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       LAHORE: Vaccination of 2.5m out-of-school girls after the floods and rains, especially in marginalised communities, could be challenging for the health teams as Punjab looks to introduce human papillomavirus (HPV) vaccine in routine immunisation programme following a campaign starting from Sept 15 to 27.

       Vaccination is part of larger global strategy for elimination of cervical cancer and Pakistan is also a signatory of the 71stWorld Health Assembly Resolution of 2018 that sets a goal of 90-70-90 by year 2030, which means 90pc of girls vaccinated against HPV by age 15, 70pc of women screened by age 35 and again by 45, and 90pc of women with cervical cancer disease receive treatment/palliative care.

       The HPV vaccine is to be given as a series of shots and is a key way to prevent the third most common cancer in women in Pakistan.

       A senior official told Dawn Punjab’s Expanded Programme on Immunization (EPI) has made preparations to reach out of school girls in its bid to introduce HPV vaccine in routine immunization for girls aged 9 to 14 years but vaccination of girls in flood-affected areas, nomadic settings, migrant populations, red light areas could pose a serious challenge.He said the overall target for the campaign is just over 8m girls across Punjab and around 5.5m are envisioned to be vaccinated in schools.

       EPI prepares to reach out to 8m girls, including those in marginalised communities

       However, reaching out to around 2.5m out-of-school girls remains a grey area largely due to the floods, which damaged the school infrastructure across Punjab.

       Quoting some recent WHO reports, the official said that cervical cancer related to HPV infection is a serious public health concern in Pakistan.“It is the third most common cancer among women in the country and the second most common cancer among women aged 15 to 44 years,” he said.

       This cancer mostly hits the population in low resource settings. This cancer is caused by a virus known as human papillomavirus (HPV) and it can silently progress into serious cancer.

       Punjab EPI Director Dr Samra Khurram says that the challenge of HPV vaccine introduction is very different to what the programme encountered previously.

       “A lot of girls are out of school. We have deployed 6,277 outreach teams and over 13,000 social mobilizers. We have developed separate plans for remote and underserved areas. Kit stations will be set up at residents of community notables, hujras and LHW houses.”

       Dr Samra says mobile/special teams are being deployed for high-risk and underserved populations such as those in prisons, orphanages, fields, markets, transport hubs, & settlements. Civil society organizations have been taken on board to reach out to special communities.

       She adds that the EPI provides vaccines against 12 diseases to children below five years of age. However, HPV addresses a different age group of 9 to 14 years. “There is injection fear and it is hard to impart complicated scientific information to such a young age group.”

       Dr Samra Khurram said this vaccine has already been introduced in over 144 countries globally, including Muslim countries such as Saudi Arabia, Qatar, UAE, Malaysia, and Indonesia. Lessons learnt from these countries have been considered before formation of operational planning, she said.

       This will be a single-dose vaccine, to be administered by trained health workers, including vaccinators, lady health visitors (LHVs) and nurses.

       It may be remembered the HPV vaccine was previously available at expensive private hospitals only and was quite costly. This is the first time in a decade this vaccine shall now be available free of cost.

       Published in Dawn, September 15th, 2025