Health Budget 2024: How govt plans to make HPV vaccine for every girl a part of its immunisation programme

All girls between the ages of 9 and 14 years will receive the vaccines in their schools or nearby government primary health centres over the next three years

The quadrivalent vaccine, which is likely to be used for the campaign, will prevent infections with the four most common cancer-causing types of HPV --- 16, 18, 6 and 11. (Representational Photo)

Union Finance Minister Nirmala Sitharaman on Thursday announced the government’s intention to include the vaccine against human papilloma virus (HPV) in its immunisation programme. “Our Government will encourage vaccination for girls in the age group of 9 to 14 years for prevention of cervical cancer,” she said in her budget speech.

The Indian Express had previously reported that the government was likely to roll out the HPV vaccination campaign by the second quarter of this year, covering all eligible girls in three phases over three years. The vaccine would then be included as part of routine immunisation for girls at age nine. The campaign would use the indigenously developed vaccine, marketed by Serum Institute of India, called Cervavac. A Lancet study had found this to be as effective as global vaccines. “I applaud the government’s announcement to vaccinate girls aged 9-14 against cervical cancer. Let’s pledge to prevent HPV and ensure easy access to vaccination,” said Adar Poonawalla, CEO, SII.

At present, the quadrivalent vaccine is commercially available at a cost of Rs 2,000 per dose. The only other HPV vaccine that protects against four most common types of HPV is available at the cost of Rs 4,000 per dose.

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How does a vaccination campaign help?

With more than 95 per cent of all cervical cancer cases linked to persistent infection with a certain high-risk type of HPV, a government vaccination campaign can effectively reduce incidence and death. HPV infection is also linked to cancers of the anus, vagina and oropharynx, so a vaccination campaign is likely to cause a drop in the incidence of these as well.

The quadrivalent vaccine, which is likely to be used for the campaign, will prevent infections with the four most common cancer-causing types of HPV — 16, 18, 6 and 11. Cervical cancer continues to be the second most common cancer in women in India, with 1.25 lakh cases reported each year and 75,000 deaths.

Who will get the vaccines and where?

All girls between the ages of 9 and 14 years will receive the vaccines in their schools or nearby government primary health centres over the next three years. The Health Ministry, Women and Child Development Ministry and the Education ministry will help in rolling out the campaign.

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Nearly eight crore children between the ages of nine and 14 years will be eligible for the vaccine across the country. When divided over three years, there will be at least 2.6 crore children eligible during the first year. In addition to these 2.6 crore children, another 50 lakh to 1 crore children, who will turn nine in the places where the campaign has already been rolled out, will need the vaccine doses during the second and third year.

How is the government preparing to roll out the vaccine?

While the government is still working on procurement of vaccines, other preparations are already under way. Officials from various states confirmed that workshops on administering HPV vaccine were conducted in 2023. Officials from all three coordinating ministries will be trained to ensure effective availability of vaccines at centres.

There is also preparation on communication before the vaccine is rolled out to ensure there is no hesitancy. The National Technical Advisory Group on Immunisation (NTAGI) had also recommended that the Indian Council of Medical Research (ICMR) conduct trials on the efficacy of a single-dose regimen of HPV vaccine in the age group of 9-15 years. While all HPV vaccines available globally state that a two-dose schedule has to be followed, the World Health Organisation (WHO) says that even a single dose has “strikingly high efficacy.”

What is the current evidence on the vaccine?

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There are over 100 countries that have HPV vaccination programmes and have seen a decline in cervical cancer cases. While the vaccines were initially approved for preventing HPV infection, by late 2000s evidence emerged that vaccination reduced the incidence of pre-cancerous lesions. In 2020 and 2021, studies from Sweden and England also demonstrated that vaccination in teenage years could reduce the risk of cervical cancer by over 85 per cent at age 30.

Anonna Dutt

Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government’s management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country’s space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University’s Dart Centre. Dutt has a Bachelor’s Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More