Explainer · Longevity & Aging
No cervical cancer deaths in vaccinated 20-to-24-year-olds in England, against 23 expected
England started vaccinating girls against HPV in 2008. Mortality data through 2024 show cervical cancer deaths in the youngest women have all but disappeared.
- An analysis of national cervical cancer death records in England from 2001 to 2024, by age group.
- England began vaccinating 12- to 13-year-old girls against HPV in 2008, later reaching 88% to 90% coverage.
- Among women aged 20 to 24 in 2020 to 2024, no cervical cancer deaths occurred, against 23.1 expected.
- Deaths also fell sharply in women aged 25 to 29, who were vaccinated at older ages with lower coverage.
- In all, the program went with about 200 fewer cervical cancer deaths by the end of 2024.
When England began offering the HPV vaccine to schoolgirls in 2008, the promise was that cervical cancer rates would eventually fall. Cases have indeed dropped. Deaths take longer to show up in the data, because cancer kills years after it starts, and until now the evidence on mortality was thin.
An analysis in The Lancet used national death records through 2024. Among women aged 20 to 24 in the most recent five years, the group with the highest vaccination coverage, there were no cervical cancer deaths at all.
What HPV has to do with cervical cancer
MedlinePlus explains that cervical cancer is cancer of the cervix, the lower part of the uterus that opens into the vagina, and that human papillomavirus (HPV) infection is the main cause. Most infections pass without harm, but some persist and, over years, can turn cells cancerous.
That link is what makes a vaccine possible. The authors set out the context: HPV vaccination is a key component of global cervical cancer elimination strategies, and while cases have fallen in several countries, evidence of its effect on mortality is scarce.
How the England mortality analysis worked
The researchers looked at cervical cancer deaths in England from 2001 to 2024 in three age bands: 20 to 24, 25 to 29 and 30 to 34. They combined that with official records of how many women in each birth year had been vaccinated.
England introduced a national HPV vaccination program in 2008 for girls aged 12-13 years, reaching 80% to 90% coverage before the pandemic, with a catch-up campaign for girls aged 14 to 18 in 2008 to 2010. The team then compared the deaths that occurred with the deaths expected from historical rates, deliberately assuming no protection for unvaccinated women from reduced virus circulation.
What happened to cervical cancer deaths
The youngest group’s figure is stark. In women aged 20-24 years between 2020 and 2024, vaccinated at 12 to 13 with coverage around 88% to 90%, no deaths occurred, compared with 23.1 expected. The estimated reduction was 100%, with a lower confidence bound of 84%.
Older groups, vaccinated later and less completely, also improved. Mortality fell by about 80% in women aged 20 to 24 in the earlier period and by around 69% in women aged 25 to 29. Adding it up, HPV vaccination in England was associated with a reduction of around 199.6 cervical cancer deaths by the end of 2024.
Why the cervical cancer result matters globally
Cervical cancer is one of the few common cancers with a known, preventable cause, and the World Health Organization has a plan to eliminate it as a public health problem. What that plan has lacked is proof that vaccination stops women dying, not just stops cases being diagnosed.
The authors call this the first robust national-level evidence, albeit observational, that high coverage goes with substantially fewer deaths. Coverage is the operative word: the groups vaccinated youngest and most completely show the biggest effect.
What this cervical cancer analysis cannot prove
This compares what happened with what would have been expected, not vaccinated women against a randomized unvaccinated group. Cervical screening, treatment and smoking rates all changed over the same decades, and the analysis cannot fully separate those from the vaccine.
Deaths in women in their twenties were rare to begin with, so the numbers behind the percentages are small and the confidence ranges wide. The assumption of no herd protection makes the estimate conservative for vaccinated women but understates the program’s total effect. And the oldest group studied, women aged 30 to 34, showed a weaker and uncertain result, as expected for cohorts vaccinated at older ages.
What this changes about HPV vaccination
For parents deciding about a school vaccination, this is the outcome the program was built for, measured in deaths rather than cell changes. The protection was greatest in those vaccinated before likely exposure.
For health systems, it strengthens the case for pushing adolescent coverage as high as possible and for catch-up programs where coverage slipped during the pandemic. Screening still matters: the vaccine does not cover every cancer-causing type, and unvaccinated women remain at the old risk.
People also ask
What did the study find?
In women aged 20 to 24 between 2020 and 2024, with coverage around 88% to 90% at age 12 to 13, no deaths occurred against 23.1 expected, a mortality reduction of 100% (95% CI 84 to 100). The estimated relative risk reduction in vaccinated women was 100% at ages 20 to 24, 100% at 25 to 29 and 63% at 30 to 34. Overall, vaccination was associated with about 199.6 fewer cervical cancer deaths (125.0 to 274.2) through 2024.
What is HPV?
Human papillomavirus, a common sexually transmitted infection. Most infections clear on their own, but persistent infection with certain types causes almost all cervical cancer.
Who is vaccinated in England?
The program started in 2008 for girls aged 12 to 13, with a catch-up campaign for girls aged 14 to 18 in 2008 to 2010. Boys were added later in many countries, including the UK.
Does this mean cervical screening can stop?
No. Vaccinated women are still offered screening, because the vaccine does not cover every cancer-causing type and coverage is not universal. Screening policies are being reviewed as vaccinated cohorts age.
Why are the older age groups less protected?
They were vaccinated later, in the catch-up campaign, at ages when some had already been exposed to HPV, and coverage was lower. Protection is strongest when the vaccine is given before exposure.
Should I or my child get the vaccine?
Vaccination programs target adolescents before exposure, and catch-up is offered in many countries into the twenties. Ask a doctor or school health service what applies locally. This is general information rather than medical advice.