E-Paper
From infectious diseases to cervical cancer, vaccination holds the key
This article is authored by Kavita Ayyagari, country director, Girl Effect, India.
As we celebrated immunisation week in the last week of April, there is a need to talk about the tremendous progress the country has made since the time Anna Dusthall, a three-year-old child from Mumbai became the first person in India to receive smallpox vaccine on June 14, 1802; to post-Independence India, when in 1948, the BCG vaccine laboratory was set up at the King Institute, Guindy, Chennai and other national institutes and a number of private vaccine manufacturers came up; to 30 years later, when India launched the Expanded Programme of Immunisation (EPI) in 1978 and the Universal Immunisation Programme (UIP) in 1985. Since 2014, with Mission Indradhanush and Intensified Mission Indradhanush, India has demonstrated immense scale and consistency in its drive to vaccinate its population and especially children. The Covid crisis tested all countries but India came through demonstrating unprecedented scale. India has built one of the world’s largest vaccination initiatives, administering billions of doses, expanding digital infrastructure and leveraging its frontline workforce to reach its vast population. India today is capable of meeting domestic demand and has also become a key supplier of vaccines to other countries. This is something we all as a nation have to celebrate and applaud.
It is against this backdrop that India’s rollout of the HPV vaccine marks a new and important chapter in India’s quest for being disease-free. For decades, immunisation efforts have focused on controlling infectious diseases. With HPV, the shift is palpably different. We are trying to prevent a cancer before it begins. In a new cohort that is not young children below five or adults but adolescents. This shift reflects a change, and it signifies a re-thinking of what a public health system can achieve. The State architecture that enabled large-scale campaigns for polio and Covid-19, is now being applied to a completely different disease: cervical cancer. Polio was a mission for decades and eradication was a goal every country endeavoured to deliver. Covid 19 was an urgent crisis that needed immediate action. Cervical cancer is the second most prevalent cancer in women. The Southeast Asia region ranks second, contributing 29.59 % of global cervical cancer cases and 34.12 % of deaths, with India alone reporting 1,27,526 new cases and 79,906 deaths in 2022.
But despite these heavy statistics, awareness of cervical cancer is dismally low. As a country, while we may demonstrate immense capacity to roll out a vaccination drive at scale, the challenge here is different. It is public awareness or lack of it and perception of the disease as a serious cancer that is taking so many lives, unseen, unheard and not really talked about.
Since the launch of the vaccine on February 28, 2026 by the Prime Minister, the media has been buzzing with information on the HPV vaccine. Through articles by experts, state statistics, health influencers, testimonials, the internet too has been abuzz. While a majority of this discourse is positive, there is a small stream of information that highlights concerns. This is not loud. But it’s out there.
In vaccination, hesitation rarely shows up as outright refusal. More often, it appears as a delay. As a decision postponed or a session missed or a question left unresolved. For a parent, the decision to vaccinate is rarely about availability. It is about confidence. Once confidence is established, then the system delivers seamlessly.
India’s experience with past immunisation campaigns offers clear lessons. From polio eradication efforts to the Covid-19 vaccination drive, success has depended not only on supply chains and delivery systems, but on sustained efforts to build and maintain public trust. These don't get built immediately. They require persistent and constant effort. The HPV vaccination is now entering that same phase. The systems are in place and the scale is significant. Sustaining momentum will depend on how effectively the programme responds to the social dimensions of vaccination.
Public perception is a powerful force that shapes behavior in ways we might not even realise. It serves as the lens through which we interpret the world around us, influencing thoughts, actions, and interactions with others. This means that public health campaigns, especially new ones, need to look not only at the supply side but also how public perceptions shape demand. They require a deep understanding of factors that shape what people give salience to, who they follow and trust, how different actors in the family and their closest circles behave, their past experiences and beliefs, and how each reinforces their perceptions and drives their behaviours.
The HPV vaccine rollout represents a significant opportunity for the country to prevent cervical cancer, and in the process strengthen our broader approach to immunisation in the complex, socially connected world we live in where both information and misinformation reach fast and wide. It opens the doors to going deep and understanding the “why”. Why do people do as they do or why not? It gives us an opportunity to strengthen not only delivery but also demand. It is in our ability to truly understand how the public receives, processes, understands and reacts to information and weighs the benefits of an action that programmes can deliver the health benefits they seek to at large.
(The views expressed are personal)
This article is authored by Kavita Ayyagari, country director, Girl Effect, India.
