ABSTRACT:
Cervical cancer remains a significant public health challenge in South Africa, driven by high rates of human papillomavirus (HPV) infection. Since 2014, the country has implemented a school-based HPV vaccination programme, initially using a two-dose schedule targeting girls aged 9 to 14 years. However, this approach has faced challenges, including vaccine hesitancy, logistical hurdles, and coverage disparities. This article presents a narrative review of South Africa’s transition to a single-dose human papillomavirus (HPV) vaccine schedule. It synthesizes available national policy documents, academic literature, and programmatic reports to assess the challenges and opportunities of this shift within the school-based vaccination programme. In 2024, South Africa adopted the World Health Organization’s recommendation to transition to a single-dose HPV vaccine schedule, a significant shift aimed at increasing vaccine uptake and reducing cervical cancer incidence. This research forms part of a larger mixed-methods study evaluating HPV vaccine delivery in Gauteng Province. The first phase involves a scoping review of HPV vaccination programmes and co-delivery interventions across African countries from 2019–2024. This review explores the challenges and opportunities presented by this transition, focusing on its implications for vaccine coverage, logistical efficiency, and cost-effectiveness. It also examines barriers such as vaccine hesitancy, infrastructure limitations, and the high prevalence of HIV, which necessitates tailored approaches for specific populations. The paper highlights the potential benefits of the single-dose strategy, including streamlined implementation, reduced dropout rates, and broader vaccine accessibility, particularly in underserved areas.