HPV Vaccination in Hyderabad, India

Role of HPV vaccination in reducing cervical cancers

The WHO aims to achieve the goal through: 

• Low-cost approaches to screening and treating cervical cancer precursors
• Development of resource-appropriate management guidelines
• Novel approaches to surgical training
• Initiatives to increase global access to anti-cancer drugs 

Along with the above factors, the WHO also ensures a constant and steady flow of commercial availability of prophylactic HPV vaccines which also plays an important role in the eradication of cervical cancers.



Among various other factors which prompted the initiation of the aforementioned campaign, the prime reason included is the slow roll-out of HPV vaccination. The other factors could include low levels of screening as well as limited access to cervical cancer treatment. 

Necessity of HPV vaccines

Fortunately, protection from HPV-related sexually transmitted diseases and infection also with its associated cancers can be obtained through immunization by HPV vaccine. HPV vaccination, in general, has demonstrated superior efficacy and tolerability (safety).

Since among 50% of adolescents become sexually active at some point during high school the Centers for Disease Control (CDC) – an American organization governing the health related aspects recommended the administration of HPV vaccination to be initiated of between the ages of 11 and 12 to, so adolescents get enough time to develop adequate immunity prior to HPV exposure. The endorsement of advisory committee on immunization practices (ACIP) supported CDC’s recommendation encouraging the incorporation of HPV vaccine into the routine immunization schedule aimed at adolescent girls.

A 2021 Danish study demonstrated that a nationwide cohort study in which the result of HPV vaccinations is reported:

• A reduction of 86% in cervical cancer among 16-year-old and younger people 
• A 68% decrease is seen among older teens 

Similarly, a Swedish study also demonstrated a reduction of 62% in cervical cancer among young women who were vaccinated between 20 and 30 years of age.

While there is an overwhelming evidence of HPV vaccination in the reduction of cervical cancer cases worldwide, the availability of HPV vaccine is constrained owing to its slow roll-out rate (which may continue until 2022/25) due to which an alternative scheduling of doses and/or reduction of doses are under discussion.

While the initial recommendation of three-dosing schedule, priming doses at 0 and 1/2 months followed by a boost at 6 months, was altered in 2014 by WHO SAGE for adolescents at <15 years of age to two doses, at 0 and 6 or 12 months.

HPV vaccine schedule by age

HPV vaccine mechanism of action

HPV vaccines administrated through intramuscular injection induce immunity by triggering B-cell and T-cell responses. These are components of the immune system. The mechanism of HPV vaccines lies in the formation of antibodies. 

• They induce formation of antibodies which bind the virions, preventing initial infections.
• These antibodies (mostly immunoglobulin G (Ig)) can reach the cervicovaginal infection sites either by 
• transudation of antibodies across the epithelial barrier into mucosal secretions at the cervix or 
• direct exudation of serum and interstitial antibodies at the site. 

The risks include both local and systemic adverse effects. The overall local side effects mainly include the possibility of infection at the injection site, which contains no statistical significance when compared with the serious side effects events.

A WHO-commissioned 2018 Cochrane study demonstrated no difference in the terms of a few selected serious side events when compared in those who were vaccinated with the HPV vaccine against the those were unvaccinated.

The data from the vaccine adverse event reporting system (VAERS) from data with over 60 million doses administered demonstrated no identified association between HPV vaccine and the following: 

• Guillain–Barré syndrome (rare autoimmune disorder affecting the nerves)
• Complex regional pain syndrome (chronic pain in the limbs which develops after injury, surgery, stroke or heart attack)
• Bell’s palsy (sudden onset of muscular weakness on one half of the face)
• Postural orthostatic tachycardia syndrome (sudden syncope due to reduced blood volume seen during getting up)
• Premature ovarian insufficiency (loss of ovarian function before the age of 40)
• Venous thromboembolism (condition of blood clot in a vein)

While HPV vaccine demonstrated no connection in pregnancy outcome, it is recommended to not get vaccinated during pregnancy.

Benefits of HPV vaccine

A 2013 European study demonstrated the benefits of HPV vaccine. It brought:

• 90% reduction in HPV infection related cancers in females 
• 86% reduction in HPV infection related cancers in males 
• 58% of reduction in HPV of infection related genital warts in females 
• 71% of reduction in HPV of infection related genital warts in males 

The study concluded that the vaccinations of both boys and girls against HPV was associated with substantial reduction of not only HPV infection related cancers and warts but also other anticipated additional clinical benefits such as reduced incidence of head/neck cancers, cervical, vaginal & vulvar diseases etc.

The scenario of HPV vaccine in India

Bivalent and quadrivalent HPV vaccines were licensed for prescription use by Indian authorities in 2008. The first large-scale introduction of HPV vaccination in the public health setting in India was in demonstration projects in 2009 that aimed to establish how best to deliver the vaccine. These projects were implemented by the state governments of Andhra Pradesh and Gujarat in collaboration with the Indian Council of Medical Research (ICMR) and the Programme for Appropriate Technology in Health (PATH), a US-based not-for-profit nongovernmental organization, in 2009.

• The bivalent vaccine (against HPV subtypes 16 and 18) was used in Vadodara district.
• The quadrivalent vaccine (against HPV subtypes 6, 11, 16, and 18) was used in Khammam district. The last couple of strains, HPV-16 and HPV-18, are responsible for causing at least 80-85% of all the cases of cervical cancers in India, while HPV-6 and -11 are responsible for at least 90% of genital warts. Vaccination against these subtypes can result in the increased chances of prevention of these cancers and warts. 
• A nonvalent vaccine had been licensed for use in India since 2018 which prevents infection arising from the nine HPV subtypes (6,11,16,18, 31, 33, 45, 52, 58). Vaccination with this nonvalent vaccine can help in the prevention of the additional about 10% of cervical cancers.

Recently, India has indigenously rolled out its own vaccine against HPV. This quadrivalent vaccine - Cervavac was launched in the eve of India’s entry into the list of the global Cervical Cancer Elimination Initiative which aims at the acceleration of cervical cancer elimination.

It was a joint venture of the Indian Government’s Department of Biotechnology and the Serum Institute of India, Pune. It was approved for marketing on the 12th of July 2022 by Drug Controller General of India after reviewing a positive data from a large-scale phase 2/3 clinical trial.

HPV vaccine types and names

Therapeutic vaccination is the most obvious strategy, as host immunity plays an important role in viral clearance. The names and efficacy of various HPV vaccines is as follows:

HPV vaccine cost in Hyderabad, India can vary from ₹ 1,000 to ₹ 10,850 (Rs one thousand to ten thousand eight hundred fifty only) per dose for child or adults that totally depends on the HPV vaccine brand a person choose. There are 4 types of HPV vaccines which are marketed in India. The below table includes HPV vaccine price in India along with their target HPV strains: