Background: PATH, in collaboration with government immunization programs in India, is implementing human papillomavirus (HPV) vaccination demonstration projects in three blocks each of Khammam district (Andhra Pradesh) and Vadodara district (Gujarat), catering to a population of approximately one-half million and targeting about 32,000 girls in two years. The aim is to generate critical data for decision-making on potential for introducing HPV vaccination as part of a comprehensive cervical cancer prevention program.

Objectives: Assess number of young adolescent girls reached using two different HPV vaccine delivery strategies.

Methods: The vaccine delivery strategies - campaign approach and routine immunization - were finalized by national-level immunization experts based on results from formative research and in consultation with state governments. Girls aged 10-14 years were categorized into school-going and non-school-going for immunization services delivery, and vaccinated by regular government health workers at schools and Anganwadi centers using the vaccination schedule and its window period. Comprehensive communication activities to sensitize and mobilize communities, parents and girls, as well as informed written consent from parents and assent from the girls, occurred prior to vaccination.

Results: Two doses are completed. Using the campaign approach, 14,091 and 13,930 girls received the first and second doses respectively. Using the routine immunization approach, 10,686 and 10,259 girls received the first and second doses respectively. The drop-out from dose one to dose two was 1.2 percent with the campaign approach and 4 percent with the routine immunization approach.

Conclusions: Uptake was higher in the campaign approach compared to the routine immunization approach. Drop-outs due to migration and the fixed-window period were decreased in the campaign approach. This pattern may be attributed to the intensity of team-based activities within a fixed time period in the campaign approach, as compared to the staggered in-flow of girls in the routine immunization approach.