Since the launch of the first HPV vaccine, the space has seen steady growth, which has been attributed to the launches of vaccination programs in most major markets. Vaccination recommendations initially centered on the treatment of girls only aged 9–14 years; however, programs have now expanded in the US and five major European markets (France, Germany, Italy, Spain and the UK) to include males and females aged 9–26 years. Moving forward, sales are expected to grow further due to the rising pressure to increase coverage rates for HPV vaccination globally, as well as the introduction of national programs in new markets such as China. Indeed, Merck & Co. attributed its $850m sales boost in 2018 to a successful launch in the Chinese market.