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All privileges reserved. Neither of the parties endorse or suggest any commercial products, services, or equipment.. Bivalent HPV vaccine has cross-protecting effect, but could wane as time passes By Sarah Man, medwireNews Reporter The bivalent vaccine for human being papillomavirus types 16 and 18 is apparently even more efficacious against outcomes connected with nonvaccine types 31, 33, and 45 than its quadrivalent counterpart, show outcomes of a systematic review and meta-analysis. Nevertheless, the efficacy of the bivalent vaccine against persistent infections and cervical intraepithelial neoplasia 2+ disease connected with HPV 31, 33, and 45 seemed to decrease as time passes, suggesting a ‘waning of cross-protection,’ say the experts.