HPV
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. There are over 200 known types, some of which are harmless though others can cause cancers such as cervical, anal, and throat cancers. Globally, HPV is responsible for nearly all cases of cervical cancer, which is the fourth most common cancer in women.
More than 270,000 people die from cervical cancer every year, with 85% of those deaths occurring in low- and middle-income countries. Low-resource countries bear the highest burden of HPV-related diseases due to limited access to screening, vaccination, and early treatment. The introduction of HPV vaccines has significantly reduced infection rates, though vaccination coverage remains uneven worldwide.
Enhancing HPV data to better inform policy
Despite the availability of vaccines, the global uptake of HPV vaccines is low, hovering at 13%. In order to help countries form evidence-driven policies around vaccine introduction and to develop more effective implementation strategies, the International Vaccine Institute has partnered with the London School of Hygiene & Tropical Medicine and Karolinska Institutet to generate primary data on the burden of HPV among girls and women in low-income and lower middle-income countries in South Asia (Bangladesh, Nepal, and Pakistan) and sub-Saharan Africa (the Democratic Republic of the Congo, Ghana, Sierra Leone, Tanzania, and Zambia).
The Global Burden Estimation of Human Papillomavirus (GLOBE-HPV) project also aims to describe the knowledge, attitudes, and beliefs regarding HPV interventions and to identify gender-related dynamics that may create barriers to girls and women accessing HPV prevention, screening, and treatment services.
“The GLOBE-HPV project presents unique challenges, particularly in educating women about cervical cancer and the importance of screening. While many women were aware of the existence of a vaccine, largely due to information disseminated during family planning or vaccination visits of their child, they were often unfamiliar with cervical cancer screening.”
Expanding HPV vaccine coverage worldwide
In 2018, IVI launched an HPV vaccine impact study in Thailand to measure the effectiveness of a single dose of HPV vaccine. At that time, the WHO recommended a two-dose regimen of the available HPV vaccines targeting girls 9-14 years, and yet there was emerging evidence that a single dose might be equally effective. Additional data on single-dose effectiveness would help inform the most cost-effective approach to HPV vaccination and national/global health policy. For instance, if a single dose of vaccine confers sufficient protection, it would reduce vaccine costs by half or more while also reducing delivery costs. Lower costs and simpler vaccination schedules could potentially increase uptake.
The results of this impact study along with other single-dose studies were submitted to the World Health Organization Strategic Advisory Group of Experts on Immunization, which concluded that a single dose delivers solid protection against HPV. The group now recommends a one- or two-dose schedule for girls and young women aged 9-20 years.
Strengthening HPV immunization through Expanded Program on Immunization-leveraged delivery
In 2025, IVI launched a pilot study to assess the safety and immunogenicity of HPV vaccines administered to toddlers and infants in collaboration with the University of Ghana and Karoliska Institutet. Even with the adoption of single-dose regimens, there remain barriers to achieving high vaccine coverage targeting 9-14-year-old girls. Barriers include the higher cost of school- and community-based immunization strategies, girls already leaving school at this age, and the social stigma associated with vaccinating girls for a sexually transmitted infection at this age. This pilot study will explore the feasibility and acceptability of expanding the target population to include infants and toddlers. This approach would leverage existing effective vaccination systems developed as part of the Expanded Program on Immunization, delivering HPV vaccine to all children and potentially greatly improving coverage toward cervical cancer elimination goals.
Page updated: March 2025