From hesitancy to hope: charting India's path to widespread HPV immunisation.

Abstract

Background: Cervical cancer remains the leading gynaecological malignancy in India, with a disproportionate burden among underserved populations. Although HPV vaccines have been available since 2008, national coverage has been hindered by safety concerns, misinformation, sociocultural resistance, and logistical barriers.

Recent developments & policy implications: The introduction of Cervavac, an indigenously developed quadrivalent HPV vaccine, marks a pivotal shift in India's immunisation landscape. By improving affordability and supply stability, Cervavac offers a sustainable path forward. State-led initiatives in Sikkim, Punjab, and Delhi highlight the effectiveness of school-based delivery and community mobilisation. Implementing HPV vaccination into the National Immunisation Schedule is a critical step. Leveraging infrastructure and strategies from the COVID-19 vaccination campaign, such as digital tracking, inter-sectoral coordination, and public trust-building, can enhance implementation at scale.

Conclusion: To achieve the WHO's cervical cancer elimination targets, India must pursue a dual approach: gender-neutral HPV vaccination alongside accessible, structured cervical screening programmes. A coordinated, evidence-based strategy is essential for equitable and sustained public health impact.