Is It Time to Reassess the Target Age of Human Papillomavirus Vaccination Globally?

In 2022, 464 000 people died from human papillomavirus (HPV)-related cancer. Despite the availability of safe, highly effective HPV vaccinations, global coverage is just 20% for girls and 7% for boys. We summarized the evidence for target vaccination age and found that vaccinating at age 9-10 years, the youngest end of the World Health Organization's (WHO) recommended age range, has multiple advantages. Earlier vaccination increases the likelihood of vaccinating before HPV exposure, may reduce the impact of sex-associated stigma, and is logistically advantageous through enabling primary-school immunization and program resilience. Furthermore, we systematically reviewed published immunogenicity data on children aged 9-15 years and identified that vaccination at age 9 is immunologically robust. Globally, most countries target ages 11 years or older for HPV vaccination. Our findings indicate an urgent need to target earlier ages to help achieve the WHO's goal to vaccinate 90% of girls against HPV by age 15.