Sindh leads HPV vaccination drive but falters in schools

Authorities push for community mobilisation and myth-busting as Karachi lags far behind provincial targets

By Mukhtar Alam

KARACHI: Sindh, while leading all provinces and territories in vaccination rates during the first six days of the first-ever Human Papillomavirus (HPV) campaign launched on September 15, is struggling to achieve meaningful penetration in schools. Nearly half (48.5%) of the targeted 9–14-year-old girls are enrolled in educational institutions—879,000 in public schools, 834,000 in private schools, and 137,000 in Sindh Education Foundation schools—yet coverage within these settings remains alarmingly low.

According to the Sindh Directorate of Immunisation’s (SDI) latest district-wise report, updated on September 20, the campaign aims to vaccinate 4.1 million girls. A source privy to the data said, “unexpected refusals at schools and community resistance remain major barriers.” The SDI circular has urged intensified mobilisation, school sensitisation, and tighter supervision to help achieve the target of at least 90% coverage.

As of September 20, Sindh had vaccinated 57% of its eligible girls—1,162,000 out of a target of 2,039,658 across 30 districts—placing it ahead of Punjab (42%), Azad Kashmir (27%) and Islamabad (18%). Around 3,600 vaccinators are deployed in Sindh, delivering a one-time HPV dose through fixed sites (490 vaccinators), outreach teams for schools, madrassahs and communities (2,990 vaccinators), and mobile units for hard-to-reach populations (131 vaccinators).

Progress, however, is uneven. Some districts have surpassed 80% coverage, but Karachi lags behind at just 32.85%. Among the poorest performers were Kemari (12%), East (22%), Central (24%), Malir (31%), South (37%), Korangi (39%), Jacobabad (48%), Tando Allahyar and Hyderabad (50% each), Mirpurkhas (51%), and others ranging between 60% and 73%. Officials also noted that the pace of coverage slowed compared to September 19.

The SDI report cited persistent parental refusals, fueled by hesitancy and misinformation, as the central obstacle. Monitoring of outreach sessions, however, remained strong, with compliance above 95% on key indicators.

To build stronger demand, authorities have recommended school-based sensitisation sessions with parents and extended door-to-door mobilisation. At a recent high-level review meeting between EPI Sindh leadership and senior Education Department officials, it was highlighted that nearly 1,900 public and private schools had resisted HPV vaccination during school hours—a major challenge to be addressed. The meeting was told that parental hesitancy has been aggravated by misinformation circulating on social media.

As a way forward, deputy education officers have been tasked to visit schools in advance to onboard administrations, while parent–teacher associations (PTAs) are expected to play a greater role in engaging families and dispelling myths. Districts have also been directed to intensify conversion of refusal schools with the support of deputy commissioners, education officers, civil society organisations, and local influencers.

At the campaign’s launch ceremony, Sindh Health and Population Minister Dr Azra Fazal Pechuho stressed the vaccine’s importance for women’s health, noting that the province is targeting 90–95% coverage and may later integrate HPV vaccination into routine immunisation for nine-year-old girls.

Medical experts have strongly endorsed the campaign, warning that cervical cancer—caused largely by high-risk HPV infections—remains a preventable disease. They emphasise that without widespread vaccination, abnormal cervical cell growth could impair reproductive health and contribute to rising cancer cases.

Photos: Official sources