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Puberty is at 8, so why the HPV vaccine until 14? Doctors respond

India is preparing to launch a 90-day mega drive to provide free HPV vaccines to 14-year-old girls. The move is being seen as a major step in preventing cervical cancer, one of the most common cancers among women in the country.

However, two key questions are being widely discussed. Why is India opting for a single-dose HPV vaccine when several other countries still follow a two-dose schedule?

And why is the vaccine being targeted at 14-year-old girls when puberty is starting earlier, and many countries vaccinate children between 9 and 12 years of age?

Gynaecologists say the answers lie in science, global guidelines, and public health strategy.

VACCINATING AT 14: DOES IT AFFECT PROTECTION?

According to World Health Organisation (WHO) guidelines, the recommended age for HPV vaccination globally is between 9 and 14 years.

Dr Tripti Raheja, Director – Obstetrics & Gynaecology at CK Birla Hospital, explains that vaccinating girls at 14 years does not reduce the vaccine’s effectiveness.

“The HPV vaccine works best when given before exposure to the virus, which usually happens after the start of sexual activity. Most girls in India are not sexually active in early adolescence and are still HPV-naive at 14.

So vaccinating at this age protects them before any possible future exposure,” she says.

Dr Payal Choudhary, Senior Consultant – Obstetrician & Gynaecologist at Rosewalk by Rainbow Hospitals, adds that while some countries vaccinate between 9 and 13 years because the immune response is very strong at that age, vaccination at 14 still provides excellent protection.

“The adolescent immune system is active and responds well to the vaccine. Being vaccinated at 14 does not significantly reduce effectiveness. The main goal is to ensure timely vaccination before exposure,” she says.

Experts emphasise that the difference between vaccinating at 11 or 14 is not dramatic, as long as it happens before exposure to HPV.

WHY IS INDIA CHOOSING A SINGLE DOSE?

Another major change is India’s decision to follow a single-dose HPV vaccine schedule.

Traditionally, many countries recommended two doses for adolescents. However, recent global studies have shown that a single dose can elicit a strong, long-lasting immune response, especially when given during early adolescence.

Doctors say that one dose is not a compromise, but a strategy backed by data. Studies have shown that a single dose provides significant protection against HPV infection and precancerous cervical lesions.

India’s decision is not only scientific but also practical.

A single-dose strategy makes it easier to vaccinate millions of girls through school-based and public health programmes. It reduces logistical challenges, improves compliance, and increases coverage, especially in rural and underserved areas.

“In a country as large as India, ensuring that every eligible girl receives even one dose is a big achievement. A single-dose programme improves reach and participation,” doctors say.

Ongoing monitoring will continue to assess long-term effectiveness, but current evidence suggests that protection remains strong.

THE BIGGER GOAL: PREVENTING CERVICAL CANCER

Cervical cancer is largely caused by persistent infection with high-risk types of HPV. The vaccine prevents infection from the most common cancer-causing strains.

Doctors stress that the key objective is to vaccinate girls before they are exposed to the virus. Whether it is given at 11, 12, or 14, the priority is high coverage and timely administration.

“Earlier vaccination between 9 and 12 years is ideal, but vaccination at 14 is still fully within the recommended range and offers long-lasting protection,” experts conclude.

With the upcoming free 90-day drive, public health authorities hope to significantly reduce future cases of cervical cancer in India. For many families, this initiative could mean protection that lasts a lifetime.

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