PESHAWAR: With the Khyber Pakhtunkhwa health department preparing to launch its first-ever human papillomavirus (HPV) vaccination campaign, experts have called for aggressive awareness drives to achieve the target given the prevalence of vaccine hesitancy in the province.

“The World Health Organisation has asked authorities in KP and Balochistan to step up awareness efforts in light of lessons learnt from Punjab, Sindh, Islamabad and Azad Jammu and Kashmir during the first phase, when coverage was below the desired level,” a public health expert told Dawn.

He said that given the misconceptions surrounding polio vaccination, efforts were needed to ensure that the majority of KP’s 2.9-3.2 million girls aged 9-14 were immunised.

The expert said the WHO’s report, compiled after the campaign in September last year, showed that Sindh recorded the highest provincial coverage at 68.6pc, exceeding the national average, while AJK reported the lowest coverage at 39.2pc.

Say WHO has asked KP, Balochistan authorities to step up awareness efforts

He said Punjab and Islamabad Capital Territory recorded moderate coverage levels of 47.6pc and 44.5pc, respectively.

A senior gynaecologist said that extensive media campaigning was required in KP, where the drive is scheduled to run from November 11 to 24, to address misconceptions and misinformation and protect women from a cancer that kills about 5,000 people in Pakistan every year.

She said Pakhtuns in general, and residents of the merged districts in particular, were curious about and sceptical of every new vaccine, and the HPV vaccine would be no exception.

Citing the WHO’s post-campaign report on the first phase, she said the high refusal rates in AJK, Punjab and even Islamabad Capital Territory were due to a lack of pre-campaign awareness and inadequate training of stakeholders, including teachers, journalists, prayer leaders, information department officials and parents, particularly fathers.

She said in AJK, principals of private and public-sector schools denied access to vaccination teams and made vaccination conditional on written consent from fathers.

Experts believe the health department should approach the education department to ensure adequate coverage. The target population includes 1.6 million school-going girls and 1.3 million out-of-school girls.

They said in the Pakhtun context, even greater efforts were required but unfortunately, no proactive steps had been taken by the health department.

Experts said the government must train and involve journalists and educated members of civil society. A structured community-awareness programme through print and social media was also essential, they said.

Experts said donors, including Unicef, WHO, Gavi and the World Bank, should provide funding, human resources and equipment, as well as teams trained to manage adverse reactions to the vaccine. Any such reaction could jeopardise the entire campaign, they said.

Experts said vaccine opponents often staged dramas to spread the message that vaccines had harmful effects on recipients.

They called for emergency teams equipped with the necessary medicines to be deployed in the field to respond to such situations.

In April 2019, more than 3,000 children were taken to hospitals after receiving polio vaccines. It later emerged that the children had been frightened by propaganda spread by vaccine opponents.

According to the WHO report, Pakistan faces a growing cervical cancer burden amid persistent gaps in awareness, screening and prevention. An estimated 73.8 million women aged 15 and older are at risk of developing cervical cancer.

Paediatricians said the campaign was likely to be more challenging in KP than in Punjab, Sindh and AJK, where opposition to vaccination was not as strong.

They stressed the need for proactive efforts, with the campaign only about a week away.

Paediatricians said the HPV vaccine had showed promising results worldwide in protecting girls against cervical cancer, so Pakistan should not allow the campaign to meet the same fate as the polio drive.

They said the province had struggled to eradicate poliomyelitis despite more than three decades of efforts as vaccination refusals persist.

Paediatricians said after the campaign, the HPV vaccine would be included in the Expanded Programme on Immunisation schedule, so it was important to build public confidence and ensure a smooth rollout from the outset.

Published in Dawn, November 4th, 2026