This CHIC technical brief synthesizes evidence and programmatic considerations to guide country decision-making on expanding HPV vaccination beyond the primary target of girls aged 9–14, in response to a growing number of African countries adopting or considering vaccination of older girls (15–18), young women up to age 26, or boys. Grounding its analysis in WHO SAGE recommendations and modelling from IARC and the WHO Cervical Cancer Elimination Modelling Consortium, the brief affirms that — in resource-constrained, Gavi-eligible settings — focusing on achieving high coverage (≥80%) in the primary cohort remains the most cost-effective and epidemiologically efficient strategy to accelerate cervical cancer elimination. Expanding to boys is the least efficient allocation in terms of numbers needed to vaccinate to prevent a case of cervical cancer, and does not accelerate elimination timelines; furthermore, no published evidence yet confirms that including boys reproducibly improves vaccine uptake among girls in low-resource settings. The brief identifies three critical evidence gaps: quantifying acceptance changes following cohort expansion in low-resource settings, generating real-world cost-effectiveness data for new target groups, and strengthening disaggregated coverage data to ensure expansion decisions serve the most underserved communities first.