South Africa’s HPV vaccine drive cuts cancer-linked infections by 83% among girls

A study of more than 2,300 girls finds steep declines in HPV 16 and 18 infections after South Africa introduced school-based vaccination, including among those living with HIV.

South Africa is seeing early evidence that its school-based HPV vaccination drive is working as intended, with new research showing steep falls in the virus strains most closely linked to cervical cancer among girls old enough to have benefited from the programme. The findings, published in The Lancet Global Health and drawn from the HOPE study, suggest the country’s long-running campaign is reducing infections at a population level, including among adolescents living with HIV, a group at especially high risk of persistent HPV infection and later cervical disease. The result matters in a country that continues to record thousands of new cervical cancer cases each year despite the availability of a vaccine. The South African Department of Health said in February 2026 that more than 5,700 women are diagnosed with cervical cancer annually and more than 3,000 die from the disease.

The vaccination programme began in public schools in 2014, targeting girls in the fourth grade and older, usually from age nine. Uptake was strong from the outset, with about 87% of eligible girls receiving at least one dose in the first year, according to the article republished from The Conversation. By February 2025, provincial health authorities in Gauteng and the Western Cape were still urging parents and caregivers to sign consent forms and return them to schools, underlining that the campaign depends on parental permission and consistent school participation. Gauteng’s health department said misinformation and weaker access to vaccination teams were among the challenges affecting coverage.

The HOPE study compared girls who were too old to be vaccinated when the programme started with those who were eligible for school vaccination, using data collected in 2019 and 2023 from 2,357 participants in public health facilities across four provinces. Roughly a quarter of the girls in the study were living with HIV, allowing researchers to measure effects in a group that faces a much higher lifetime risk of cervical cancer. They found that infections with HPV types 16 and 18, which are responsible for most cervical cancers, fell by 83% overall between the pre-vaccine and post-vaccine groups. Among girls living with HIV, the fall was 82%, from 29% to 4%.

The researchers also found evidence of cross-protection, meaning the vaccine appeared to reduce related high-risk HPV types beyond the two main targets. Other HPV types did not decline in the same way, which strengthens the case that the drop was due to vaccination rather than changes in behaviour. There was also a sign of herd protection, with unvaccinated girls in the post-vaccine period showing lower rates of HPV 16 and 18 than girls before the programme began. That pattern suggests the virus is spreading less widely in the community as coverage rises.

The latest findings fit with South Africa’s wider push to eliminate cervical cancer as a public health problem by 2030. The government’s 2026-2030 framework sets a target of vaccinating 90% of girls against HPV by age 15 and improving screening and treatment for women diagnosed with the disease. In 2022, the World Health Organisation recommended a single-dose HPV vaccine for the general population, and South Africa switched to a single-dose approach in October 2024. Officials and researchers alike say continued monitoring will be needed to make sure protection lasts, particularly for people living with HIV, but the evidence so far suggests the country’s school programme is already preventing infections that could otherwise develop into cancer years later.