Vaccination for girls and women across the life course: Evidence-based recommendations for clinical practice and policy.
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Vaccination across the life course is a cornerstone of preventive health care for girls and women. Although WHO recommends completion of essential vaccines by adolescence, global coverage remains suboptimal. Vaccine-preventable diseases-including HPV-related cancers, vaginal, vulvar, anal, oropharyngeal, influenza, pertussis, hepatitis B, herpes zoster, and pneumococcal disease-continue to impose a disproportionate burden on girls and women, particularly in low- and middle-income countries (LMICs) and migrant populations. Key life stages, such as childhood (early and middle), adolescence, preconception, pregnancy, postpartum, midlife, and beyond, offer critical opportunities for immunization. Obstetricians, gynecologists, midwives, and other women's healthcare providers are uniquely positioned to integrate vaccination into routine care in all settings and influence vaccine acceptance. Strengthening vaccine advocacy within women's health care is essential to reduce preventable morbidity and mortality and advance health equity for girls and women globally. This paper presents evidence-based recommendations for equitable vaccination across the life course of girls and women, synthesizing guidance from WHO, the Strategic Advisory Group of Experts on Immunization (SAGE), the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and national immunization technical advisory groups. Vaccines reviewed include HPV, tetanus-diphtheria-pertussis (Tdap), influenza, hepatitis B, measles-mumps-rubella (MMR), varicella, herpes zoster, pneumococcal, Respiratory Syncytial Virus (RSV), and COVID-19. A life-course framework is proposed, emphasizing maternal immunization, cervical cancer prevention, and integration of regular and opportune vaccination into routine obstetric and gynecologic services. Practical implementation strategies and policy recommendations are outlined to support FIGO member societies.