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Gardasil 9: what safety margin did regulators accept?

human papillomavirus 9-valent vaccine, recombinant · HPV 9-valent L1 VLPs
Safety margin at NOAEL
Rat reproduction studies: up to 240 and 160 times the human dose (mg/kg) without fertility or fetal effects
“Reproduction studies have been performed in rats at doses up to 240 and 160 times the human dose on mg/kg basis and revealed no evidence of impaired fertility or harm to the fetus due to V503 vaccine.”
✓ VerifiedFDA pharmacology/toxicology review, p. 43Source ↗
NOAEL / key findings
No NOAEL stated; only immune-response and injection-site effects in rats
“The only treatment-related effects were indicative of the immune response and injection site reactions.”
✓ VerifiedEMA assessment report, p. 24Source ↗

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)

Cervarix

human papillomavirus bivalent (types 16, 18) vaccine, recombinant, AS04-adjuvanted · HPV 16/18 L1 VLPs; TLR4 (AS04 adjuvant)
No adverse systemic effects at dosages up to more than 50-fold the human dose (body weight basis)

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

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 →