With HPV vaccine coverage still nowhere near global goals, the World Health Organization’s vaccine advisers are urging countries to weigh an uncommon step: offering routine human papillomavirus (HPV) vaccination to girls as young as four, if it would help lift stubbornly low uptake.
Anthony Scott, who chairs the WHO’s Strategic Advisory Group of Experts on Immunisation (SAGE), said 165 countries have already introduced the HPV vaccine.
But progress has not translated into broad protection worldwide. “However, the global HPV vaccine coverage, at 33%, is far short of the global target we’re looking for, which is 90%,” he told reporters.
The WHO continues to identify HPV vaccination as a priority for all girls aged nine to 14.
Ireland’s programme recommends the HPV vaccine for both boys and girls in their first year of secondary school, when students are typically 12 to 13 years old.
The Health Service Executive (HSE) also says vaccination may be recommended for someone with a weak immune system.
In 2022, SAGE endorsed flexible dosing: a one- or two-dose schedule for girls aged nine to 14; the same for young women aged 15 to 20; and two doses, spaced six months apart, for women over 21.
After examining updated evidence, the expert group concluded that a single-dose schedule for girls aged nine to 14 represents the most efficient path to closing the gap on the global coverage target.
Scott said countries could go further if it improves participation. “Countries may also consider routine vaccination (for) girls aged four to eight years if this is likely to result in increased vaccination uptake and coverage,” he said.
Persistent infection with HPV is the cause of cervical cancer, which the WHO says is the fifth most commonly diagnosed cancer in women worldwide. In 2024, the agency recorded about 604,000 new cases and roughly 280,000 deaths.
By the end of 2025, more than 95 million girls had received HPV vaccines, according to Kate O’Brien, who leads the WHO’s vaccines department.
SAGE also advised that single-dose HPV vaccination could be widened to additional groups, ranked by priority: first catch-up vaccination of women up to age 25, then women up to 30; next routine vaccination for boys aged nine to 14; and then catch-up vaccination of males up to 20.
As of 2025, there were eight licensed HPV vaccines.
Ireland uses an HPV vaccine known as Gardasil 9.
The WHO notes that cervical cancer remains the leading cause of cancer death in women in 26 countries, largely in sub-Saharan Africa and in parts of South and Central America, Melanesia, and southeast Asia.
