Nationwide Single-Dose HPV Immunisation Drive to Combat Cervical Cancer

Why in News ?

The Union government is preparing to launch a nationwide 90-day single-dose HPV vaccination campaign targeting 14-year-old girls to reduce the burden of cervical cancer in India. The initiative marks a major preventive public health intervention aimed at tackling one of the leading causes of cancer-related deaths among Indian women.

Background & Context

Cervical cancer is primarily caused by persistent infection with high-risk strains of the Human Papillomavirus (HPV), a common sexually transmitted infection. Nearly 90% of cervical cancer cases are linked to HPV infection, especially types 16 and 18.

India accounts for nearly one-fifth of the global cervical cancer burden. Despite screening and treatment efforts, late diagnosis remains common due to low awareness, limited screening coverage, and social stigma.

Globally, HPV vaccines have demonstrated strong effectiveness in preventing pre-cancerous lesions and cervical cancer. In 2022, the World Health Organization endorsed a single-dose HPV vaccine schedule for girls aged 9–14 years, significantly strengthening the case for mass immunisation in low- and middle-income countries like India.

The current campaign aligns with India’s broader goal of reducing preventable cancers and improving women’s health outcomes.

What is HPV ?

• HPV is a group of viruses with over 100 types, at least 14 of which are cancer-causing.
• Types 16 and 18 account for nearly 70% of cervical cancer cases globally.
• Apart from cervical cancer, HPV can cause anal, penile, vaginal, vulvar, and oropharyngeal cancers.
• Vaccination before sexual debut offers maximum and long-lasting immunity.

HPV Vaccination Drive: Eligibility and Rollout Plan

• Target Group: All 14-year-old girls across India.
• Duration: 90-day nationwide campaign.
• Dose Schedule: Single-dose vaccination.
• Annual Beneficiaries: Approximately 1.15 crore girls turning 14 each year.
• Registration Platform: Appointments to be booked through the U-Win digital portal, modeled on the Co-WIN system used during COVID-19.
• Post-Campaign Plan: HPV vaccination will be integrated into the routine immunisation programme through Health & Wellness Centres.

The strategy focuses on age-based cohort vaccination rather than school-based targeting alone, ensuring wider inclusion.

Vaccine Choice and Supply Strategy

Vaccine Being Used: Gardasil

The campaign will use Gardasil, manufactured by MSD Pharmaceuticals, due to its established global efficacy and safety record.

Indigenous Vaccine: Cervavac

India has developed its own HPV vaccine, Cervavac, produced by the Serum Institute of India.

However, it is not being used in the current drive because:

• It is awaiting WHO prequalification.
• The Indian Council of Medical Research is still evaluating its effectiveness under a single-dose schedule.

A transition to Cervavac may occur in the coming years once regulatory processes are completed.

Role of GAVI

The GAVI, The Vaccine Alliance will supply 2.6 crore doses over two years.

• One crore doses have already been delivered.
• Remaining supplies will arrive in phases.

Is a Single Dose Sufficient ?

In 2022, the WHO’s Strategic Advisory Group of Experts recommended a single-dose schedule for girls and women up to 20 years, citing strong immune response and sustained protection.

Guidelines:

• 9–20 years: Single dose sufficient.
• Above 21 years: Two doses (six months apart).
• Immunocompromised individuals (including HIV patients): Ideally three doses.

This simplified schedule enhances feasibility and reduces programmatic costs.

Why the HPV Vaccination Campaign Matters

1. High Disease Burden in India

• ~1.25 lakh new cases annually.
• ~75,000 deaths per year.
• Second most common cancer among Indian women.

India contributes nearly 20% of global cervical cancer cases, making preventive action urgent.

2. Proven Vaccine Effectiveness

Global evidence shows significant reduction in HPV infection rates and pre-cancerous lesions following vaccination.

3. Herd Immunity Benefits

Vaccinating girls reduces HPV transmission to boys, lowering risks of other HPV-related cancers and strengthening community-level protection.

4. Global Evidence – Australia Model

Countries like Australia introduced HPV vaccination in 2007 and extended it to boys in 2013. Within a decade:

• HPV prevalence among young women dropped sharply.
• Significant indirect protection observed even among unvaccinated groups.

Australia is now on track to nearly eliminate cervical cancer as a public health problem.

5. Long-Term Public Health Gains

• Reduced cancer treatment costs.
• Lower burden on tertiary healthcare.
• Improved female workforce participation and productivity.
• Progress toward universal health coverage.

Is This India’s First HPV Immunisation Programme 

No. Several states have piloted HPV vaccination drives earlier:

State-Level Initiatives

• Sikkim (2018): First state to launch a statewide HPV vaccination programme. Achieved over 95% coverage.
• Punjab (2016): Began in Mansa and Bathinda districts; recorded over 97% coverage in initial phase.
• Delhi (2016): Launched via Delhi State Cancer Institute; limited uptake due to hospital-based delivery.

The current initiative marks the first nationwide, centrally coordinated HPV immunisation campaign.

Significance of the Initiative

Strategic Public Health Intervention

Shifts policy focus from cancer treatment to prevention — aligning with global best practices.

Women-Centric Healthcare Reform

Strengthens reproductive and preventive health systems targeting adolescent girls.

Digital Health Integration

Leverages digital platforms like U-Win, improving tracking, transparency, and coverage.

Alignment with Global Health Goals

Supports WHO’s global strategy to eliminate cervical cancer as a public health problem by 2030.

Economic and Social Impact

Prevention reduces catastrophic health expenditure for families and enhances long-term human capital formation.