Dibrugarh: A survey on HPV vaccination awareness and willingness conducted among students in Upper Assam has revealed extremely low vaccine uptake, with less than one percent of respondents having received the HPV vaccine.
The survey was conducted in early 2025 by Dr Gayatri Gogoi, a well-known cancer researcher and professor, assisted by Sadiqah Kouser, an MBBS student at Assam Medical College and Hospital (AMCH), Dibrugarh.
It assessed awareness, hesitancy, and willingness towards HPV vaccination among 160 high school and college students from Upper Assam, highlighting the need for proactive and large-scale vaccination initiatives to prevent HPV-related diseases, including cervical cancer.
Cervical cancer is the second most common cancer among women and claims the life of one woman every eight minutes in India.
In 99 per cent of cervical cancer cases, the proven cause is long-term infection with high-risk human papillomavirus (HPV) subtypes such as HPV 16 and 18.
HPV can also cause other cancers in both men and women, although the overall burden is lower compared to cervical cancer.
The survey revealed that less than one percent of respondents had received the HPV vaccine. Among those who were aware that the vaccine can prevent cervical cancer but had not taken it, 60.1 per cent said they had not had the opportunity, while 39.9 per cent were completely unaware of the vaccine.
Further evaluation of concerns and barriers showed that the majority cited high cost as the main obstacle, while a smaller percentage expressed concerns about side effects or uncertainty regarding the vaccine’s necessity.
When asked about interest in subsidised vaccination, 88.1 per cent of unvaccinated respondents expressed willingness to receive the HPV vaccine if it were made available at a reduced cost.
The majority of respondents also supported the inclusion of the HPV vaccine in routine immunisation programmes.
These findings underscore the urgent need for increased awareness campaigns, improved accessibility, and government-supported vaccination drives to ensure widespread protection against HPV-related diseases.
Based on these findings, Dr Gayatri Gogoi, a strong advocate of community-driven cancer awareness campaigns in Assam, designed and conceptualised a project in consultation with Pratishruti Cancer and Palliative Trust.
The project aimed to create large-scale awareness about the importance of HPV vaccination, particularly to prevent cervical cancer and other HPV-related tumours, while ensuring vaccine availability at nearly half the cost compared to hospital settings.
Question-and-answer sessions were conducted after each batch of HPV vaccination beneficiaries was enrolled and before vaccination.
The first drive was flagged off in Dibrugarh by Pratishruti in collaboration with the Indian Medical Association, Dibrugarh, and the Federation of Obstetrics and Gynaecological Societies of India (FOGSI), Assam, on March 6 at the IMA House.
Subsequently, vaccination drives were conducted across Assam, including Guwahati with Nemcare Hospital; Dhemaji; Jorhat at Satyam Hospital; Sibsagar; Diphu at Diphu Medical College and Hospital (DMCH); Nalbari at IHA House; Tezpur at Sankara Hospital and Research Centre; Nagaon at SIMS Hospital; Morigaon at Maternity Multispeciality Hospital; and Tinsukia in collaboration with the Rotary Club.
Over the past seven months, nearly 3,000 vaccine doses have been administered.
Several doctors have led these drives, including Dr Rina Ahmed, Dr Gourangie Gogoi, Dr Sikha Sarma, Dr Vandana Gupta, Dr Bihari Agarwal, Dr Ajanta Deuri, Dr Rakhi Shyam, Dr Malabika Saikia, Dr Jyotika Boidya, and Dr Anjan Rajkonwar, among others. District-level coordination has been spearheaded by Manjula Agarwal, Panna Bharali, Jayshree Gogoi, Sewali Chetia, Utpala Shrutikar, Shabina Yasmin, Deepika Bordoloi, Asmita Kalita, Mouchumi Gogoi, and Karabi Hazarika.
Cervavac, a quadrivalent HPV vaccine produced by the Serum Institute of India, is now available at a significantly lower cost. After the indigenous Cervavac vaccine was approved by the Drug Controller General of India in 2022, vaccine prices became more affordable.
The recommended schedule includes two doses for the 9–14 age group at a six-month interval and three doses for the 15–26 age group at 0, 2, and 6 months.
According to records, this is the largest HPV vaccination coverage achieved by a non-profit organisation in India within a span of seven months.
Pratishruti has also been providing free HPV vaccination to the daughters of women affected by cervical cancer and to selected economically weaker cancer-affected families.
While there are hundreds of cancer types and not all are preventable, cervical cancer can be effectively prevented through HPV vaccination. Early detection through regular screening tests at periodic intervals further strengthens prevention efforts.
Hospitals, doctors, healthcare workers, and volunteers from various districts of Assam continue to support this mission.
The Nagaon district administration has taken steps to prioritise HPV vaccination, improve affordability, and raise public awareness. Debasish Sarma collaborated with Pratishruti and Nagaon Medical College and Hospital to sensitise the public during the Independence Day programme at the parade ground, where free and subsidised vaccinations were provided to 100 beneficiaries with support from Deepsikha Foundation.
HPV vaccines are currently administered in a limited number of hospitals in Assam; however, coverage of all eligible age groups will remain difficult unless the vaccine is integrated into the universal immunisation programme.
Utpal Borah, MLA of Gohpur constituency, organised free HPV vaccination for 40 girls from his constituency on December 28.
India declared HPV vaccination for girls a national priority in the 2024 Union Budget, with a phased, school-based rollout targeting 9–14-year-olds. India accounts for nearly 20 per cent of global cervical cancer cases and would need to vaccinate approximately 68 million girls initially.
The World Health Organization’s 2022 recommendation for a single-dose HPV vaccination schedule is particularly relevant for India.
Strong evidence, including long-term Indian cohort data, shows that a single dose provides vaccine efficacy of about 95 per cent, comparable to two or three doses, and could prevent nearly one million cervical cancer cases cost-effectively.
With the launch of the indigenous Cervavac vaccine, India can adopt pragmatic strategies such as extended dosing intervals and rapid evaluation of a single-dose schedule to accelerate cervical cancer elimination.
This initiative by Pratishruti, under the leadership of Dr Gayatri Gogoi, has triggered a widespread vaccination movement across Assam.
Pratishruti Cancer and Palliative Trust, an organisation working in cancer care and palliative services, continues to advance efforts aligned with the World Health Organization’s targets.