Published Feb 25, 2026 | 1:26 PM ⚊ Updated Feb 25, 2026 | 1:26 PM
Representative image. Credit: iStock
Synopsis: In 2009, HPV vaccine trials in tribal schools in Andhra Pradesh and Gujarat sparked controversy after seven deaths, later found unrelated to the vaccine but exposing grave ethical lapses in consent and oversight. 16 years on, India launches a nationwide free HPV drive with Gardasil, aiming to protect every 14-year-old girl, while tackling mistrust, gaps in screening, and misinformation.
In July 2009, a health worker visited an ashram school in Yeragutta, a village that was then part of Khammam district in Andhra Pradesh, and is now in Bhadrachalam district, Telangana. She carried a cooler box. Inside it: doses of Gardasil, a vaccine the world had spent decades developing to stop cervical cancer before it starts.
The girls who lined up ranged between 10-14 years. Most belonged to Scheduled Tribe families. Their parents worked as agricultural labourers, or had fled violence spilling over from Chhattisgarh. The girls lived in the hostel. Their parents lived elsewhere. A warden signed the consent form.
By January 2010, five girls from this district were dead.
India suspended the programme. Parliament demanded answers. The HPV vaccine. built specifically to save women like the ones in those villages, became, in the public imagination, a killer.
16 years passed.
In February 2026, the Government of India announced a nationwide, free HPV vaccination drive. The target: every 14-year-old girl in the country.
The vaccine: Gardasil again. One shot, free of cost, tracked through the U-WIN digital portal, the same system that managed Covid-19 vaccination.
Bhadrachalam now sits inside Telangana. A new state, new administration, new drive. But the memory of 2009 does not dissolve across state boundaries.
The Government of India did not bury the 2009 episode. It commissioned an inquiry — chaired by Professor SS Agarwal, with experts from AIIMS — that spent months reviewing first information reports, post-mortem records, forensic analyses, and hospital case files. It published its findings in February 2011.
Seven deaths in total: five from Khammam, two from Vadodara, Gujarat.
Two girls had consumed organo-phosphorus pesticide. Autopsies confirmed the presence of poison in their viscera. The committee stated: “It can be clearly stated that the cause of death is not causally related to the vaccine.”
One girl drowned, she “accidentally fell in an open well, a granite quarry filled with water”, 49 days after her first dose. Unrelated, with certainty.
In Gujarat, a 10-year-old developed fever 20 days after her second dose. Her haemoglobin read 4 grams/decilitre. Her blood slide tested positive for Plasmodium vivax. She died of malaria with severe anaemia. The report noted her inclusion in the study “was in contravention to the inclusion/exclusion criteria.” The death traced to malaria, not the vaccine.
A 15-year-old in Gujarat complained of a leg pain one afternoon, her family suspected an insect bite. By morning she had deteriorated. A 108 ambulance carried her toward the community health centre. She died in transit. A post-mortem was not done, the family refused.
The attending doctor recorded death by snake bite, “very common in the area.” The committee’s finding: “Death is definitely not linked to the vaccine.”
Two deaths remained uncertain. One girl developed sudden headache and lost consciousness 96 days after her third dose. The committee noted that vaccine-induced neurological reactions “usually would manifest within four weeks of the last dose,” making a vaccine link “very unlikely.”
Another girl developed fever 23 days after her first dose and died eight days later. Probable causes: malaria, typhoid, or infection. The committee concluded she “did not present with clinical manifestations similar to acute demyelinating encephalomyelitis or GB syndrome which are known to occur with the vaccine.”
The committee’s overall conclusion: “There is no common pattern to the deaths that would suggest that they were caused by the vaccine. In cases where there was an autopsy, death certificate, or medical records, the cause of death could be explained by factors other than the vaccine.”
The background death rate among girls aged 10 to 14 in both districts showed no increase during the vaccination period. In Vadodara, it had in fact decreased.
The vaccine did not kill those girls.
The committee did not absolve the programme. It found serious failures — not in the vaccine, but in the people who ran it.
Wardens of tribal hostels signed consent forms on behalf of hundreds of girls. Their parents knew nothing. The committee called this legally problematic: “Students cannot be considered to have full autonomy in front of their teachers or headmaster.”
In Andhra Pradesh alone, 2,763 out of 14,254 consent forms carried the signature of a warden or headmaster, not a parent.
Consent forms were printed in English. Neither the girls nor their parents read English. The Sama Resource Group’s March 2010 fact-finding captured what families understood: “Since it was a vaccine being given by the government, we all trusted it blindly and considered it reliable, like any other vaccine that is given in the immunisation programme,” one mother said.
Nobody told her it was a Phase IV, post-marketing clinical trial funded by the Bill and Melinda Gates Foundation and run by PATH, an American non-profit. The Ministry of Health only conceded this on 22 April 2010, under pressure. ICMR admitted on 29 April that its own ethical guidelines had been violated.
Deaths went unreported for months. Deaths from September 2009 reached the ethics committee in January 2010. The report called this “a significant lapse,” adding: “No independent mechanism was set up to cross verify the adequacy of the routine state programme.” The study also carried no insurance for participants — PATH insured itself, not the girls.
The programme concentrated in tribal areas where, as the report acknowledged, “the standard of medical care in remote areas is generally not of the same level as in the urban areas.” The entire tribal mandal of Bhadrachalam had no gynaecologist. Pap smear facilities did not exist in any government facility in the area.
The committee’s summary: “A collective effort is required to raise the standards of clinical research, one in the arena of implementation of bioethical guidelines and the other in the monitoring and investigation of Adverse Events Following Immunisation.”
These were failures of ethics, administration, and accountability. They were not failures of the vaccine.
Dr V Annapurna, Senior Consultant and Head of Gynaecologic Oncology at Sri Shankara Cancer Hospital and Research Centre, Bengaluru, works in cancer that vaccination could have prevented. She traces what happened directly to misinformation.
“There were four deaths following that vaccination, they said, but it later turned out that all the deaths were not because of the vaccination,” she had told South First in an Interview.
“Because of the propaganda that happened then on social media claiming that the vaccine was causing all the deaths, which was totally wrong and totally unscientific, the government withdrew the vaccine from the market.”
She draws a parallel with a vaccine that transformed cancer prevention in India without controversy: the hepatitis B vaccine.
“We do not see so many liver cancers in India, despite alcohol consumption going up so high. Why? Because the majority of people are vaccinated.” The same logic, she argues, applies here. “If we start vaccinating against cervical cancer, we can eliminate it completely from India.”
On the vaccine’s safety, she is direct: “Almost around 135 million doses of this vaccine have been given all over the world so far. There have not been any deaths related to the vaccine. So far, no deaths.”
She explains why: “There is no virus in it. No live virus, no dead virus, not even any part of the viral DNA. What is present is only the coat around the virus, virus-like particles. It is just a hollow virus body without any content inside.”
The timing matters. “If a child who is not sexually active, around 11 years of age, receives the vaccine, that is the right time. Before sexual activity starts, if there are antibodies in the body, the antibodies will take over and clear the virus, and you will not get this virus in the future.”
The 2026 programme delivers what 2009 did not: parental consent, public transparency, digital tracking, and a single dose that WHO data confirms produces lasting protection. 2.6 crore doses reach India through Gavi, the Vaccine Alliance, by 2027.
But gaps remain. Girls who dropped out of school, often the most vulnerable, often from exactly the communities that populated those Bhadrachalam hostels, fall outside the school-based delivery net.
The cold chain that keeps Gardasil stable breaks down in remote areas. And vaccination prevents future infection; it does not reverse decades of missed screening. Women who grew up while India debated need PAP smears and HPV DNA tests, a national screening programme that still does not exist at scale.
Misinformation persists too. The ICMR committee itself acknowledged that “a crisis-like situation was created by the publication of reports of deaths in HPV vaccine recipients in the media,” made worse by “lack of anticipation and preparedness to counter adverse coverage.”
That groundwork — building trust, speaking in Telugu, explaining what the shot does and does not do — still needs laying, village by village.
