WHO Panel Endorses Single HPV Vaccine Dose

An expert panel that advises the World Health Organization (WHO) on vaccines now says there is enough evidence to recommend a single dose of the HPV vaccine for girls aged 9 to 20. The vaccine, which protects against some forms of cervical cancer and other HPV-related cancers, is typically given in several doses.

The WHO Strategic Advisory Group of Experts on Immunization (SAGE) made the recommendation in early April, concluding that a single dose of the HPV vaccine provides “solid protection” against the virus and is comparable to receiving two doses.

“This could be a game-changer for the prevention of the disease; seeing more doses of the life-saving jab reach more girls,” the WHO said in a news release.

“The HPV vaccine is highly effective for the prevention of HPV serotypes 16 & 18, which cause 70% of cervical cancer,” SAGE chair Alejandro Cravioto, MD, said in a statement. “SAGE urges all countries to introduce HPV vaccines and prioritize multi-age cohort catch up of missed and older cohorts of girls."

Why a Single-Dose Vaccine Matters

The HPV vaccine has not been widely used on a global scale. According to WHO data, just 13% of girls across the world received two doses of the vaccine, citing supply challenges and relatively high cost of the vaccines as obstacles. Plus, there’s the cost of delivering a two-dose vaccine to older girls who are not usually part of childhood vaccination programs.

"In 2020 the Cervical Cancer Elimination Initiative was launched to address several challenges including the inequity in vaccine access," said WHO Assistant Director-General Princess Nothemba Simelela, MD. “This single-dose recommendation has the potential to take us faster to our goal of having 90% of girls vaccinated by the age of 15 by 2030.”

Richard Watkins, MD, an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University, tells Verywell a single dose make work well only in younger age cohorts because “there can be less of an immune response to the vaccine as a woman gets older.”

What the Recommendations Say

SAGE doesn’t recommend that all girls receive one dose of the HPV vaccine. Instead, the advisory group suggests the following HPV dose schedule:

• One or two-dose schedule for the girls aged 9–14
• One or two-dose schedule for young women aged 15–20
• Two doses with a 6-month interval for women older than 21

People who are immunocompromised should receive three doses, if possible, or at least two doses.

The recommendations are not finalized. Instead, the WHO will consult with stakeholders before making a final decision.

“The recommendations are based on data and will help stretch the supply of HPV vaccines, reduce costs, and ease administration,” infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, told Verywell.

U.S. Recommendations

In the U.S., the Centers for Disease Control and Prevention (CDC) recommends that children—girls and boys—receive two doses of the HPV vaccine at ages 11 through 12, although it can be started at age 9.

The CDC recommends three doses of the vaccine if starting the series at age 15 or later, or if you’re immunocompromised. The vaccine is not recommended for people older than 26. Doses are typically given six to 12 months apart.

HPV vaccines were first introduced in the U.S. in 2006. Since then, the percentage of cervical precancers caused by HPV has dropped 40% in vaccinated women.

Adalja notes that there are limitations to SAGE’s global recommendations: It doesn’t apply to boys and only focuses on cervical cancer prevention.

“In the United States, HPV is now something that is a routine childhood immunization for both boys and girls,” he said, adding that the CDC’s Advisory Committee on Immunization Practices “will have to decide if this is a path they want to follow in the U.S. as well.”