WHO advisers open door to HPV vaccination for girls as young as four

WHO immunisation experts say countries could consider vaccinating girls aged four to eight if it helps raise coverage, which remains far below the target needed to prevent HPV-related cancers.

Experts advising the World Health Organization have suggested that countries could consider extending routine human papillomavirus vaccination to girls aged four to eight if the move would help lift uptake. The recommendation, which emerged from a meeting of the WHO’s Strategic Advisory Group of Experts on Immunisation, reflects concern that global coverage remains well below the level needed to curb HPV-related cancers.

Anthony Scott, speaking after the panel’s twice-yearly meeting, said worldwide HPV vaccination stands at about 33 per cent, far short of the WHO’s 90 per cent goal. The expert group concluded that a single dose for girls aged nine to 14 is the most effective way to reach that target globally, building on the organisation’s 2022 position that one dose in that age range offers protection similar to a two-dose schedule.

The latest advice does not replace the broader standard approach used in many countries. The WHO’s 2022 guidance says girls aged nine to 14 may receive one or two doses, while girls and women aged 15 to 20 may also receive one or two doses. For women older than 21, the organisation recommends two doses six months apart. It also says people with weakened immune systems, including those with HIV, should receive at least two doses and, where possible, three.

The panel’s proposal to consider vaccinating younger girls is meant as a practical tool for governments struggling to improve coverage. Scott said countries could look at immunising girls below nine if doing so is likely to increase the number protected, and he said other groups could follow with single-dose vaccination later, including boys and men.

HPV is passed on through sexual contact and can cause cervical cancer, as well as cancers of the throat, anus and genital areas. The WHO says almost all sexually active people acquire the virus at some point in life, although most clear it without symptoms. In other cases, the infection can trigger cell changes that lead to cancer.

Cervical cancer remains the most common HPV-related cancer among women. The WHO said there were just over 600,000 new cases and 280,000 deaths in 2024. Vaccine access has expanded, with a shot against HPV now available in roughly 165 countries, but public health officials say raising uptake remains the central challenge.