ISLAMABAD: Pakistan’s first large scale campaign to vaccinate adolescent girls against human papillomavirus (HPV) reached only slightly more than half of the target population, with an independent post campaign survey estimating coverage at 53.4 per cent and identifying weak awareness, parental refusals and reporting gaps as key factors limiting the campaign’s reach.
The HPV vaccination campaign was conducted from September 15 to 27, 2025, targeting girls aged 9 to 14 years in Punjab, Sindh, Islamabad and Azad Jammu and Kashmir (AJK) as part of Pakistan’s strategy to prevent cervical cancer.
To evaluate the campaign, a Post Campaign Coverage Survey was conducted in October 2025 using a household based methodology aligned with international evaluation standards.
Officials in the federal health ministry said the survey was carried out with technical oversight of the World Health Organisation in collaboration with the Federal Directorate of Immunisation under the Ministry of National Health Services, while field implementation was undertaken by RIZ Consulting and RBC Global Consultants.
The survey estimated that 53.4 per cent of eligible girls received the HPV vaccine, indicating that nearly half of the target population was missed during the campaign.
The estimate was also considerably lower than the administrative coverage reported by the programme, suggesting gaps in reporting systems, including possible over reporting or inaccuracies in population denominators used for calculating coverage.
Field teams visited 988 clusters across 19 administrative strata in Punjab, Sindh, Islamabad and AJK. Of these, 974 clusters were successfully surveyed while 14 clusters could not be completed due to security issues and post-flood situation.
During the survey, 19,480 households were listed and 7,769 eligible girls aged 9 to 14 years were interviewed, producing an overall response rate of about 85 per cent.
The findings showed large differences in coverage across regions. Sindh recorded the highest estimated coverage at 68.6 per cent, above the national average.
Punjab reported 47.6 per cent coverage, while Islamabad recorded about 44.5 per cent. AJK had the lowest coverage at 39.2 percent.
At the divisional level the differences were even more pronounced. Faisalabad division recorded the highest coverage at 87.9 percent, while Gujranwala division reported only about 22.7 per cent. Poonch division also showed very low coverage at around 24.9 percent.
The survey identified gaps in awareness and vaccine hesitancy as important barriers to uptake. Many caregivers had limited knowledge about HPV infection, cervical cancer and the role of vaccination in prevention. Some parents also expressed concerns about vaccine safety and possible side effects. Operational challenges also affected the campaign. School-based vaccination was the primary delivery strategy, but a portion of the target population remained difficult to reach because they were not enrolled in school. The survey found that about 10 per cent of interviewed girls were out of school, with higher proportions observed in several divisions of Sindh and southern Punjab.
Survey teams also reported logistical and field challenges, including outdated maps that complicated identification of clusters and households, as well as security constraints in parts of Islamabad and AJK. In some locations, interview teams also encountered refusals due to sensitivities surrounding the vaccine.
The HPV vaccine is considered one of the most effective tools for preventing cervical cancer, which is caused by persistent infection with high risk types of the human papillomavirus.
Health authorities say the survey findings will be used to strengthen future phases of HPV vaccination, including improved awareness campaigns, stronger community engagement and better monitoring of vaccination coverage.
Future phases of the HPV vaccination programme are planned for Khyber Pakhtunkhwa in 2026, followed by Balochistan and Gilgit-Baltistan in 2027.
Published in The NEWS on March 07, 2026.
