Pakistan Plans First HPV Vaccination Drive for 13 Million Girls from September 15

Free vaccination campaign to begin in four regions

Pakistan will launch its first national human papillomavirus vaccination drive from 15 to 27 September 2025, aiming to protect 13 million girls aged 9 to 14 in Punjab, Sindh, Islamabad Capital Territory and Azad Jammu and Kashmir. The vaccine will be free at public vaccination sites, with schools serving as the main delivery points and community teams reaching girls who are not enrolled.

The federal Expanded Programme on Immunisation (EPI) is leading the campaign with support from the World Health Organization (WHO), Gavi, UNICEF, Jhpiego and local partners, including the DOPASI Foundation. The introduction brings a vaccine that prevents a major cause of cervical cancer into a country where thousands of women die from the disease each year.

Pakistan records an estimated 5,000 cervical cancer diagnoses annually and roughly 3,000 to 3,200 deaths, with a mortality rate among the highest in South Asia. Health officials identify late diagnosis and limited access to screening as major reasons women die. Vaccination offers protection much earlier in life, before an infection can lead to cancer in adulthood.

The campaign will use a single dose schedule endorsed by WHO. More than 49,000 health workers have been trained for the introduction, according to WHO's training announcement. Provincial teams will deploy more than 14,000 field workers and supervisors during the first phase.

Officials plan to follow the September campaign with routine vaccination for girls aged nine from January 2026, then expand to the remaining provinces and territories. Across campaigns and routine services, Pakistan intends to vaccinate about 18 million girls over three years, placing the programme among the largest introductions globally.

Why preventing infection matters

Cervical cancer affects the cervix, and is almost entirely preventable through vaccination and screening. In Pakistan, it is the third most prevalent cancer among women. Federal officials also describe it as the second leading cause of cancer death among women of reproductive age.

Health agencies warn that without vaccination, Pakistan's cervical cancer burden could triple over the next seven decades. A large female population faces the risk over a lifetime, while many women have limited access to routine gynecologic care. Vaccinating girls before adolescence provides a chance to prevent illness that might otherwise emerge many years later.

HPV is a common virus transmitted through intimate skin contact. Most infections clear on their own. Some infections with high risk types persist, however, and can cause abnormal changes in cells that progress to cancer over many years.

Two types of HPV, 16 and 18, cause around seven in ten cervical cancer cases worldwide. Vaccines targeting these types prevent infection and the precancerous changes that can follow. Precancerous changes are abnormalities in cells that can develop into cancer if they are not found and treated.

The vaccine prevents infection rather than treating an existing HPV infection or cancer. That is why the campaign targets girls before exposure to the virus. Adult women still need screening and care, while the benefits of vaccinating today's girls will extend into their adult lives.

What a single dose means for families

WHO's global guidance supports a single dose for girls aged 9 to 14, based on evidence that one dose provides lasting protection comparable to two doses in this age group. Using one dose reduces costs and makes delivery simpler, especially where health services have limited resources.

Parents will not need a laboratory test or pelvic examination for their daughters to receive the vaccine. On vaccination day, nurses or vaccinators will answer questions and screen girls for any short term illness. Girls will be asked to wait briefly for observation afterward before returning to class or going home.

Minor side effects can include soreness in the arm, fatigue or a mild fever that resolves quickly. Serious adverse events are very rare, and vaccination sites will have safety monitoring and protocols for responding to them.

Concerns about fertility have accompanied HPV vaccination in many countries. Large studies in several regions have found no effect on fertility or future pregnancy. The vaccine contains no live virus and does not alter hormones. Pakistani health authorities and clinicians are preparing clear messages about these concerns, using scientific evidence and the experience of dozens of countries that have used the vaccine for years.

Schools, health centres and mobile teams

Public and private schools will receive visits from health teams on dates announced in advance. Parents will receive information through schools and neighbourhood outreach before vaccination days. Most girls attending school will receive their dose during class hours.

Families who prefer a health facility can use designated EPI centres during the campaign. Girls who are not enrolled in school can receive the vaccine at designated community sites, basic health units or through visits by Lady Health Workers and mobile teams. The campaign will combine fixed vaccination sites, outreach sessions and mobile services.

Sindh alone plans to cover all 1,190 union councils across 30 districts with more than 3,600 teams. Local planning includes mapping eligible girls, arranging school visit calendars and consent procedures, and organising transport and vaccine storage.

Vaccines must remain cold during storage and travel. The arrangements for keeping them at the required temperature, known as the cold chain, are part of the campaign's preparations, alongside procedures for managing very rare adverse events.

Families will receive vaccination cards as proof that a dose was given. The cards will also carry contact details for follow up if needed. Parents should keep the card safely and take a photograph in case the paper copy is lost.

Reaching girls outside the classroom

Girls who do not attend school are a priority for the campaign. Outreach workers will visit neighbourhoods, madrassas and community centres, extending vaccination beyond the school system. Partnerships with madrassas and local schools will help reach learners outside public education.

Lady Health Workers will mobilise parents, answer questions and accompany girls to nearby vaccination points. Their familiarity with families and neighbourhoods gives them an important role in explaining the vaccine and helping households find a suitable place to receive it.

Community leaders and civil society groups will help arrange sessions at times and locations that work for families. In remote or underserved areas, mobile clinics and small outreach teams will bring vaccination closer to homes.

Parents of girls who are not in school can ask Lady Health Workers, local EPI centres or community outreach points about dates and locations. Consent procedures will follow school and provincial guidelines, with flyers and messages distributed ahead of vaccination.

After the campaign, routine services will offer the vaccine to girls turning nine. Catch up sessions will also be organised during the school year for girls who missed the initial dates.

Doctors and community voices address concerns

A nationwide cross sectional survey in 2022 found that about two thirds of respondents would accept HPV vaccination, while only a small fraction had received it. Such a survey captures people's responses at a particular point in time. Lack of information was the leading barrier, followed by safety concerns and false beliefs that vaccination might affect fertility or encourage early sexual activity.

Experience from polio and other vaccination campaigns has shown health officials that public confidence matters as much as delivery arrangements. The first national HPV campaign gives them an opportunity to explain the vaccine before misinformation gains traction.

The DOPASI Foundation and the Federal Directorate of Immunization have brought together doctors, journalists and community advocates to plan communication in plain language. Media roundtables in Islamabad and Karachi stressed the role of clinicians, school heads and religious scholars in answering questions.

WHO and UNICEF are supporting social mobilisers, training them to respond with empathy and facts and to refer questions to qualified providers when necessary. Teachers trusted by parents, Lady Health Workers familiar with local streets, and midwives who support families will help create conversations close to home. Community networks and civil society groups will also organise information sessions before school vaccination days.

Dr Khurram Shahzad, Director Technical at the Federal Directorate of Immunization, has urged physicians to speak directly with parents. At a briefing with partners in Islamabad, he explained why doctors have a central role in responding to safety concerns.

The public trusts doctors more than anyone else on vaccine safety. Their voice is the most effective tool to counter myths.

A survivor's experience brings prevention closer to home

Shahida Bibi, a mother from Wah in Punjab, endured surgery, radiation and months of treatment after a late diagnosis of cervical cancer. Her family faced financial strain and long journeys for care. She is now cancer free and advocates for prevention in her community.

UNICEF has shared her experience as part of efforts to explain the human cost of the disease. Bibi urges girls and mothers in her village to use the opportunity offered by vaccination.

I do not want anyone else to go through the pain I endured. If I had access to this vaccine when I was younger, I would not have suffered so much. I urge all the young girls in my village and their mothers to get vaccinated. They are fortunate to have this opportunity.

Her experience connects the campaign's prevention goals with the treatment, travel and financial pressures a family can face after a late diagnosis. Health agencies say messages like these work best when delivered close to home, through people whom families already trust.

How vaccination will expand through 2027

The September drive is the first stage of a wider introduction, rather than the full geographic rollout. Federal plans link the campaign to routine immunisation, allowing new groups of girls to receive protection as they reach the eligible age.

The Ministry of Health and its partners have outlined expansion to Khyber Pakhtunkhwa in 2026, followed by Balochistan and Gilgit Baltistan in 2027. Officials say funding has been set aside for the next three years.

• 15 to 27 September 2025: The first campaign targets 13 million girls aged 9 to 14 in Punjab, Sindh, Islamabad Capital Territory and Azad Jammu and Kashmir.
• January 2026: Routine HPV vaccination is planned to begin for girls aged nine, through EPI during the school year and at health facilities.
• 2026: The programme is scheduled to expand to Khyber Pakhtunkhwa.
• 2027: Expansion is planned for Balochistan and Gilgit Baltistan.

The plan aims to reach about 18 million girls over three years through campaigns and routine services. The first phase's target of 13 million is about 72 percent of that planned total, showing how much of the initial work is concentrated in the first four regions.

Gavi support covers initial vaccine procurement and operational costs. Federal and provincial health departments have also established budget lines to continue routine services. Maintaining vaccination year after year will require sustained funding and steady supplies as new groups of girls aged nine become eligible.

Adult women still need screening and treatment

Women who are already adults need screening and care even as Pakistan begins vaccinating girls. Screening looks for infection or abnormal changes before cancer develops, allowing health services to find and treat precancerous changes early.

Methods include visual inspection with acetic acid, Pap tests and HPV DNA testing. Visual inspection uses acetic acid to help identify abnormal areas, Pap tests examine cells, and HPV DNA testing looks for the virus. The shared goal is to identify women who need further assessment or treatment.

The World Health Assembly's global strategy sets targets often described as 90 70 90. By 2030, it aims for 90 percent of girls to be vaccinated by age 15, 70 percent of women to have been screened at least once, and 90 percent of people with precancer or cancer to receive treatment.

Pakistan's plan to add HPV vaccination to routine immunisation follows that roadmap. Provincial health departments say they are also working to expand screening clinics and referral networks, which direct patients to the services they need.

Vaccinating girls now addresses future disease. Screening and treatment address the needs of women who may already have an infection, abnormal cells or cancer. Pakistan's prevention effort therefore depends on services for both age groups.

Lessons from other vaccination programmes

Pakistan will become the 150th country to introduce HPV vaccination, joining 149 countries that have already done so. The scale of its first phase places it among the largest initial introductions anywhere.

UNICEF and Gavi point to programmes in Africa and Asia where delivery through schools, combined with community engagement, has achieved high coverage. Tanzania reports high uptake after careful coordination with education authorities. Bangladesh has moved from pilot programmes to a national rollout using schools.

Those experiences have helped shape Pakistan's preparations, with education departments serving as central partners. Schools offer an organised setting for reaching enrolled girls, while community outreach extends access to those outside the classroom.

Partners are also drawing on other immunisation efforts within Pakistan. Clinics on wheels supported by Gavi have brought infant and child vaccines to settlements where clinics are difficult to reach. The same approach will be tested for adolescent girls in selected districts during September.

Coordination cells in provincial capitals will monitor progress each day. Partners will visit a sample of vaccination sites to identify problems and help teams resolve them while the campaign is running.

Weather, access and accurate records will shape delivery

Urban slums, informal settlements and areas affected by flooding present practical difficulties for vaccination teams. Security concerns can restrict movement in some locations. Girls outside school may need flexible session hours and outreach suited to their circumstances.

Hot weather and transport conditions make reliable refrigerators and ice packs essential. Planners have stockpiled cold chain supplies, trained backup teams and prepared contingency arrangements to reschedule sessions disrupted by weather or local events.

The Sindh Electronic Immunisation Record will support tracking and monitoring, including data entry on the same day and quick checks for gaps in coverage. Supervisors will compare school enrolment lists, community registers and tally sheets to ensure eligible girls are counted accurately.

Daily dashboards will track the share of schools visited, the proportion of eligible girls vaccinated and reports of adverse events following immunisation. Independent monitors will check a sample of the data, while vaccination cards provide families with their own record.

Officials say the early priority is high coverage in the first four regions, followed by orderly expansion in 2026 and 2027. Regular reviews will allow teams to adjust their methods based on performance. Sustained funding, reliable vaccine supplies and continued participation will be needed to keep routine vaccination reaching each new group of eligible girls.

Key Points

• Pakistan's first HPV vaccination campaign will run from 15 to 27 September 2025, targeting 13 million girls aged 9 to 14 in four regions.
• The vaccine will be free, using a single dose schedule endorsed by WHO.
• More than 49,000 health workers have been trained; schools, health facilities and outreach teams will deliver vaccination.
• Girls outside school will be reached through Lady Health Workers, community sites, madrassas and mobile services.
• Pakistan has an estimated 5,000 cervical cancer diagnoses and roughly 3,000 to 3,200 deaths each year.
• Routine vaccination for girls aged nine is planned from January 2026, with expansion to Khyber Pakhtunkhwa in 2026 and Balochistan and Gilgit Baltistan in 2027.
• Officials aim to vaccinate about 18 million girls over three years, while screening and treatment remain priorities for adult women.