In a country where urban India is often seen as more informed, connected, and health-aware, the persistent hesitancy around the Human Papillomavirus (HPV) vaccine presents a paradox. Despite growing conversations around preventive healthcare, HPV vaccination, which is critical in preventing cervical cancer, continues to see low uptake even in cities.
At the heart of this hesitation lies a fundamental issue: lack of awareness. Multiple studies indicate that knowledge about HPV itself remains limited, even among educated populations. In some urban cohorts, less than half of respondents were aware of HPV’s link to cervical cancer, and awareness about the vaccine was even lower. This gap is particularly concerning given that cervical cancer remains one of the leading causes of cancer-related deaths among women in India.
Compounding this is a deeper misunderstanding of what the vaccine represents. HPV is a sexually transmitted infection, and this association often creates discomfort, especially among parents considering vaccination for adolescents. Conversations around sexual health continue to be culturally sensitive, leading to avoidance rather than informed decision-making. In some cases, there is also a concern that administering the vaccine at a young age may inadvertently promote early sexual activity, an assumption not supported by scientific evidence, but one that continues to influence parental attitudes.
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Misinformation and safety concerns further complicate the landscape. Social media has amplified myths around side effects, long-term health risks, and even fertility-related fears. Doubts about the vaccine’s long-term efficacy also persist, despite strong global evidence confirming both its safety and effectiveness. Additionally, past controversies around vaccine trials in India have contributed to lingering distrust, reinforcing hesitation even in urban, educated populations.
Practical barriers such as cost and accessibility also play a role. While urban populations have relatively better access to private healthcare, the HPV vaccine is still perceived as expensive, often costing several thousand rupees per dose. Unlike vaccines included in India’s Universal Immunisation Programme, HPV vaccination has not yet achieved universal visibility or integration, making it less likely to be part of routine healthcare conversations.
Healthcare provider influence adds another layer to the issue. Studies suggest that physicians do not always proactively recommend the HPV vaccine, whether due to time constraints, assumptions about patient receptivity, or their own uncertainties. In urban India, where medical advice strongly shapes health decisions, the absence of a clear recommendation often leads to inaction.
Finally, there is a broader issue of perceived risk. Many individuals in urban settings do not consider themselves or their families at risk of HPV-related diseases. Preventive healthcare measures, especially vaccines for conditions that are not immediately visible or widely discussed, often struggle against this sense of complacency.
The irony is stark: urban India has access to information channels and healthcare infrastructure, yet continues to hesitate. Addressing this gap requires more than availability. It calls for clear and culturally sensitive communication, normalisation of conversations around sexual health, stronger advocacy from healthcare providers, and policy-level interventions to make the vaccine both affordable and routine.
Until then, the gap between awareness and action will continue to define India’s HPV vaccination story even in its most informed urban pockets.
The author is the senior director and unit head – Radiation Oncology at Fortis Medical Research Institute, Gurgaon.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.