India Passes 8 Million HPV Vaccinations, but Uneven Coverage Tests Cervical Cancer Campaign

Millions vaccinated, with large gaps still to close

India crossed 8 million HPV vaccinations by September 11, 2026, seven months after Prime Minister Narendra Modi launched the national campaign in Ajmer, Rajasthan, on February 28. The programme offers a free dose to about 11.5 million girls aged 14 each year, aiming to prevent a cancer that kills nearly 80,000 women in India annually.

The national total hides sharp differences in access and acceptance. Delhi had vaccinated about 20% of its target group by October 12. Rajasthan reached 71.8% by October 17 after a month of accelerated vaccination. Gujarat, Uttar Pradesh, Madhya Pradesh and Mizoram had reported full coverage of their identified target populations in September.

Parents are now central to the campaign's next stage. Vaccination is voluntary and requires parental consent. Health officials are working through schools, doctors and community networks to answer questions, particularly fears about fertility, while identifying girls who have missed their dose.

The stakes extend beyond India. The country accounts for about one fifth of cervical cancer cases worldwide and one quarter of deaths from the disease. Preventing persistent infection with human papillomavirus, or HPV, could spare future generations surgery, radiation and chemotherapy, as well as the loss of mothers and daughters.

What the free programme provides

The national programme offers a single dose of Gardasil-4 at government health facilities across all 36 states and Union Territories. Its annual target is approximately 11.5 million girls turning 14. Families do not have to buy the vaccine through a private hospital to obtain protection under the campaign.

Gardasil-4 is a quadrivalent vaccine, meaning it protects against four HPV types. Types 16 and 18 cause approximately 70% of cervical cancers in India. Types 6 and 11 cause genital warts. Vaccinating before exposure gives the immune system time to prepare to recognise the virus.

Medical officers supervise vaccination, and doses are recorded on U-WIN, the national digital immunisation platform. Health workers can use those records to monitor progress and identify eligible girls who have missed vaccination. Schools and local authorities help families connect with vaccination services.

Age descriptions have varied in public announcements: the September milestone announcement described girls aged 14 and above, while the programme's detailed descriptions identify girls aged 14 as the target group. Parents seeking vaccination for a daughter outside that age group should check eligibility with their local government health facility.

Why the cancer burden is so heavy

GLOBOCAN 2022 estimates put India's annual cervical cancer burden at more than 120,000 new cases and nearly 80,000 deaths. Health officials also cited more than 80,000 cases for 2023–24, although they did not explain how that figure was compiled or how its coverage compared with the GLOBOCAN estimate.

Cervical cancer begins in the cervix, the lower part of the uterus. Persistent infection with certain HPV types can cause cells there to change gradually. Most HPV infections clear naturally, but some persist long enough for abnormal cells to develop into cancer.

Partha Basu, head of the Early Detection, Prevention & Infections Branch at the International Agency for Research on Cancer, described the lifetime risk facing girls in India:

Currently, approximately one in every 50 girls born in India is expected to develop cervical cancer during her lifetime, and widespread vaccination is likely to reduce this risk significantly.

Indian American radiation oncologist Dattatreyudu Nori has put the daily death toll at around 200 women. That is close to the scale suggested by the annual estimate of nearly 80,000 deaths. Nori, a recipient of the 2026 Padma Bhushan, welcomed free vaccination as an opportunity to prevent a disease that can also be detected and treated.

Vaccinating today's adolescents addresses their future risk. Women already old enough to have persistent HPV infections still need screening and access to treatment, making prevention a task for both vaccination clinics and services caring for adult women.

How the rollout has developed

India first introduced HPV vaccination in 2008, but access remained limited for years. Punjab and Sikkim began geographically limited public programmes in 2016. The national launch in February 2026 expanded free access to an annual cohort numbering in the millions.

The campaign's main milestones show how quickly delivery has grown:

• November 2024: The Indian Council of Medical Research began a study of responses to a single dose among 500 girls aged 9–14.
• February 28, 2026: Modi launched the national vaccination campaign in Ajmer.
• First two weeks: Nearly 300,000 girls aged 14 received the vaccine.
• September 11: The Health Ministry announced that India had crossed 8 million HPV vaccinations.
• October 12: Delhi recorded about 30,500 doses, covering roughly 20% of its target group.
• October 17: Rajasthan reported coverage of 71.8%, following an intensive vaccination push.
• October 31: Rajasthan's revised deadline for full coverage falls due.

Madhya Pradesh, Andhra Pradesh, Tamil Nadu, Gujarat, Odisha and Mizoram were among the states identified as early leaders during the first fortnight. Health authorities coordinated with schools while examinations were underway, expecting vaccination activity to increase after the examination season.

The campaign is planned to run again in 2027 for girls entering the eligible age group. Reaching a new cohort each year will require sustained delivery, rather than a single round of mobilisation.

Delhi and Rajasthan show different challenges

Delhi's roughly 30,500 vaccinations by October 12 represented about one fifth of its target cohort. A Delhi Health Department official said coverage had risen from only 5–7% during the first four months to at least 20% over the following two months.

Doctors and district immunisation officers across Delhi's 13 districts have been visiting schools and attending parent teacher meetings. Teachers are circulating information through parents' WhatsApp groups, while newspaper campaigns, bus stop banners and billboards seek to reach families beyond school meetings.

Officials identified infertility fears and negative campaigning as obstacles. They also described hesitation among some educated and affluent families, showing that access to information does not automatically translate into confidence in vaccination.

Rajasthan vaccinated 210,000 girls between September 16 and October 17, bringing its total to approximately 520,000 against a target of 720,000. Those rounded totals leave about 200,000 girls still to reach. The state reported coverage of 71.8% and set October 31 as its latest completion deadline after missing three earlier deadlines.

District results within Rajasthan varied. Deeg reached its full target, followed by Sirohi at 94%, Alwar at 93%, Tonk at 90.9% and Jalore at 90.1%. Officials instructed districts to identify remaining eligible girls, organise vaccination sessions and review progress regularly.

Local results reveal where delivery is working

Kozhikode district in Kerala reported 13,505 vaccinated girls in October, representing about 51% of its target population. Of those girls, 1,854 received vaccination through schools, and the drive had operated in 169 schools.

School vaccinations therefore accounted for about 14% of Kozhikode's recorded total, calculated from 1,854 out of 13,505 vaccinations. Schools provided a useful route into the programme, while most doses were delivered through other channels.

Uttar Pradesh had administered more than 2.2 million doses in September, rising to 2.75 million in the October figures accompanying Rajasthan's update. Bihar recorded 1.15 million doses and Madhya Pradesh 760,000. Rajasthan's approximately 520,000 placed it fourth by the dose totals cited in that update.

Percentage coverage gives a different view from the number of doses. Delhi's 20% coverage and Kozhikode's 51% describe the share of each local target reached. A large state can administer far more doses because it has many more eligible girls. Both measures help health departments decide where additional sessions and outreach are needed.

September figures also placed Bihar, Andhra Pradesh and Assam above 90% of their identified targets, and Karnataka above 85%. Chhattisgarh, Sikkim, Kerala, Telangana and Odisha had exceeded 60%. The variation makes local follow through central to the national campaign's success.

What parents should know about safety and fertility

India's rollout followed scrutiny by the national drug regulator and the National Technical Advisory Group on Immunisation, the country's leading vaccine advisory body. HPV vaccines have also undergone extensive safety monitoring internationally since their introduction in 2006.

Large studies have found no link between HPV vaccination and fertility problems. Cervical cancer treatment, however, can damage fertility. Surgery may remove reproductive organs, while radiation and chemotherapy can affect the ability to become pregnant. Preventing cancer can help protect that future choice.

Vaccination sites in the Indian programme are linked to centres that manage adverse events following immunisation, known as AEFI centres, with support available around the clock. Staff received training before rollout, and vaccination takes place under medical supervision with parental consent.

Parents can discuss a daughter's medical history and any concerns with the doctor or health worker administering the vaccine. A clear explanation before consent is especially useful where rumours have become the main source of information.

Globally, 160 of 194 countries have introduced HPV vaccination into national immunisation programmes. Ninety use a single dose schedule, including many countries in Southeast Asia. Of 80 countries using Gardasil-4 in their national programmes, 61 use a single dose schedule.

Why one dose is being used

India's programme uses one dose of Gardasil-4, simplifying delivery for families and health services. An eligible girl can complete the campaign's vaccination schedule in one visit rather than having to return for another scheduled dose.

Serum Institute of India has also developed Cervavac, a quadrivalent HPV vaccine. In a study using two doses, it met the comparison standard for immune responses against existing vaccines. The company is seeking World Health Organization prequalification, an assessment used to support international vaccine procurement.

The Indian Council of Medical Research study begun in November 2024 is examining responses to a single dose among 500 girls aged 9–14. The distinction matters for vaccine supply planning: the national campaign currently uses Gardasil-4, while research is assessing another vaccine under a single dose approach.

Protection against the HPV types responsible for most cervical cancers makes vaccination a major prevention tool. Continued screening remains necessary because the vaccine does not cover every cancer causing HPV type and many adult women were already beyond the campaign's target age when it began.

Screening remains essential, even without symptoms

Dr. Rashmika Gandhi, a fertility specialist at Birla Fertility & IVF in Gurgaon Sector 14, advises women to seek cervical screening even when they feel healthy. Changes in cervical cells can develop slowly without obvious symptoms, creating an opportunity to find and treat them before cancer develops.

Gandhi explained why women should arrange screening rather than wait for warning signs:

Women should talk to their gynecologist about their screening schedule, rather than wait for symptoms to develop.

An HPV test looks for virus types associated with a higher cancer risk. A Pap smear examines cervical cells for abnormalities. Depending on age, medical history and the screening protocol, a clinician may recommend one or both tests, generally at intervals of three to five years.

A positive HPV result or abnormal Pap result calls for a follow up plan based on the exact findings. The next step may be repeat testing, colposcopy, which examines the cervix under magnification, or a biopsy, in which a small tissue sample is checked in a laboratory.

Gandhi also advises medical assessment for bleeding after intercourse, bleeding between periods or persistent unusual vaginal discharge. These symptoms have several possible causes and need assessment when they occur, rather than waiting for the next routine screening appointment.

Vaccination may also be available outside the national campaign's age group. Gandhi describes vaccination options between ages 11 and 45, ideally before first sexual contact. Anyone seeking vaccination outside the free programme should ask a clinician about the appropriate product and schedule.

Prevention depends on reaching both generations

Jyoti Vajpayee, a senior obstetrician and gynaecologist and a board member of Population Services International, India, links the vaccination campaign's success to screening adult women. Her work on HPV in Uttar Pradesh has also highlighted parental questions, social stigma and gaps in awareness.

Vajpayee described the combined approach:

If we are able to continue the vaccination of the girls and simultaneously screen the eligible women between the age group of 30–65 years, we can significantly reduce the incidence of the disease.

Free vaccination changes access for families who previously faced private medical costs. Vajpayee estimated that private HPV vaccine sales in India reached up to US$10 million, or 950 million rupees, in 2025. The public programme brings prevention within reach regardless of a family's ability to pay for a private appointment.

Rajasthan's October 31 deadline is the next concrete test identified in the campaign updates. Beyond that date, states must continue finding girls missed during the initial push and prepare for the next annual cohort. For adult women, screening and timely treatment remain the immediate routes to reducing illness and deaths.

Key Points

• India crossed 8 million HPV vaccinations by September 11, 2026.
• The national campaign offers a free, voluntary single dose to girls aged 14, with parental consent.
• Delhi had reached about 20% of its target by October 12; Rajasthan reached 71.8% by October 17.
• Rajasthan set October 31 as its revised deadline for full coverage.
• Large studies have found no link between HPV vaccination and fertility problems.
• Vaccination, cervical screening and timely follow up serve different parts of cancer prevention.
• The campaign is planned to continue in 2027 for girls entering the eligible age group.