# Single-dose HPV vaccination plus HPV self-sampling to reach WHO elimination in low-income countries

Source: https://onco.cc/ideas/idea-single-dose-hpv-self-sampling-elimination/  
OnCo record `idea-single-dose-hpv-self-sampling-elimination` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

One shot for girls and a mail-in swab for women could hit the WHO 90-70-90 targets at a fraction of the cost of the traditional three-dose, clinic-based model.

## Summary

KEN SHE showed 97.5% single-dose efficacy; self-sampled HPV PCR matches clinician sampling; thermal ablation enables screen-and-treat. Modelling (Lancet Global Health 2024) suggests single-dose schedules could make elimination feasible in most low-income settings within the century, but coverage of girls is still ~27% globally.

## Fields

- Kind: Idea
- Last checked: 2026-09-07
- Hypothesis: Countries adopting single-dose HPV vaccination plus HPV self-sampling with screen-and-treat reach 90% vaccination and 70% screening coverage a decade earlier than those on multi-dose, cytology-based programmes.
- Rationale: Cost per protected girl halves; self-sampling removes clinic access and stigma barriers; ablation removes the surgeon bottleneck.
- Proposed test: Country-level comparisons within the WHO Cervical Cancer Elimination Initiative dashboards, and cluster-randomised implementation trials (e.g., in Kenya, Rwanda, India).
- Maturity: being-tested-at-scale

## Sources

- ClinicalTrials.gov NCT03675256: KEN SHE (single-dose HPV vaccine): https://clinicaltrials.gov/study/NCT03675256

## Connected records

- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/)
- technologies: [HPV & HBV vaccination](https://onco.cc/technologies/hpv-vaccine/), [HPV DNA testing and self-sampling](https://onco.cc/technologies/hpv-testing/), [Thermal ablation and cryotherapy for cervical precancer](https://onco.cc/technologies/precancer-ablation/)
- drugs: [CERVAVAC (quadrivalent HPV vaccine, India)](https://onco.cc/drugs/cervavac/), [Nonavalent HPV vaccine](https://onco.cc/drugs/gardasil-9/)
- trials: [IARC India HPV vaccine dose study (one, two or three doses)](https://onco.cc/trials/iarc-india-hpv-dose-study/), [KEN SHE (single-dose HPV vaccine)](https://onco.cc/trials/ken-she/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prevention we already have is not deployed](https://onco.cc/bottlenecks/b-prevention-adoption/)
- key papers: [Swedish registry study: HPV vaccination almost eliminates cervical cancer when given before 17](https://onco.cc/key-papers/paper-hpv-vaccine-sweden-nejm-2020/)
- roadmaps: [Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers](https://onco.cc/roadmaps/prevention-roadmap/)

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