India’s move to roll out a structured, school-based HPV vaccination programme marks a significant turning point in its battle against cervical cancer, a disease that continues to impose one of the highest burdens on Indian women globally.
According to the 2022 estimates of the International Agency for Research on Cancer, India recorded nearly 1,25,000 new cervical cancer cases in a single year, contributing close to one-fifth of the global total. Public health experts say the transition from a largely “opt-in” private vaccination model to a government-backed nationwide drive signals a decisive shift from reactive cancer treatment to proactive, population-level prevention aligned with the WHO elimination strategy.
Firstpost talked to Dr. Neelam Mohan, Sr. Director, Medanta (Gurugram) to understand how targeting 14-year-old girls strengthens vaccine efficacy, addresses hesitancy among parents, expands protection beyond the primary age group and improves last-mile access in rural and underserved communities.
India bears a high share of global cervical cancer cases. How does this nationwide school-based government drive transform preventive oncology compared to the earlier opt-in model?
Dr Mohan: India continues to shoulder a disproportionately high share of the global cervical cancer burden. According to 2022 estimates from the International Agency for Research on Cancer, India recorded approximately 1,25,000 new cervical cancer cases in that year alone, making it the second most common cancer among women in the country. India contributes nearly one-fifth of the global burden, highlighting the urgent need for a systemic, large-scale preventive strategy.
The transition from an “opt-in” model to a structured, nationwide school-based government programme is transformative for preventive oncology. The vaccine moves from being an individual, privately accessed intervention to a public health priority delivered at scale. This ensures standardisation, accountability, and equitable access.
More than 160 countries have incorporated HPV vaccination into their national immunisation programmes, guided by the World Health Organisation global cervical cancer elimination strategy. Countries implementing organised vaccination have demonstrated significant declines in HPV infection rates and precancerous cervical lesions. By institutionalising this effort, India aligns itself with global elimination targets and shifts from reactive cancer treatment to proactive cancer prevention.
India bears a high share of global cervical cancer cases. How does this nationwide school-based government drive transform preventive oncology compared to the earlier opt-in model?
Dr Mohan: From a pediatric preventive health perspective, targeting 14-year-old girls is considered the gold standard for HPV vaccination because it ensures protection well before any potential exposure to the Human Papillomavirus (HPV), which causes over 95% of cervical cancers. The HPV vaccine is preventive, not therapeutic — it blocks initial infection rather than treating existing disease. Adolescents aged 9–14 mount a stronger immune response than older individuals, leading to more robust and durable protection. Delivering the vaccine at 14 through a structured programme also maximizes both individual protection and long-term population impact.
For those older than 14, vaccination can still provide significant benefit. Approved for use in women up to 45 years in many settings, the vaccine can protect against high-risk HPV strains to which an individual has not yet been exposed. However, the overall benefit decreases with age due to the higher likelihood of prior exposure. Therefore, vaccination in older adolescents and women should be considered individually after medical consultation, while early adolescence remains the most impactful window for universal immunisation.
What common misconceptions do parents have about the HPV vaccine, and how do you address them?
Dr Mohan: Common concerns relate to safety, dosing schedules, fertility, and infection risk.
One misconception is that multiple doses are always mandatory. The World Health Organisation has reviewed emerging evidence and endorsed a single-dose schedule for girls aged 9–14 years as an option, based on data showing comparable short- to medium-term protection. This simplifies implementation and improves feasibility for large-scale programmes.
Another frequent concern is whether the vaccine can cause HPV infection or affect fertility. The HPV vaccine is non-infectious and cannot cause HPV infection. There is no scientific evidence linking it to infertility. Globally, HPV vaccines have demonstrated an excellent safety profile across millions of administered doses.
Importantly, HPV vaccination is one of the very few vaccines proven to prevent a cancer, which makes it a powerful tool in preventive medicine.
What advice would you give parents on how to discuss the HPV vaccine with their daughters in a comfortable and appropriate way?
Dr Mohan: It is natural for some parents to feel hesitant. However, the most effective way to frame this vaccine is as a cancer prevention intervention. Parents can explain that this vaccine protects against certain cancers affecting organs such as the cervix, similar to how other vaccines protect against serious infectious diseases. The focus should remain on health, safety, and long-term protection.
At 14 years of age, adolescents are developmentally capable of understanding basic health concepts. With reproductive and adolescent health increasingly included in school curricula, these conversations can be handled in a factual and age-appropriate manner. Open communication helps prevent misinformation and empowers young girls to make informed health decisions.
How will this nationwide rollout improve long-term sustainability and last-mile access in rural and underserved areas?
Dr Mohan: A government-led programme improves last-mile delivery through schools, primary health centres, and outreach services in rural and underserved areas. It also strengthens monitoring systems, cold-chain management, and accountability mechanisms to ensure that eligible adolescents are not missed.
HPV vaccines used globally have demonstrated strong safety and high efficacy against high-risk HPV types responsible for the majority of cervical cancers. With robust global evidence supporting their effectiveness, large-scale implementation in India has the potential to substantially reduce future disease burden.
This initiative is not merely a vaccination campaign. It represents a long-term investment in women’s health, cancer prevention, and intergenerational well-being.
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