What is the difference between Gardasil 9 and Gardasil 4?

Gardasil 4 protects against HPV subtypes 6, 11, 16, and 18. Gardasil 9 protects against those same 4 subtypes plus 5 additional ones: HPV 31, 33, 45, 52, and 58, offering broader coverage.

How effective is Gardasil 9 against cervical cancer compared to Gardasil 4?

Gardasil 4 provides approximately 70% protection against cervical cancer, while Gardasil 9 provides approximately 90% protection — a significant improvement in coverage.

Does Gardasil protect men against penile cancer?

Current evidence shows that Gardasil vaccination does provide HPV protection in men with some benefit against penile cancer, though the cost-effectiveness in males is considered lower than in females based on available literature.

How effective is Gardasil 4 against genital warts?

Gardasil 4 has been reported to provide approximately 77% protection against genital warts. Gardasil 9 is expected to offer even greater protection, though updated efficacy data specific to genital warts for Gardasil 9 is still pending.

Do I get any protection from the first dose of Gardasil before completing all 3 injections?

Yes. A study from Spain in 2017 showed that a single dose of Gardasil 4 provided approximately 61% protection. However, it is unclear how long this partial protection lasts, so completing all 3 doses at months 0, 2, and 6 is still recommended.

Can I still benefit from Gardasil vaccination if I have already had an HPV infection?

Yes. A large study of 18,174 women published in 2009 confirmed that Gardasil still provides meaningful protection against other HPV subtypes even in patients who have had a prior HPV infection.

Is Gardasil 9 worth the extra cost compared to Gardasil 4?

Gardasil 9 is more expensive than Gardasil 4 but offers broader protection against 9 HPV subtypes versus 4, and higher efficacy against cervical cancer (90% vs 70%). Whether it is worth the additional cost depends on individual circumstances — discuss with your urologist or doctor.

Gardasil 9 vs Gardasil 4: Which HPV Vaccine?

Last updated: May 18, 2026

Soarawee Weerasopone, Urologist

Bangkok hospital Headquarter, Bangkok

Samitivej Sriracha hospital, Chonburi

LINE Contact

When lots of patients in my office who asked about what the differences between these HPV vaccination, Gardasil 9 and Gardasil 4. In this article it will answer for all those questions in the details.

Several gentlemen have questions on Gardasil 9 vaccination.

Gardasil 9 FAQ

Which HPV subtypes are covered?

Gardasil 4: covers HPV 6, 11, 16, and 18.
Gardasil 9: covers HPV 6, 11, 16, 18, 31, 33, 45, 53, and 58 — 5 additional high-risk strains.

Protection rate against cervical cancer?

Gardasil 4: approximately 70% protection.
Gardasil 9: approximately 90% protection.

Gardasil 9 can protect men against penile cancer and genital warts.

Protection against genital warts?

Gardasil 4: approximately 77% protection.
Gardasil 9: expected to provide higher protection, though updated efficacy data for genital warts is still pending.

Can partial vaccination (1 jab) provide protection?

Yes. A 2017 Spanish study showed 61% protection after just 1 Gardasil-4 injection, though the duration of this partial protection is unclear. A complete 3-dose course (at 0, 2, and 6 months) is still recommended for maximum protection.

Can previously HPV-infected patients still benefit from vaccination?

Yes. A 2009 study of 18,174 women showed Gardasil still provides significant protection even in those with prior HPV infection, as vaccination protects against strains not previously encountered.

Patients still get benefit from Gardasil 9 even with previous HPV infection history.

Gardasil 9 is a bit more costly than Gardasil 4, but offers significantly broader protection. Any question, talk to your trusted urologist, or it would be my honor if you text me. Take care!

You can visit my official website here.

Frequently Asked Questions

Q1: What is the main difference between Gardasil 9 and Gardasil 4?

Gardasil 9 covers 9 HPV strains (6, 11, 16, 18, 31, 33, 45, 53, 58) while Gardasil 4 covers only 4 strains (6, 11, 16, 18). The 5 additional strains in Gardasil 9 are high-risk cancer-causing types. This broader coverage translates into approximately 90% protection against cervical cancer with Gardasil 9 versus approximately 70% with Gardasil 4, making Gardasil 9 the superior choice where available.

Q2: Should men get the Gardasil HPV vaccination?

Yes. While HPV vaccination is most studied and cost-effective in females, men can still benefit significantly. HPV vaccination in men reduces the risk of penile cancer, anal cancer, oropharyngeal cancer, and genital warts. HPV strains 6 and 11 (covered by both Gardasil 4 and 9) cause approximately 90% of genital warts cases. Vaccination before first sexual exposure offers the highest protection.

Q3: How many doses of Gardasil are needed?

A complete HPV vaccination course consists of 3 injections given at 0, 2, and 6 months. For individuals aged 9-14 who start the series early, a 2-dose schedule may be sufficient. Even a single dose provides some protection (approximately 61% based on Gardasil-4 data), but completing the full course is strongly recommended for maximum and most durable protection.

Q4: Is it worth getting Gardasil 9 if I have already been infected with HPV?

Yes. Even if you have had a prior HPV infection, vaccination still provides significant benefit by protecting against HPV strains you have not yet been exposed to. A landmark 2009 study of over 18,000 women confirmed that Gardasil provides meaningful protection even in individuals with prior HPV infection. Your urologist can advise whether vaccination is appropriate based on your specific HPV history.

Q5: Is Gardasil 9 worth the higher cost compared to Gardasil 4?

In most clinical settings, yes. The additional 20% improvement in cervical cancer protection (90% vs 70%) and coverage of 5 extra high-risk HPV strains make Gardasil 9 the preferred choice from a medical standpoint. While Gardasil 9 is more expensive, the broader protection against cancer-causing strains represents significant long-term health value. Your doctor can help you make an informed decision based on your individual risk profile and budget.

If you would like to discuss HPV vaccination or sexual health screening, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Book a Consultation.

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.

Medically written & reviewed by: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters. International Fellow: Baylor College of Medicine (USA) · Juntendo University (Japan) · Chang Gung Memorial Hospital (Taiwan).

Dr. Soarawee Weerasopone

Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (Da Vinci System), and Kidney Stone treatment. He has completed international fellowships at Baylor College of Medicine (USA), Juntendo University Hospital (Japan), and Chang Gung Memorial Hospital (Taiwan). All medical content on this site is written and reviewed by Dr. Soarawee based on his clinical experience and international training.