A Single Shot That Could Save Lives: How One Dose of the HPV Vaccine Is Reshaping Preventive Healthcare
The human papillomavirus vaccine has long been regarded by medical experts as one of the most powerful tools in cancer prevention, yet its potential remains vastly underused in the United States. This is despite overwhelming data showing its effectiveness in preventing HPV-related cancers and reducing long-term healthcare costs. At the heart of the current discussion is a breakthrough that could dramatically alter public health policy: emerging research suggests that just one dose of the HPV vaccine may offer the same level of protection as the traditionally recommended two- or three-dose regimens. This simple adjustment could have profound implications for public health, access to care, and healthcare affordability, especially for families facing rising health insurance premiums and out-of-pocket healthcare expenses.
HPV is the most common sexually transmitted infection globally. While most HPV infections resolve naturally without causing harm, certain high-risk strains can persist in the body and lead to the development of various cancers. These include cervical cancer, which remains a leading cause of cancer-related death among women worldwide, as well as anal, throat, vulvar, vaginal, and penile cancers. Each year in the United States, HPV is responsible for nearly 36,000 new cancer cases. Scientific evidence now demonstrates that the HPV vaccine can prevent about 90% of these cases. In addition to saving lives, this would significantly reduce the billions of dollars currently spent on the treatment and long-term management of HPV-related cancers, making the vaccine not only a life-saving intervention but also a cost-effective cornerstone of preventive care.
The vaccine has been available for nearly two decades. Originally, the Centers for Disease Control and Prevention recommended a three-dose schedule for girls beginning at age 11, and this was later expanded to include boys. In 2016, the CDC revised its guidance, reducing the recommendation to two doses for individuals starting the series before age 15. However, the possibility that just one dose might be sufficient has gained considerable traction. This reconsideration is not just about simplifying logistics; it is about equity, affordability, and maximizing public health outcomes. If a single dose can offer adequate immunity, it could remove a major barrier for many families—especially those facing vaccine access issues, financial constraints, or transportation challenges.
The global health community has already begun to respond to this emerging evidence. In 2022, the World Health Organization recommended that girls and young women aged 9 to 20 could receive one or two doses of the HPV vaccine, depending on local circumstances. This guidance has already prompted numerous countries to adopt a one-dose strategy, especially where budgetary limitations previously made it difficult to offer the vaccine at all. By reducing the number of doses, public health authorities are able to stretch resources further, increase vaccine coverage, and make preventive care more accessible to broader segments of the population.
One of the most compelling case studies comes from Scotland, where researchers tracked individuals vaccinated at age 12 or 13 as part of the country’s early HPV immunization program, launched in 2008. In a landmark study published in 2024, researchers found zero recorded cases of cervical cancer among these vaccinated individuals, providing real-world evidence of the vaccine’s long-term efficacy. This result not only supports the scientific case for vaccination but also highlights the transformative potential of early and widespread immunization.
Additional support for the effectiveness of a single dose comes from unexpected sources. In a large-scale clinical trial conducted in Costa Rica starting in 2004, approximately 20% of participants did not complete the full three-dose schedule—many simply didn’t return for follow-up appointments. However, researchers continued to monitor these women over many years, collecting cervical and blood samples to assess infection rates. Surprisingly, women who received only one dose showed infection rates similar to those who completed the entire regimen. This accidental data set provided a valuable glimpse into real-world vaccine efficacy under less-than-ideal conditions.
Further validation came from a randomized controlled trial in Kenya, considered one of the most rigorous scientific methods for testing vaccine efficacy. That study found a single dose of the HPV vaccine to be more than 97% effective against HPV16 and HPV18, the two strains responsible for approximately 70% of cervical cancer cases globally. These findings reinforce the hypothesis that even one dose can trigger a sufficient immune response to prevent the virus from establishing an infection in the body.
The scientific rationale is rooted in how the immune system interacts with HPV. According to Dr. Ruanne Barnabas, chief of infectious diseases at Massachusetts General Hospital and a lead investigator in both the Costa Rica and Kenya studies, HPV is a virus that is relatively slow to establish an infection compared to other viruses. This means that even a modest level of antibodies produced by a single vaccine dose may be enough to prevent the virus from taking hold.
Despite these encouraging results, progress in the United States has stalled due to political and bureaucratic interference. Earlier this year, the CDC’s internal HPV vaccine workgroup was actively reviewing the latest research and considering whether to recommend a shift to a single-dose protocol. However, that process was abruptly halted in June 2024 when the newly appointed Secretary of Health and Human Services, Robert F. Kennedy Jr., disbanded the CDC’s Advisory Committee on Immunization Practices, effectively ending the formal discussion. The HPV vaccine was also removed from the committee’s agenda, a decision for which no public justification was provided.
Kennedy has a history of controversial positions regarding vaccines and has publicly questioned the safety of the HPV vaccine, despite overwhelming scientific consensus to the contrary. Media reports and congressional testimony have revealed that he referred lawsuits against Merck, the sole manufacturer of the HPV vaccine in the U.S., to a law firm that employs his son. He reportedly earned referral fees from these cases. During his Senate confirmation hearing, Kennedy said that any fees earned during his time in office would be redirected to his son. This situation has raised ethical concerns about potential conflicts of interest and the role of political influence in shaping public health policy.
Meanwhile, the economic reality for many families continues to grow more challenging. The HPV vaccine costs more than $300 per dose without insurance, according to pharmaceutical manufacturer Merck. Although the vaccine is covered under the Affordable Care Act and offered free of charge to children under 18 through the Vaccines for Children Program, adults who fall outside these categories may be forced to pay the full cost out of pocket. With health insurance premiums expected to rise sharply in 2026, as reported by KFF, and with millions of Americans at risk of losing Medicaid coverage due to legislative changes, access to affordable preventive care is becoming increasingly precarious.
A shift to a single-dose schedule could dramatically lower these barriers. It would mean fewer clinic visits, lower overall vaccine cost, and increased accessibility for those living in underserved areas. It would also benefit parents who often must take time off work to bring their children in for multiple appointments. As Dr. Linda Eckert, a professor of obstetrics and gynecology at the University of Washington and member of the CDC advisory group, explained, streamlining the schedule could significantly reduce logistical and financial burdens for families across the country.
In the absence of clear national guidance, some parents are already making their own decisions based on available evidence. Dr. Barnabas, who played a leading role in many of the landmark single-dose studies, said she followed the two-dose protocol for her older child three years ago. But when her younger child recently became eligible for the vaccine, she and her husband reviewed the data and, in consultation with their pediatrician, opted to forego the second dose. Their decision, based on a careful assessment of the risk-benefit balance, reflects a growing trend among informed parents who are increasingly aware of the latest research.
This grassroots movement, while unofficial, underscores the urgency of updating official recommendations. A single-dose strategy could be a game-changer for U.S. public health, expanding access to preventive care, improving vaccine uptake, and lowering overall healthcare expenditures. Delaying this change not only perpetuates inequality but also undermines trust in the healthcare system, particularly when evidence is clear and action is within reach.
The conversation about HPV vaccination is ultimately a reflection of broader systemic issues within American healthcare. It raises questions about how medical decisions are made, who gets to influence them, and whose interests are prioritized. It also highlights the growing tension between scientific progress and political power. As the cost of inaction continues to rise—measured in lives lost, dollars spent, and trust eroded—the case for a single-dose HPV vaccine has never been stronger.
By embracing the science and moving toward a more accessible vaccination protocol, the United States has an opportunity not just to prevent disease, but to reaffirm its commitment to evidence-based healthcare, health equity, and long-term public health sustainability. And in a time of rising costs and healthcare uncertainty, such a commitment has never been more urgently needed.