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Cervarix: what safety margin did regulators accept?

human papillomavirus bivalent (types 16, 18) vaccine, recombinant, AS04-adjuvanted · HPV 16/18 L1 VLPs; TLR4 (AS04 adjuvant)
Safety margin at NOAEL
No adverse systemic effects at dosages up to more than 50-fold the human dose (body weight basis)
“No other vaccine- or adjuvant-associated adverse systemic effect was noted, even though the studied dosages exceeded the human dosage (up to more than 50-fold factor on a body weight basis), as well as the immunization schedule.”
✓ VerifiedFDA toxicology review, p. 10Source ↗
NOAEL / key findings
No NOAEL stated; vaccine and AS04 well tolerated with no consistent systemic findings in rabbits
“The HPV-16 /18 L1 VLP AS04 vaccine and the AS04 adjuvant were well tolerated. The organ-weight data, macroscopic pathology evaluation, and evaluation of systemic effects showed no consistent treatment-related findings.”
✓ VerifiedEMA assessment report, p. 11Source ↗

Same question, other vaccines

Arexvy

respiratory syncytial virus vaccine, adjuvanted (AS01E) · RSV preF3; TLR4 (AS01E adjuvant)
Rabbit developmental toxicity study: full antigen dose ≈20x the human dose by body weight (3 kg rabbit, 60 kg human)

Fendrix

hepatitis B vaccine (rDNA), AS04C-adjuvanted · HBsAg VLPs; TLR4 (AS04C adjuvant)
Safety pharmacology only: no cardiorespiratory effects up to 63-fold the human dose (bodyweight basis); no repeat-dose margin stated

Gardasil

human papillomavirus quadrivalent (types 6, 11, 16, 18) vaccine, recombinant · HPV 6/11/16/18 L1 VLPs
Mouse repeat-dose: ~1450-fold the projected human dose on a body weight basis

Gardasil 9

human papillomavirus 9-valent vaccine, recombinant · HPV 9-valent L1 VLPs
Rat reproduction studies: up to 240 and 160 times the human dose (mg/kg) without fertility or fetal effects

Heplisav-B

hepatitis B vaccine (recombinant), adjuvanted · HBsAg; TLR9 (CpG 1018 adjuvant)
Monkey NOAEL 0.5 mg/kg CpG adjuvant, >10-fold the clinical mg/kg dose, for systemic immunostimulation

Mosquirix

RTS,S/AS01 malaria vaccine · P. falciparum CSP-HBsAg (RTS,S) VLPs; TLR4 (AS01 adjuvant)
Rabbit study used RTS,S/AS01B with twice the antigen and adjuvant content of Mosquirix; no numeric margin stated

Nuvaxovid

COVID-19 vaccine, recombinant spike protein nanoparticle, Matrix-M-adjuvanted · SARS-CoV-2 spike (nanoparticle)
Rat DART study: dose exceeds the human dose 40-fold on a weight-adjusted basis

PreHevbrio

hepatitis B vaccine (recombinant), 3-antigen · HBsAg S/pre-S1/pre-S2 VLPs
DART: rats given a dose equivalent to the adult human dose; no numeric multiple stated

Shingrix

zoster vaccine recombinant, AS01B-adjuvanted · VZV glycoprotein E; TLR4 (AS01B adjuvant)
Full human dose given to rabbits, with more doses than clinically; no numeric multiple stated

Cyfendus

anthrax vaccine adsorbed, adjuvanted · B. anthracis PA; TLR9 (CpG 7909 adjuvant)
Not stated in public reviews

Flublok

influenza vaccine, recombinant hemagglutinin · Influenza HA
Not stated in public reviews

HBVaxPro

hepatitis B vaccine (rDNA) · HBsAg VLPs
Not stated in public reviews

Summary across all 13 vaccines →