One dose: WHO current guidelines, available vaccines and opportunities for MAC catchup programs with one dose

In this presentation, WHO’s updated recommendations on HPV vaccination are outlined, reflecting the latest evidence reviewed by the Strategic Advisory Group of Experts (SAGE) in April 2022. The key change is the endorsement of a single-dose schedule as an equally effective alternative to the traditional two-dose regimen for girls aged 9–14 and for young women aged 15–20. Immunocompromised individuals should continue to receive two or preferably three doses. This shift is backed by robust data from multiple randomized controlled trials and long-term observational studies (e.g., Costa Rica, India, KEN SHE, and DORIS), showing high and durable efficacy, stable immune responses lasting over a decade, and strong public health impact. WHO emphasizes that these recommendations also consider program feasibility and cost-effectiveness, especially in low-resource settings. The updated guidance also re-prioritizes catch-up vaccination for missed cohorts, and reintroduces boys’ vaccination where feasible, noting improved global supply projections by 2024. Only Cervarix and Gardasil currently have sufficient data to support one-dose use, with more evidence awaited for other vaccines. A new WHO position paper incorporating these recommendations is expected by the end of 2022. Several countries (e.g. Cambodia, the UK, Netherlands, Nigeria, and Pacific Island nations) are already shifting to single-dose schedules. WHO also offers a global HPV vaccine dashboard to track country implementation and coverage.

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