Province-wide HPV vaccination campaign to start Sept 15

The Sindh Health Department is launching a province-wide HPV (Human Papillomavirus) vaccination campaign from September 15 to 27, targeting 4.1 million girls aged nine to 14. The virus not only causes life-threatening cervical cancer, the fourth most common cancer among women, but is also linked to vulvar and vaginal cancers.

The HPV vaccine has already been administered in 148 countries, with Pakistan now joining the ranks. In Pakistan, 69 million girls over the age of 15 are at risk of developing cervical cancer. Each year, 5,800 new cases are diagnosed, and 3,309 women lose their lives to the disease.

A digital system, the Sindh Immunisation Electronic Record System, is in place to enroll the concerned girls and track their vaccination status for decades, enabling long-term monitoring of effectiveness. The single-dose vaccine, as multi-dose schedules risk dropouts, is being provided free of cost and will be administered at Expanded Program on Immunisation (EPI) fixed centres, schools, and through mobile outreach teams. Over 3,000 vaccinators, mostly women, have been mobilised, with each team including a vaccinator, a data entry operator, a social mobiliser, and an assistant. Emergency medical support (1122 ambulances) will accompany teams in case of rare adverse reactions.

While the campaign is a one-time drive, from 2026 onwards the HPV vaccine will become part of the routine immunisation schedule, starting with nine-year-old girls. Additionally, a three-year budget for the HPV vaccination program has already been allocated by the Sindh government.

Expert opinions

Professor Tazeen Abbas, Secretary General of the Society of Obstetricians and Gynecologists of Pakistan and part of the HPV vaccine technical team, stated, "Cervical cancer is dangerous during reproductive age, but can also occur in older women. It is preventable through screening and vaccination."

She noted that 80 to 90 per cent of cervical cancer cases are caused by HPV, which has over 100 strains, some harmless, others cancer-causing. Prof Abbas termed HPV as a "silent intruder," as it often enters undetected and can cause pre-cancerous changes over years. Its risk increases with weakened immunity, malnutrition, diabetes, or smoking.

Prof Abbas noted that the HPV vaccine existed twelve years ago, but was expensive and required three doses, costing Rs24,000 per person, which limited use.

Screening and prevention

Professor Abbas emphasised that screening is important through tests including the pap smear, HPV DNA testing, Visual Inspection with Acetic Acid, and Colposcopy. She recommended two lifetime screenings, at ages 35 and 45 and stressed that all married women should get screened.

Further, she warned against believing false narratives like those claiming the vaccine causes infertility or cannot be given during menstruation.

Campaign strategy

Dr Saira Zaidi of the EPI shared that the 4.1 million target includes two million school-going and 2.1 million out-of-school girls.

She noted that coordination with the education department covers public schools, private, NGO-run, trust schools, and madrasas. For out-of-school girls, Lady Health Workers (LHWs) cover 40 to 44 per cent of Sindh's population through door-to-door visits. In areas not covered by LHWs, Community Support Groups (CSGs) hold orientation sessions.