When India launched its national HPV vaccination programme on 28 February 2026, it was rightly hailed as a watershed moment in public health. Over 11.5 million girls aged 14 are being offered a single free dose of the quadrivalent Gardasil-4 vaccine at government health facilities across the country, marking, in the words of the WHO Director-General, the largest free HPV vaccination drive in history. It is a milestone worth celebrating. But doctors watching the rollout say a quieter question deserves far more attention than it is currently receiving: what about the boys?
"The instinct to prioritise girls makes clinical sense — cervical cancer is the second most common cancer among Indian women, and the burden is enormous," says a consultant paediatrician involved in adolescent immunisation. "But treating this as purely a girls' vaccine reflects an outdated, incomplete picture of what HPV actually does."
The virus itself makes no distinction between sexes. It spreads through skin-to-skin contact, most commonly during sexual activity, and it can settle in tissue well beyond the cervix. In boys and men, persistent high-risk HPV infection is linked to cancers of the throat, anus and penis, as well as genital warts — conditions that receive a fraction of the public attention cervical cancer does, largely because they are less visible and more stigmatised, not because they are rare.
There is also the matter of transmission. Unvaccinated boys can carry and pass on the virus to partners regardless of gender, meaning a vaccination strategy that overlooks half the population leaves a persistent reservoir of infection in circulation. "Herd protection through girls-only vaccination helps, but it isn't the same as closing the loop," the doctor explains. "Countries that have added boys to their national schedules — Australia and the UK among them — have seen infection rates fall further and faster than girls-only programmes achieved on their own."
India's current approach is not without sound reasoning. Resources are finite, and cervical cancer remains a leading cause of cancer death among Indian women, with the country accounting for roughly a quarter of the world's cervical cancer deaths. Beginning with girls, particularly at age 14, before likely exposure to the virus, is a defensible first phase rather than a permanent exclusion. Health officials have indicated the vaccine is being folded into the universal immunisation programme over time, which leaves room for expansion.
In the meantime, the vaccine is not unavailable to boys — it simply is not yet free or state-administered for them. Private clinics across India do offer HPV vaccination to boys and young men, and clinicians increasingly recommend it, particularly for those under 26 and, in select cases, up to 45. The obstacle is less medical than financial and informational: many families are simply unaware that the option exists, or assume, understandably, that a girls-focused government campaign means the vaccine has nothing to offer their sons.
"This is where myth-breaking matters most," the consultant adds. "A vaccine doesn't become irrelevant to a family just because the person in front of the needle is a girl. If a household understands that HPV threatens sons just as much as daughters, uptake conversations change entirely."
As India's campaign matures, the hope among clinicians is straightforward: that today's girls-first strategy becomes tomorrow's everyone-included one, and that awareness moves at the same pace as policy.
The author is the Director - Surgical Oncology, CK Birla Hospital, 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.
