This presentation shares the Gambia’s journey in implementing HPV vaccination, highlighting key lessons, challenges, and the way forward. HPV vaccination began with a demonstration program between 2014 and 2016 in two health regions—Western I and II—chosen for their diverse and representative populations. Using a school-based, campaign-style delivery, the program targeted girls in grade 3 and out-of-school girls aged 9–14. After meeting demonstration targets, the Gambia launched a nationwide rollout in 2019, using a multi-age cohort approach and reaching a national coverage of 83% in the first year. However, the COVID-19 pandemic disrupted momentum. School closures, misinformation, and public fear due to viral social media posts about vaccine trials caused a dramatic drop in HPV vaccine uptake—coverage fell to under 10% in 2021. Additional challenges included limited funding, competition with COVID-19 vaccination campaigns, and manual tracking systems. In response, the Gambia implemented targeted community engagement, integrated HPV messaging into COVID-19 communication, and strengthened collaboration with schools and religious leaders. The country plans to align with WHO’s one-dose recommendation, integrate HPV into other school health activities, and upgrade to electronic registries to better track adolescent vaccination.