The 9-valent Gardasil 9 HPV vaccine was FDA approved in December. Read more here. ACOG yesterday endorsed its use in place of the 4-valent vaccine. The new vaccine offers protection against not only HPV 6, 11, 16, and 18, but now also 31, 33, 45, 52, and 58. These additional types are associated with cervical, vaginal, and vulvar cancers and the vaccine may also impact anal cancer.