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

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.

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.

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.