HPV Vaccine in Nepal: 2025 Campaign and Routine Program Guide

The human papillomavirus (HPV) vaccine protects against the virus types that cause the large majority of cervical cancers. On 4 February 2025 (Magh 2081 BS), which is World Cancer Day, Nepal's Ministry of Health and Population (MoHP) launched the country's first large-scale national HPV vaccination campaign. The two-week drive was led by the Family Welfare Division under the Department of Health Services (DoHS) and supported by Gavi, the Vaccine Alliance, the World Health Organization (WHO) and UNICEF.

The campaign used a "multi-age cohort" (MAC) approach, meaning it vaccinated several age groups at once rather than only a single birth-year. The target was adolescent school girls in grades 6 to 10 plus out-of-school girls aged 10-14 years, a combined target population of roughly 1.6 million girls. Vaccination was delivered mainly through schools, supplemented by community and health-facility sessions to reach out-of-school and hard-to-reach girls.

Within about two weeks, more than 1.46 million girls received the vaccine, giving approximately 94% administrative coverage. This exceeded the initial two-year target of 90% coverage in a single campaign, making it one of the most successful new-vaccine introductions in Nepal's history. In a few high-Himalayan districts, sessions were postponed due to snow and conducted later.

During the February 2025 catch-up campaign, eligibility was deliberately broad so that no adolescent girl in the target range was missed. Any girl studying in grades 6 through 10, and any out-of-school girl aged 10 to 14 years, was eligible for one free dose. Boys and adult women were not part of this campaign, because the vaccine gives the strongest protection when given before a person is exposed to HPV, which is why the focus is on younger adolescent girls.

From 2026 onward the eligibility rule is simpler and repeats every year. Under routine immunization the vaccine is offered annually to girls in grade 6, and to out-of-school girls who are about 10 years old, so that each new cohort of adolescent girls is protected in turn. Parents of grade-6 girls should therefore expect an HPV vaccination session each school year.

Girls who missed the 2025 campaign should ask at their school, local health post, or urban health centre about catch-up options, as immunization programs generally try to reach children who were not vaccinated on schedule. Because eligibility and catch-up rules can be updated by the Family Welfare Division, families are advised to confirm the current year's criteria with their nearest health facility.

Nepal's program uses a bivalent HPV vaccine that protects against HPV types 16 and 18, the two types responsible for roughly 70% of cervical cancers worldwide. The product used is an Escherichia coli-produced recombinant bivalent vaccine (branded Cecolin, manufactured by Innovax/Xiamen), which WHO added to its list of prequalified vaccines confirmed for single-dose use in October 2024. It is given as one 0.5 millilitre injection into the muscle of the upper arm (the deltoid).

HPV became the 14th antigen in Nepal's national immunization schedule. Nepal follows the World Health Organization's Strategic Advisory Group of Experts (SAGE) recommendation, endorsed nationally by the National Immunization Advisory Committee, that a single dose gives protection comparable to two doses for girls in this age group. A single-dose schedule lets the program reach far more girls at lower cost, which is central to Nepal's plan to sustain the program.

Like all vaccines, the HPV shot can cause mild, short-lived side effects such as soreness at the injection site, mild fever or headache; serious reactions are rare. The vaccine does not treat an existing HPV infection or cervical cancer; it prevents new infection, which is why it is given to adolescents before likely exposure. Vaccinated girls will still need cervical cancer screening later in adult life.

The 2025 drive was designed as a one-time catch-up to rapidly protect five school grades at once, followed by permanent integration into the National Immunization Program. From 2026 the HPV vaccine is a standing part of routine childhood immunization, delivered every year to a single new cohort rather than through mass campaigns. This mirrors how other routine vaccines such as measles-rubella and DPT are sustained.

The annual routine cohort is grade-6 school girls, with out-of-school girls of about 10 years of age reached through community sessions. Delivering it once a year to a fixed grade keeps coverage high, makes planning predictable for schools and health workers, and ensures that girls receive the vaccine at the ideal age, before likely exposure to HPV.

Because the vaccine is now part of routine immunization, families do not need to wait for a special campaign; grade-6 girls are offered the dose during the school year at no cost. As Gavi's initial support tapers over time, Nepal is expected to contribute a growing share of the cost, a standard part of the country's transition toward financing its own immunization program.

Cervical cancer is the second most common cancer among women in Nepal and a leading cause of cancer deaths in Nepali women. According to Global Cancer Observatory (Globocan) 2022 data, cervical cancer accounted for about 17.8% of all cancers among Nepali women, with an estimated 2,169 new cases and 1,313 deaths that year. Public-health advocates note this is on the order of several women dying from the disease every day.

Nearly all cervical cancer is caused by persistent infection with high-risk HPV types, which the vaccine directly targets. A major challenge in Nepal has been late diagnosis: a large share of cases are detected at an advanced stage, when treatment is harder and outcomes are poorer. Preventing infection through vaccination, decades before cancer would otherwise develop, is therefore one of the most cost-effective interventions available.

The campaign supports the World Health Organization's global strategy to eliminate cervical cancer as a public-health problem, often summarised as the 90-70-90 targets: 90% of girls fully vaccinated against HPV by age 15, 70% of women screened with a high-performance test, and 90% of women with cervical disease receiving treatment. Nepal has set national goals aligned with this, including fully vaccinating 90% of girls aged 10-14 and screening 90% of women aged 30-49 by 2030.

For girls in the routine cohort, the simplest route is through school. Grade-6 girls are offered the HPV vaccine during school-based immunization sessions organised each year, so parents usually do not need to visit a separate clinic. Schools receive advance notice and coordinate consent with parents before the session.

Out-of-school girls and any eligible girl who missed a school session can get the single dose at government health facilities, health posts and urban health centres, where routine immunization services are provided free of charge. Because the vaccine is delivered through the public National Immunization Program, there is no fee for the dose in government facilities.

Parents who are unsure whether their daughter is eligible, or where the nearest session is, should contact their child's school, the local health post, or the ward or municipal health office. The Family Welfare Division under DoHS updates the annual schedule and eligibility, so confirming the current year's session dates locally is the most reliable approach.