HPV Vaccine: A life saving shot still out of reach for so many

Zeynep Sude Yeşildağ is a 4th year medical student, Nakhcivan State University, Azerbaijan

According to the World Health Organisation (WHO), cervical cancer is the fourth most common cancer in women globally. In 2022, 660,000 women were diagnosed with cervical cancer. In the same year, 350,000 women died from cervical cancer, and 94% of these deaths happened in low- and middle-income countries.¹

The link between HPV and cancer

What makes such statistics particularly devastating is that cervical cancer is, in most cases, preventable. Human Papilloma Virus (HPV) is a sexually transmitted infection so common that nearly all sexually active individuals will encounter it at some point. While most types are benign, some—particularly types 16 and 18—are high-risk strains that can lead to several cancers, with cervical cancer being the most common.

A breakthrough: the HPV vaccine

First introduced in 2006, the HPV vaccine marked a significant breakthrough public health efforts aimed at eliminating cervical cancer. Today, the most effective and reliable vaccine, Gardasil-9, offers nearly 100% protection against HPV-related diseases (types 16, 18, 31, 33, 45, 52, 58, 6, and 11) when administered before exposure to HPV.⁷ It is important to note that the vaccine does not treat existing HPV infections; rather, it protects against new infections. As such, it is most effective when given before the onset of sexual activity, ideally between the ages of 11 and 12, as the immune system responds most strongly at this age. However, vaccination is recommended for individuals aged 9-26, and women between 26 and 45 may also receive the vaccine under the guidance of a healthcare provider.^{5 6}

Why the HPV Vaccine is not reaching everyone and how we can change that

Despite its proven effectiveness, access to the HPV vaccine remains limited, especially in low- and middle-income countries. High-income nations like the UK, Australia, and Germany have included it in national immunization programs and offer it free of charge, aiming to eliminate cervical cancer. In contrast, countries such as Turkey, Azerbaijan, Afghanistan, and Pakistan often rely on private healthcare, where the vaccine is costly and less accessible.

Unfortunately, financial barriers are not the only issue. The vaccine also faces cultural and societal resistance, particularly in conservative and religious communities. A common misconception is that it promotes sexual activity. However, studies show no link between the vaccine and increased sexual behavior.² In fact, taboos around sexuality and limited discussion lead to low awareness. Many women may not even know the vaccine exists, despite its life-saving potential.

Concerns about giving the vaccine at a young age, fears over side effects, and the mistaken belief that it is only needed for girls further hinder uptake. Vaccine-related conspiracy theories also contribute to public hesitancy.

First step in addressing these barriers is raising public awareness. It’s important to emphasize that the HPV vaccine protects not only against a sexually transmitted infection but also against several types of cancer. People need to understand that the vaccine is essential for both girls and boys, as HPV can also cause oropharyngeal, penile, and other cancers in males. Misconceptions and fears fueled by conspiracy theories must be countered with accurate, science-based information.

To correct misunderstandings, build trust, and boost vaccination rates, a strong public education and awareness campaign is essential. This effort should target not only the general population but also healthcare providers. Family doctors, in particular, play a key role in informing and guiding the public. If well-informed, they can explain the vaccine’s importance and help reduce unnecessary concerns.

However, healthcare workers cannot achieve this alone. Widespread adoption of the HPV vaccine requires collective action. Governments, health professionals, educators, and religious leaders must work together to support and promote vaccination.

Religious leaders, in particular, can play a significant role in breaking societal taboos and dispelling misconceptions about the HPV vaccine. In many conservative societies where sexual health remains a sensitive and often unspoken topic, the involvement and support of religious leaders can be instrumental in easing public concerns and positively influencing attitudes toward the vaccine.

Governments must also act as regulators and key supporters in this process. They must contribute to the necessary policies, financial support, and public health campaigns to promote widespread adoption of the vaccine. It is crucial for governments to recognize that the HPV vaccine is just as important as other routine childhood vaccines, such as those for mumps or polio. By working closely with healthcare professionals, they can ensure that the HPV vaccine becomes part of national immunization schedules, thereby emphasizing its vital role in preventing serious illnesses and saving lives.

One of the biggest obstacles to wider HPV vaccine coverage is financial. Although the vaccine is cost-effective, especially in the long term, many low- and middle-income countries face significant budget limitations. As a result, they often prioritize treatment over prevention, focusing resources on managing existing diseases rather than investing in measures like vaccination.

However, by prioritizing preventive healthcare, countries can reduce the future burden of diseases such as cancer—both in terms of lives lost and the high cost of treatment. In the long run, investing in prevention is not only a more humane approach but also an economically sound one.

International aid initiatives like GAVI, the Vaccine Alliance, offer a potential solution. GAVI provides funding and support to low- and middle-income countries for essential vaccines, including the HPV vaccine. This assistance helps overcome financial barriers and expands access to life-saving preventive care for those who need it most. ^3,4

The HPV vaccine is a critical public health tool that must become more widely accessible. It faces both societal and cultural resistance as well as governmental barriers, particularly in the context of financial issues. While challenges exist, there are accessible solutions too. We must work together to overcome these challenges and remember that the vaccination provides not just individual protection, but also population-level protection!

References:

1. World Health Organization (WHO), Cervical Cancer, https://www.who.int/news-room/fact-sheets/detail/cervical-cancer [Accessed 7 May 2025].
2. PBS, Promoting the HPV Vaccine Doesn’t Lead to More Teen Sex, Study Shows, https://www.pbs.org/newshour/health/promoting-the-hpv-vaccine-doesnt-lead-to-more-teen-sex-study-shows [Accessed 7 May 2025].
3. Wikipedia, HPV Vaccine, https://en.m.wikipedia.org/wiki/HPV_vaccine [Accessed 7 May 2025].
4. Frontiers in Oncology, HPV Vaccination and Cancer Prevention, https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1380663/pdf [Accessed 7 May 2025].
5. PubMed, HPV Vaccine, https://pubmed.ncbi.nlm.nih.gov/17010274/ [Accessed 7 May 2025].

Featured photo by Tim Marshall on Unsplash.