Cervical cancer is a largely preventable disease, yet it remains a leading cause of cancer deaths among Indian women. Examine the challenges in scaling up HPV vaccination in India.

Vaccination and screening can largely prevent cervical cancer. Yet India records about 1.25 lakh cases and over 75,000 deaths every year, and 83% of invasive cases are linked to HPV 16/18 [1]. The free nationwide HPV drive launched in February 2026 [2] is a turning point, but scaling it up faces structural hurdles.

Supply and product challenges

• Import dependence: the drive covers ~1.15 crore girls aged 14 with imported Gardasil-4 [2], even though India has had its own vaccine, Cervavac (DBT–BIRAC–Serum Institute), since 2022 [1].
• Dose-schedule evidence: single-dose HPV schedules are now favoured globally [3][5]. China's Cecolin is already WHO-confirmed for single-dose use [3]. Cervavac has only just received WHO pre-qualification [4], which certifies its quality, not its dose schedule.
• Supply fragility: global shortages since 2018 [3] show the risk of relying on one foreign supplier.

Programme design and coverage gaps

• Narrow cohort: only 14-year-old girls are covered [2], although Cervavac is licensed for girls and boys aged 9–26 [4]. This limits catch-up and herd protection.
• Consent and tracking: written parental consent is mandatory and tracking runs on U-WIN [2]. That makes it harder to reach out-of-school and migrant girls.
• Low baseline: only 27% of girls aged 9–14 worldwide had even one dose in 2023, against WHO's 90% target [3]. Scale-up is hard everywhere.

Social and health-system barriers

• Hesitancy and stigma: because HPV is sexually transmitted, the vaccine faces misinformation and parental reluctance.
• Last-mile logistics: cold-chain and staffing gaps in remote districts.
• Delayed impact: vaccinating 14-year-olds protects future cohorts. Women who are adults today still depend on screening, which is often under-funded.

Way forward

• Generate single-dose evidence for Cervavac and move procurement to it, cutting cost and import reliance [3][4].
• Widen coverage to the 9–14 age group and boys, integrated into the UIP through U-WIN [2].
• Mobilise ASHAs and schools for awareness, and pair vaccination with screening at primary-care centres.

India now has an indigenous vaccine, a digital platform and clear political commitment. What remains is to combine domestic single-dose supply, wider cohorts and strong screening into one strategy. That would carry India towards WHO's 90% vaccination goal [3] and SDG 3.4, making cervical cancer a disease of the past.