December 23, 2025, 3:51 pm | Read time: 5 minutes
Cervical cancer is almost always linked to human papillomaviruses (HPV). The HPV vaccination is therefore a reliable way to prevent HPV infection and, consequently, cancer. However, not only girls should receive the HPV vaccination, but boys as well. Scientists at the University of Maryland have now modeled how significant this strategy could be. According to them, heterosexual vaccination against HPV is the key to eliminating cervical cancer.
In 2022, approximately 4,400 women were diagnosed with cervical cancer, and 1,413 women died from it.1 The vaccination offer that could protect young girls and women is only hesitantly accepted. In 2024, the vaccination rate for a complete HPV vaccination series among 15-year-old girls in Germany was 55 percent. For an initiated vaccination series (with at least one HPV vaccination), the rate was 68 percent. Since the introduction of the vaccination in 2012, the vaccination rate increased annually by about 3 percentage points compared to the previous year but plateaued since 2021.2
The vaccination rate is significantly better in South Korea, where around 80 percent of girls aged 12 to 17 are vaccinated.3 The country was the subject of a model study in which scientists aimed to determine what it would take to eliminate cervical cancer in the foreseeable future through herd immunity. Using South Korean cancer data from 1999 to 2020, the researchers created a model that highlighted two potentially effective strategies. They consider one of these strategies slightly more promising than the other–namely, the one that includes HPV vaccination for both girls and boys.4
The Study
In their mathematical model, they simulated the spread and disease progression of cervical cancer in South Korea using differential equations. The scientists integrated the following data into the model:
- HPV transmission between men and women (cross-gender transmission)
- Relevant disease stages from initial infection to precancerous changes and cancer
- Pap screenings (conducted biennially in South Korea)
- Natural healing processes
- Disease developments
- Cancer incidence and mortality data (data from 1999 and 2020)
- Routine and catch-up vaccinations for girls and boys
A control model was similarly structured but did not consider preventive Pap screenings to more accurately determine the effect of other measures, such as vaccinations, on disease development and mortality.
In the next step, the researchers used their mathematical model to simulate various scenarios:
- HPV vaccination only for girls (current vaccination strategy)
- HPV vaccination for both girls and boys
- Various coverage levels for Pap screening.
The “controlled reproduction number” (Rv_s) was calculated. This indicates the potential spread of diseases. Specifically, it shows how many new infections a disease leads to on average. If the controlled reproduction number is greater than 1, it indicates the spread of a disease. If the value is less than 1, it suggests a decline up to the elimination of a disease. The goal with the HPV vaccination is to achieve the latter for cervical cancer.
HPV Can Cause Cancer in Children–Why Many Parents React Too Late
Causes, Symptoms and Treatment of Cervical Cancer
How Many Girls and Boys Need to Be Vaccinated for Eradication
The central finding of the researchers: The status quo in South Korea is not sufficient to eliminate cervical cancer. The controlled reproduction number (Rv_s) is currently 1.6181–well above the required threshold of 1. This means that the HPV infection will continue to spread and lead to a corresponding number of cancer cases under the current vaccination and screening conditions.
Notably, the model shows which strategies could lead to the goal of disease elimination. One approach would be to expand HPV vaccination only for girls (strategy of vaccinating only girls). The current vaccination rate of 80 percent would need to be increased to 99 percent.
The favored scenario is the heterosexual vaccination scenario. An 88 percent vaccination rate for girls would suffice for Rv_s under 1–if the vaccination rate for boys also rises to 65 percent. The researchers see the advantage here that not one gender needs to be completely vaccinated, but the rate is distributed across two genders, which is more realistic for implementation.
Moreover, the heterosexual HPV vaccination not only better protects girls and women from cervical cancer but also better protects boys and men from HPV-related cancers such as penile cancer. Increasing participation in Pap screening would, according to the model, help reduce mortality but not change the incidence of the disease.
In summary, the result can be boiled down to this: Either 99 percent of girls or 88 percent of girls and 65 percent of boys need to receive the HPV vaccination. Under this condition, the elimination of cervical cancer could be achieved within the next 60 to 70 years.
Study Assessment
The strength of the model lies in the amount of information and data considered–from vaccination and preventive behavior, diseases and disease progression to mortality data.
A major weakness of the study is that the model only considers heterosexual, not homosexual transmission. Additionally, vaccine breakthroughs and multiple HPV infections were not considered; instead, a permanent vaccine protection was assumed.
Nevertheless, the study provides valuable, reliable insights that have significance far beyond the South Korean context. The model shows how community immunity, also known as herd immunity, can protect women from cervical cancer. Moreover, the model’s structure with country-specific parameters can be easily transferred to other regions. This means that with the appropriate data, the model could also provide the most promising scenario for Germany.