Table 2.

Three main assay types used in monitoring HPV vaccine immunogenicity and their advantages and disadvantages.

	Advantages	Disadvantages
Neutralization assay	•Measures function closest to presumed mechanism of protection •All immunoglobulin classes are detected	•Requires pseudovirions for each type •Requires cell culture and time for cells to grow •Time-consuming and labor intensive •Limited ability to multiplex •Higher coefficients of variation
Competitive immunoassay	•Detects neutralizing antibodies •Easily multiplexed with bead arrays (e.g. Luminex) •Rapid, high throughput •All immunoglobulin classes detected	•Only a subset of total neutralizing antibodies detected •Requires type-specific neutralizing monoclonal antibodies •Mulitplexing requires compromise between selecting dominant epitope and retaining type specificity
Enzyme linked immunosorbent assay	•Fast, high throughput •Familiar assay format •Amenable to multiplexing (bead arrays or multispot wells)	•Detects one immunoglobulin class (IgG or IgA), determined by secondary antibody •Non-neutralizing binding antibodies can be detected