by training your immune system to recognize specific strains before you're ever exposed — so the number of strains a shot covers directly shapes how much disease it can head off.
The original Gardasil was quadrivalent: it covered four types — 6 and 11 (the warts strains) plus 16 and 18 (two of the most dangerous cancer strains). An older vaccine called Cervarix was bivalent, covering only 16 and 18. Gardasil 9 is nine-valent. It keeps all four of the original types and adds five more high-risk cancer strains: 31, 33, 45, 52, and 58 CDC Pink Book.
Here's the practical bottom line: the HPV vaccine used in the United States today is Gardasil 9. The earlier Gardasil and Cervarix are no longer distributed here, so if you're being vaccinated now, you're getting the nine-valent version. The comparison matters mostly for understanding what protection you have if you were vaccinated years ago with the older shot.
The key differences between Gardasil and Gardasil 9
The headline difference is broader cancer coverage. Types 16 and 18 — covered by both vaccines — cause about 66% of cervical cancers. The five extra high-risk types in Gardasil 9 (31, 33, 45, 52, 58) cause roughly another 15% NCI. Both vaccines cover types 6 and 11, which cause more than 90% of genital warts, so warts protection is the same.
That extra coverage translates into real cancer prevention. Given at the recommended ages, HPV vaccination can prevent more than 90% of HPV-caused cancers, and Gardasil 9 is about 98% effective against the precancers caused by HPV 16 and 18. The cancer toll reaches well beyond the cervix: HPV causes virtually all cervical cancer, over 90% of anal cancers, and about 70% of throat (oropharyngeal) cancers. Oropharyngeal cancer has now overtaken cervical as the most common HPV-related cancer in the US — a shift worth keeping in mind when you think about why broader strain coverage is the point of the upgrade. You can read more on how hpv leading to other kinds of cancers, but vaccine does help to reduce cervical cancer.
One thing that hasn't changed between versions: the vaccine is prevention, not treatment. Gardasil 9 protects against future infection with the strains it covers, but it won't clear an HPV infection or warts you already have. And no matter which vaccine you received, vaccinated people still need cervical screening — the shot doesn't cover every cancer-causing strain.
Gardasil vs Gardasil 9 side by side
| Feature | Gardasil (quadrivalent) | Gardasil 9 (nine-valent) |
|---|---|---|
| HPV types covered | 6, 11, 16, 18 | 6, 11, 16, 18, 31, 33, 45, 52, 58 |
| Genital warts strains (6, 11) | Yes | Yes |
| Main cancer strains (16, 18) | Yes | Yes |
| Extra high-risk strains (31, 33, 45, 52, 58) | No | Yes |
| Cervical cancers attributable to covered strains | About 66% (from 16 & 18) | About 66% plus another ~15% |
| Available in the US now | No (discontinued) | Yes — the only HPV vaccine distributed since 2016 |
Which one applies to you and how to choose
For anyone getting vaccinated today, there's no choice to make — Gardasil 9 is what's available, and it's the version with the broadest protection. The real question for most readers is what they already received.
- If you were vaccinated before 2016, you likely got the original Gardasil or Cervarix. You're protected against 16 and 18, which is the bulk of cervical cancer risk, but not the five additional high-risk strains.
- If you were vaccinated more recently, you almost certainly received Gardasil 9 and have the wider coverage.
- If you're not sure which you got, your immunization record or your clinician can tell you — but for most fully vaccinated adults, the older shot already covers the highest-risk strains, so re-vaccination decisions are individual and worth discussing with a provider.
- Regardless of which vaccine you had, cervical screening stays on the schedule because no HPV vaccine covers every cancer-causing type.
The reassuring context: in most cases — about 9 out of 10 — HPV clears on its own within two years without causing health problems. The vaccine matters most for the infections that persist, because persistent high-risk HPV is what can progress to cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancers over time.
The practical next step
Vaccination is one of three layers of HPV protection — the others are condoms (partial only, since HPV can infect skin a condom doesn't cover) and cervical screening. If you've had the vaccine, screening is still the tool that catches precancer early.
Cervical screening guidance has shifted toward HPV testing. Newer guidance starts screening at 25 with a primary HPV test every 5 years (preferred) rather than a yearly Pap, because most HPV clears within two years and HPV testing catches more real precancer with fewer visits ACS. The longstanding USPSTF schedule (2018, Grade A) offers cytology every 3 years for ages 21–29, and from 30–65 either cytology every 3 years, high-risk HPV testing alone every 5 years, or co-testing every 5 years USPSTF.
A common point of confusion: HPV usually isn't part of a general STD panel. There's no routine HPV test for men, and for women HPV is detected through cervical screening, not a standard panel — so does hpv show up on an std test? is worth reading before you assume a checkup screened you for it. If you do need broader STI testing, you can get tested, and if you're timing a test around a recent exposure, here's when to test after exposure.
When to see a clinician
See a clinician if you notice a new bump or group of bumps in the genital area, since genital warts usually appear this way and a provider can confirm and offer treatment. Options include clinic-applied cryotherapy (freezing with liquid nitrogen) or prescription home creams used over weeks; none is clearly best, and because treatment removes warts but not the virus, they can recur CDC Tx Guidelines. Also see a clinician to discuss vaccination if you haven't been vaccinated, to confirm which vaccine you received, or to set up cervical screening if you're due. Anyone planning a pregnancy with a history of HPV can read up on hpv in pregnancy for what to expect.