Seven months ago, when India’s HPV vaccination programme was launched, I watched girls come forward to be vaccinated in numbers I had never imagined. It filled me with hope and painful memories of a time when this seemed impossible. I thought of the many women I had diagnosed with cervical cancer, some of whom might never have faced the disease had this protection existed earlier.
Their stories reflect a national crisis: India bears one of the world’s heaviest cervical cancer burdens, accounting for a quarter of all cervical cancer deaths globally. Behind these statistics are women who may lose their fertility to surgery, endure long treatments with radiation and chemotherapy, or leave behind children and loved ones far too soon.
What has made this burden especially difficult to accept is the fact that cervical cancer is largely preventable. This has been the basis of the work by innumerable gynaecologists, oncologists, epidemiologists, scientists and paediatricians towards finding solutions that are safe, workable, and can be escalated to reach each young girl and each woman in this country. That belief has shaped two decades of my own work to check the safety and efficacy of HPV vaccines, and having done so, to advocate for making HPV vaccination part of India’s public health response. Repeated requests from all professional bodies, who already recommended it in their guidelines from the time of launch in 2009, influenced the Government of India’s decision to launch the National HPV Vaccination Campaign, a historic step toward consigning this cancer to the past.
But policy alone cannot save lives. Ensuring every eligible girl receives the vaccine matters as much as introducing it, and that will depend on one of the most important decisions parents can make for their daughters.
And parents understandably have questions.
The two I hear most often are: Is the HPV vaccine safe? Will the vaccine affect my daughter’s fertility? These are reasonable questions, and ones that were examined long before the programme was introduced.
The rollout of the HPV vaccination campaign follows rigorous scrutiny by India’s drug regulator and the National Technical Advisory Group on Immunisation, India’s apex vaccine advisory body. Every HPV vaccine available in India has cleared the same levels of testing and all have been found to be safe and effective. This safety profile is backed by decades of scientific evidence and real-world experience, with more than 80 crore doses of HPV vaccines administered worldwide since 2006, and 160 of the world’s 194 countries having added it to their national immunisation programmes. Multiple large studies have found no link between HPV vaccination and fertility problems. In fact, the irony is that the opposite is true. Cervical cancer itself, and its treatment, radical surgery, radiation and chemotherapy, can threaten a woman’s fertility, so preventing the cancer protects the very future parents fear losing.
The programme was designed with safety at its core: Staff across all 36 states and Union Territories were trained before rollout, every dose is administered under medical supervision and with parental consent, and every vaccination is recorded on the national U-WIN platform. These are the same principles behind India’s enormous and successful immunisation programme for decades.
Its effectiveness is equally compelling. Research from England found that between 2020 and 2024, no woman aged 20 to 24 died of cervical cancer among girls vaccinated at ages 12 to 13, where coverage reached 88 to 90%. Australia, an early adopter, now expects to eliminate the disease altogether by 2035. India has had similar success with vaccines in the past, eliminating polio more than a decade ago and ending maternal and neonatal tetanus, proof that diseases once thought inevitable can disappear.
The programme is already in motion. Every girl turning 14 is entitled to a free dose at a government facility, reaching roughly 1.15 crore girls annually. The government has secured the vaccine and built the delivery system. The decision it cannot make is the one taken at home.
India can achieve a cervical cancer-free status if parents make the choice to take their daughters for the vaccine. Whether you choose to go to a public health centre or a private hospital, every HPV vaccine offers the same protection. After three decades of diagnosing and treating cervical cancer, I know what happens when we do nothing. Today, I can also see a different future: Fewer mothers losing daughters, fewer daughters losing mothers, and far fewer women ever hearing that diagnosis.
That is why I am asking every parent not to let fear decide for them: Ask questions, seek the facts, speak to your doctor or health worker, and if your 14-year-old daughter is eligible, take her to get the HPV vaccine, for the protection this generation finally has within reach.
A vaccine is a small moment in a girl’s life. But it can change the course of an entire lifetime. Every girl vaccinated today is one more girl saved from a cancer that can be prevented.
(The views expressed are personal)
This article is authored by Dr Neerja Bhatla, head, Department of Obstetrics and Gynaecology, AIIMS, New Delhi, and first Indian chairperson, FIGO Gyn Oncology Committee.
