HPV Vaccination Advisor | MEDiscuss CDSS

⚠ Clinical Disclaimer: This pathway is a decision support tool, not a substitute for clinical judgement. Always verify contraindications individually. Vaccination does NOT eliminate the need for cervical screening. Adhere to local programme guidelines.

📚 Indian HPV Vaccination Landscape

💡 India's National HPV Campaign (Launched 28 Feb 2026)

Vaccine: Gardasil-4 (Quadrivalent: HPV types 6, 11, 16, 18) via GAVI partnership.
Target: Girls aged 14 years (completed 14, not yet 15). Annual cohort: approximately 1.2 crore girls.
Schedule: Single dose (0.5 mL IM, left deltoid). Voluntary and free at Government health facilities.
Platform: U-WIN digital platform for registration, consent recording, and tracking. e-VIN for cold-chain logistics.
Post-vaccination: 30-minute observation mandatory. All sites linked to 24/7 AEFI management facilities.

India's Cervical Cancer Burden

⚠ The Indian Imperative: India accounts for approximately one-sixth of global cervical cancer cases and one-fifth of global deaths. An estimated 1,23,907 new cases and 77,348 deaths annually (GLOBOCAN 2022). A woman in India dies of cervical cancer every 8 minutes.

Second most common cancer among Indian women aged 15 to 44 years.
Over 480 million women aged 15+ are at risk.
HPV types 16 and 18 account for >80% of cervical cancers in India.
Fewer than 2% of Indian women have undergone cervical cancer screening (NFHS-5).

HPV Vaccines Licensed in India

Vaccine	Manufacturer	Valency	HPV Types	Licensed Age
Cervarix	GSK	Bivalent	16, 18	Females 10 to 45
Gardasil	MSD	Quadrivalent	6, 11, 16, 18	Females 9 to 45
Gardasil 9	MSD	Nonavalent	6, 11, 16, 18, 31, 33, 45, 52, 58	Both sexes 9 to 45
Cervavac	SIIL (India)	Quadrivalent	6, 11, 16, 18	Both sexes 9 to 26

Dosing Schedules (FOGSI GCPR / WHO / NTAGI)

Age Group	Immunocompetent	Immunocompromised
9 to 14 years	1 dose (WHO off-label) or 2 doses (0, 6 months)	3 doses (0, 1-2, 6 months)
15 to 20 years	1 or 2 doses (WHO)	3 doses (0, 1-2, 6 months)
21 years and above	2 doses (WHO) or 3 doses (manufacturer)	3 doses (0, 1-2, 6 months)

💡 India's UIP Programme: Uses single-dose Gardasil-4 for the national campaign (14-year-old girls). For Cervavac, NTAGI recommends two doses until stable antibody levels at 2 years post-introduction are demonstrated per WHO criteria.

Contraindications & Deferrals

Absolute: Severe allergic reaction (anaphylaxis) to a prior HPV vaccine dose or to yeast (for Gardasil/Cervavac).
Defer: Moderate to severe acute illness (until recovery). Current pregnancy (defer remaining doses postpartum).
NOT contraindicated: Lactation, menstruation, mild illness, prior abnormal Pap/HPV+ test, immunocompromised state (use 3-dose schedule).

WHO Cervical Cancer Elimination Targets (90-70-90)

90% of girls fully vaccinated with HPV vaccine by age 15.
70% of women screened with a high-performance test by ages 35 and 45.
90% of women identified with cervical disease receive treatment.

FOGSI Resource-Based Screening Recommendations (2023)

Setting	Preferred Method	Age Group	Frequency
Good Resource	Primary HR-HPV DNA testing or Co-testing (HPV + Cytology)	30 to 65	Every 5 years
Limited Resource	VIA (or affordable HPV testing)	30 to 65	Every 5 years (minimum 1 to 3 times in a lifetime)
HIV+ Women	HR-HPV DNA testing (from age 25)	25+	Every 3 to 5 years (twice as often as general population)

HPV Natural History: Key Numbers

~90% of HPV infections clear spontaneously within 12 to 18 months.
10 to 15% of women develop persistent infection (risk factors: immunosuppression, smoking, multiple partners).
CIN1 regresses in 60% of cases; CIN3 progresses to invasive cancer in 10 to 12% if untreated.
Progression from persistent HPV infection to invasive cancer typically takes 10 to 20 years.
HPV vaccines are 93 to 100% effective against persistent infection with vaccine-covered types.