In this case series, Ndiaye and colleagues describe how Senegal, Togo, Tanzania, and Lesotho have operationalized integrated HPV vaccine service delivery with adolescent health programmes. Across four countries, three models of integration emerge: incorporation into routine immunisation, co-delivery with non-vaccine adolescent health services (e.g., nutrition, deworming, sexual and reproductive health education), and leveraging new vaccine introductions for co-delivery. Tanzania’s HPV-Plus programme demonstrates a scalable school-based model combining vaccination with comprehensive adolescent preventive care. The authors propose a three-level integration framework and underscore the need for robust evaluation of sustainability, costs, and outcomes across diverse low- and middle-income country contexts.