China's Integration of HPV Vaccine into National Immunization Program: Current Challenges and Future Path.

Abstract

Cervical cancer, predominantly caused by persistent human papillomavirus (HPV) infection, remains a major global health burden, with approximately 660,000 new cases and 350,000 deaths reported in 2022. The introduction of prophylactic HPV vaccines since 2006 has significantly advanced primary prevention. In China, the national HPV immunization strategy has progressed from regional pilot programs to the recent announcement that HPV vaccination will be incorporated into the National Immunization Program, representing a milestone in cervical cancer control. Nevertheless, substantial challenges persist. Vaccine coverage among girls aged 9-14 years remains extremely low, with first-dose uptake estimated at only 4% in 2022. Barriers include preferences for higher-valency vaccines, public concerns over vaccine safety, misinformation on social media, and insufficient knowledge among non-specialist healthcare providers. Logistical obstacles, such as the lack of school-based mass vaccination, further reduce program efficiency. In addition, debates continue regarding optimal dosing schedules, with the World Health Organization recommending single-dose regimens, as well as the potential expansion of vaccination to older women and males. Strengthening health education, addressing vaccine hesitancy, and optimizing delivery strategies are essential for improving coverage and achieving cervical cancer elimination in China.