Originally published 2021-11-10.
Yes, the HPV vaccine is preventing cervical cancer, and England produced some of the first hard proof. A study published in The Lancet in November 2021 found that cervical cancer rates were 87% lower among women who had been offered the vaccine at age 12 to 13 than among women born before the programme began. The benefit was smaller, though still real, for those first vaccinated as older teenagers: a 62% reduction for girls offered it at 14 to 16, and 34% for those offered it at 16 to 18. The researchers estimated that by mid-2019 vaccination had already prevented around 450 cancers and roughly 17,200 cases of serious pre-cancerous change in England.
Headlines at the time often rounded this to "a 90% fall in cervical cancer across the UK". That is not quite what the study measured. The striking figure applies to a specific group, young women in England who were vaccinated in early adolescence, compared with similar women from earlier birth years. Women in their thirties, forties and older were never offered the vaccine as children, so their risk is unchanged, and screening remains their main protection.
What the English study actually looked at
The research was led by Professor Peter Sasieni of King's College London, working with colleagues from the UK Health Security Agency and the national cancer registration service. The team used cancer registry records covering every cervical cancer diagnosed in England in women aged 20 to 64 between January 2006 and June 2019.
England began routine school vaccination against HPV in September 2008, using a vaccine called Cervarix, and offered catch-up doses to older teenagers in the first years. That design created a natural experiment. Girls born in different years were offered the vaccine at different ages, or not at all, so researchers could compare cancer rates between neighbouring birth cohorts while accounting for age and calendar trends.
The youngest vaccinated group, offered the jab at 12 or 13, were only in their early twenties by the end of the data. Cervical cancer is uncommon at that age, so the absolute numbers are small. The value of the study lies in the direction and size of the effect: in every cohort that was offered the vaccine, rates fell, and the earlier the vaccine was given, the bigger the drop.
Why age at vaccination matters so much
HPV vaccines work by preventing infection; they do not clear an infection a person already has. Most people pick up HPV within a few years of becoming sexually active, so a vaccine given at 12 is far more likely to arrive before any exposure than one given at 17 or 18. That is the main reason public health programmes target early adolescence, and the 87%, 62% and 34% pattern in the English data reflects it closely.
How HPV causes cervical cancer
Human papillomavirus is a large family of viruses, and a small number of "high-risk" types are responsible for almost all cervical cancers. Types 16 and 18 alone cause roughly 70 to 75% of cases worldwide. The virus spreads through intimate skin-to-skin contact, including but not limited to sexual intercourse, and it is extremely common: most sexually active adults are infected at some point, usually without knowing it.
In most people the immune system clears HPV within a year or two. When a high-risk type persists for many years, it can slowly change the cells of the cervix, first into abnormal but non-cancerous lesions and eventually, in some cases, into cancer. That long timeline, often 10 to 20 years, is why the full effect of a vaccine programme takes decades to appear in cancer statistics, and why screening can catch changes before they become dangerous.
HPV is not only a women's health issue. The same high-risk types cause most anal cancers and a growing share of throat (oropharyngeal) cancers, as well as some cancers of the penis, vulva and vagina. Other low-risk types cause genital warts.
What the researchers and charities said
Professor Sasieni described the results as proof that vaccination had already spared hundreds of women from cancer. Looking ahead, he predicted that as long as uptake stays high and people keep attending screening, cervical cancer will become a rare disease
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Cancer Research UK, which helped fund the work, welcomed it as the first study to show directly that the vaccine prevents cervical cancer itself rather than just infection or early cell changes. Its chief executive, Michelle Mitchell, pointed out that about 850 women still die of cervical cancer in the UK each year, which is why the charity saw the findings as a chance to save many lives.
Evidence since 2021: Scotland and beyond
Later research has strengthened the picture. In January 2024, Public Health Scotland and the Universities of Strathclyde and Edinburgh published a study in the Journal of the National Cancer Institute covering every woman eligible for Scotland's screening programme. It found no cases of cervical cancer at all among fully vaccinated women who had received their first dose at 12 or 13. That does not mean the risk is zero for every vaccinated person forever, but it is a remarkable result for a cancer that used to be among the most common in young women.
The vaccines themselves have also changed. The UK switched from Cervarix, which targets types 16 and 18, to Gardasil in 2012, which adds protection against the two types behind most genital warts. Gardasil 9, now widely used, covers nine types, including five additional high-risk types responsible for roughly another fifth of cervical cancers.
The World Health Organization concluded in 2022 that a single dose gives protection comparable to two or three doses in young people, and the NHS now usually gives one dose to those under 25. The WHO's global elimination strategy aims to vaccinate 90% of girls by age 15, screen 70% of women at 35 and again at 45, and treat 90% of women found to have disease, with the goal of bringing cervical cancer below 4 cases per 100,000 women.
Who can get the vaccine in the UK
All children aged 12 to 13 in England are offered the HPV vaccine at school. Boys have been included since September 2019, both to protect them from HPV-related cancers and to reduce the spread of the virus overall. According to the NHS, catch-up vaccination is available for girls and for boys born after 1 September 2006 up until their 25th birthday, and men who have sex with men can get it through sexual health clinics up to age 45. Some other higher-risk groups are also eligible.
If you or your child missed the school dose, the NHS advises contacting the school nurse, school vaccination team or your GP surgery. Outside the UK, eligibility and age limits vary, so a family doctor or local health service is the best place to ask.
Common myths and why screening still matters
"If I've had the vaccine, I don't need smear tests." Not true. The vaccine does not cover every cancer-causing HPV type, and people vaccinated later in their teens may already have been exposed. The NHS and Public Health Scotland both stress that vaccinated women should still attend every screening invitation.
"The vaccine encourages early sexual activity." Studies in several countries have found no evidence of this. The vaccine is given young precisely because protection works best before any exposure.
"It's too new to know if it's safe." HPV vaccines have been used since 2006, with hundreds of millions of doses given worldwide. Sore arms, headaches and occasional fainting just after the injection are the most common reactions; large reviews have not found links to serious long-term conditions. Anyone with specific health concerns should talk to a doctor or nurse.
"Only women need to worry about HPV." Men can carry and pass on the virus and can develop HPV-related cancers of the throat, anus and penis, which is why boys are now vaccinated too.
The English and Scottish results show what a combined approach can achieve: vaccinate early, keep screening, and treat abnormal cells promptly. If those three steps continue, cervical cancer could become a rare disease within the lifetime of today's teenagers.
Sources: Cancer Research UK news, 3 November 2021 (on Falcaro, Sasieni et al., The Lancet, 2021); Public Health Scotland, January 2024; NHS: HPV vaccine; Wikipedia: HPV vaccine; Wikipedia: Cervical cancer.
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