As Pakistan introduces the Human Papilloma Virus (HPV) Vaccine to its routine immunisation programme and is running the first vaccination campaign from September 15 to 27 in Punjab, Sindh, Islamabad and AJK, the media is rife with all kinds of rumours and elaborate conspiracy theories.
Summarily, the HPV vaccine is administered to prevent certain types of human papillomavirus (HPV) infection, which can lead to cancers such as cervical, vulvar, vaginal, anal, and head and neck cancers, as well as pre-cancerous lesions. An Aga Khan University study estimates that over 80% of sexually active people will acquire HPV at some point in their life.
But even as the vaccine is rolled out to mitigate the spread of the virus, it is the mix of dis- and mis-information by so-called social media ‘influencers’, irresponsible politicians and an ill-informed and ultra-conservative religious lot, which is both distressing and annoying.
Below are some frequently asked questions about the vaccine, and brief answers that may clarify some of these myths.
What is the status of the vaccine in other countries?
Pakistan is now among around 150 countries — around 76 per cent of the UN member states — that recommend the HPV Vaccine. The majority of these countries have included the vaccine in their routine national vaccine programmes.
With the exception of Afghanistan, Pakistan is the last country in South Asia to introduce the routine HPV vaccination programme, and so is the case in the Muslim world. All major Muslim-majority countries have already taken this step.
Indonesia, the largest Muslim-majority country in the world, started introducing the vaccine in 2016, established a National Cervical Cancer Elimination Plan in 2023 and is now locally producing the vaccine. In Iran, the vaccine was made available for personal use two decades ago, and in May 2025, Iran started producing two versions of the HPV vaccine.
Is cervical cancer a major health problem in Pakistan?
More than 95pc of the 660,000 cervical cancer cases occurring globally each year are caused by HPV. Every two minutes, a woman dies from this preventable disease globally, and 90pc of these deaths occur in low- and middle-income countries.
According to official data, around 5,000 new cases of cervical cancer are diagnosed every year in Pakistan, out of which 3,200 affect women, resulting in 64pc deaths. The detection of pre-cancer stage or cancer requires regular screening among women of reproductive age through the Pap test and the specific HPV test.
Since such screening for various reasons does not take place in Pakistan, nor do we maintain a national cancer registry, we don’t know the actual number of cases and deaths. Globally, and in Pakistan, cervical cancer is among the top cancers affecting women.
What is cervical cancer and what causes it?
The cervix is an anatomical part between the vagina and uterus which connects them. HPV can cause sexually transmitted infections which can result in the development of precancerous lesions or warts on the inner surface of the cervix.
This was discovered by Dr Hérald zur Hausen, a German virologist, who won the Nobel Prize in 2008 for his important research. It proved that certain strains of HPV (namely HPV 16 and 18) could eventually cause cervical cancer, which led to the development of the HPV vaccine.
The interval between the acquisition of HPV infection and progression to invasive carcinoma is usually 15–20 years or longer.
Most HPV infections remain asymptomatic, but once cancer develops, there will be unusual bleeding and discharge. There may also be persistent lower abdominal pain and weight loss.
How much does this vaccine protect against cervical cancer?
Scientific evidence shows that this vaccine provides 90pc protection against developing cervical cancer if the injection is provided to young girls between the ages of 9 and 14 years. In relative terms, this is a very high level of protection.
Is it right for Pakistan govt to include HPV vaccine in its national programme?
Absolutely yes! From a public health standpoint, it may not be the most important and common health issue being faced by women in Pakistan, but since we don’t know the exact extent of it and since we have a vaccine that can prevent this cancer, so, why not protect our women against this scourge?
Other key health issues of women in Pakistan, like anaemia, maternal mortality, and breast cancer, must also be attended to as a priority. In 2020, 194 member states of the World Health Organisation, including Pakistan, launched a global strategy to eliminate cervical cancer as a public health problem.
One important element of this strategy is to prevent cancer by immunising young girls.
Why young girls? Because the vaccine is most effective when given just before or at the start of the sexual and reproductive life of the girl.
Is HPV vaccine safe?
The US Food and Drug Administration (FDA) approved the HPV vaccine, Gardasil 4 by Merck, in 2006. Since then, the WHO Prequalification Programme has approved at least five different HPV vaccines, including single-dose vaccines for their safety, quality and efficacy. There are hardly any side effects, and if at all, these are very minor and rare.
Which vaccine is exactly being used in Pakistan?
The Pakistan Federal Directorate of Immunisation is using the HPV vaccine called Cecolin. It is manufactured in China and is supplied through Gavi — the global vaccine alliance. It is a single-dose vaccine.
WHO prequalified this vaccine in October 2024 for its quality, safety and efficacy and the decision was made based on new data on the product that fulfilled the criteria set out in WHO’s 2022 recommendations for alternative, off-label use of HPV vaccines in single-dose schedules.
Research has shown that the single-dose vaccine is not inferior to the double-dose one in terms of providing immunity. The single-dose vaccine will, however, contribute to improving a more sustainable supply of HPV vaccines, allowing more girls to be reached.
Previously, HPV vaccine introductions have been hampered by global supply shortages.
Who is financing the HPV vaccine supply, globally and in Pakistan?
Donors globally have committed nearly $600 million towards the elimination of cervical cancer. Funding includes $180m from the Bill & Melinda Gates Foundation, $10m from Unicef, and $400m from the World Bank.
In Pakistan, currently, 95pc of the vaccine delivery is financed by global sources through Gavi and five per cent of the funds are provided by the government. This is a standard mechanism. In due course of time, however, Pakistan has to foot the full bill from domestic sources.
Published in DAWN on September 27, 2025.
