PESHAWAR: The World Health Organisation has recommended training of staff and scaling up of awareness before the launch of human papillomavirus (HPV) vaccination campaign in Khyber Pakhtunkhwa.

The HPV vaccination drive was carried out in September last year targeting girls aged 9-14 years in Punjab, Sindh, Azad Jammu and Kashmir, and Islamabad.

Next month, the WHO conducted a post-campaign coverage survey (PCCS) to evaluate the effectiveness of the HPV vaccination campaign.

The 101-page survey report shared evidence-based assessment of vaccination coverage in addition to identification of barriers along with highlighting areas for improvement.

Cervical cancer third most common cancer among women in Pakistan

It presented the overall process and phase-wise approach commencing with the preparation phase, followed by the implementation of training, field implementation process, key observations, lessons learned and recommendations to inform and strengthen future HPV-related interventions planned for Khyber Pakhtunkhwa, Gilgit-Baltistan and Balochistan in the years 2026 and 2027.

According to the report, Pakistan faces a growing cervical cancer burden amid persistent gaps in awareness, screening and prevention. It has a large at-risk female population, with an estimated 73.8 million women aged 15 years and older vulnerable to developing cervical cancer.

It says that multiple studies highlight that low awareness of HPV, limited knowledge of its vaccination, poor understanding of cervical cancer risk factors and misconceptions about screening remain major barriers to early detection and disease prevention and has recommended the use PCCS 2025 findings to refine strategies for upcoming rollout phases, including KP, Balochistan and Gilgit-Baltistan.

Overall, a majority of respondents nationally perceived the HPV vaccine as important, with 51.6 per cent indicating that the vaccine is important for girls’ health. However, a substantial proportion of caregivers either didn’t perceive the vaccine as important (32.2pc) or reported uncertainty (16.2pc), highlighting gaps in awareness and confidence.

In Khyber Pakhtunkhwa, the Technical Working Group (TWG) meetings are being conducted quarterly and attended by EPI, WHO and Jhoiego but there is no awareness campaign, training, teachers or journalists as yet, according to gynecologists. They said that the department must start an awareness drive as the province had already suffered due to misconceptions about polio vaccination.

The situation was more or less the same in Punjab, AJK and Islamabad which resulted in refusal by schools, parents and community, they said.

The remedy devised was to start activities at least 6 months before the launching HPV vaccine, they suggested.

The WHO said HPV was recognised as one of the most prevalent sexually transmitted infections worldwide and the leading cause of cervical cancer among women and nearly 99pc of cases are linked to persistent HPV infection. In Pakistan, cervical cancer ranks as the third most common cancer among women, representing a growing public health concern, according to it.

The introduction of the HPV vaccine through Pakistan’s Expanded Programme on Immunisation (EPI) marked a pivotal advancement in national efforts to prevent cervical cancer and protect adolescent girls aged 9–14 years from HPV-related diseases.

The survey covered Punjab, Sindh, AJK and Islamabad, encompassing both in-school and out-of-school girls.

At the national level, the PCCS report estimated HPV vaccination coverage at 53.4pc, indicating that just over half of the eligible target population was reached during the campaign.

The survey-based estimate was substantially lower than the administrative coverage reported by the programme, highlighting a notable gap between reported delivery data and independently verified population coverage.

The survey report underscored the importance of PCCS data for validating administrative reporting and guiding corrective actions.

Marked geographic variation in coverage was observed across provinces and divisions. Sindh recorded the highest provincial coverage at 68.6pc, exceeding the national average, while AJK reported the lowest coverage at 39.2pc.

Punjab and Islamabad Capital Territory demonstrated moderate performance, with coverage levels of 47.6pc and 44.5pc, respectively.

EPI Director Dr Mehtab Khan told Dawn that activities had already begun.

However, senior officials in the education department said they weren’t aware of those activities.

Local gynaecologists said that the province had already suffered due to misconception about polio vaccines and the department should immediately start an awareness drive in collaboration with professional associations of doctors as well as the education department to make the campaign successful.

Published in Dawn, May 26th, 2026