Why Pakistan’s HPV Vaccine Campaign Has Faced Backlash
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Pakistan launched its first-ever national HPV vaccination drive to prevent cervical cancer in millions of young girls. But misinformation, cultural taboos, and conspiracy theories have sparked resistance to the life-saving campaign.
Introduction
In September, Pakistan took a bold step in public health by launching its first-ever national vaccination campaign against the human papillomavirus (HPV) — a virus known to cause cervical cancer, one of the deadliest cancers among women.
The ambitious programme, spearheaded by Pakistan’s Ministry of Health in collaboration with the World Health Organization (WHO), UNICEF, and Gavi – the Vaccine Alliance, aims to immunise over 13 million girls aged nine to 14 during its first phase.
Cervical cancer kills eight Pakistani women every day, according to Dr Dapeng Luo, WHO’s representative in Pakistan. The HPV vaccine is globally recognised as a safe and effective measure to prevent the disease, which the UN hopes to eradicate by 2030.
Yet, despite the medical consensus, the campaign has met a wave of public resistance. Rumours, misinformation, and cultural taboos surrounding both the virus and the vaccine have triggered a backlash, particularly in conservative communities.
What Is HPV?
A Silent but Common Virus
The human papillomavirus (HPV) is not a single disease but a group of more than 100 related viruses. It spreads primarily through skin-to-skin contact, often during intimate or sexual contact.
Most HPV infections are harmless and go unnoticed. In fact, many infected individuals show no symptoms at all and recover naturally within a couple of years. However, some high-risk strains persist in the body, silently causing cellular changes that can later lead to cancer.
How HPV Leads to Cervical Cancer
According to WHO data, 95 percent of all cervical cancer cases worldwide are caused by persistent HPV infection.
Once infected, the virus can trigger abnormal growth of cells in the cervix — the lower part of the uterus — leading to precancerous lesions. Over 10 to 20 years, if untreated, these cells may evolve into full-blown cervical cancer.
Globally, HPV is also linked to other cancers such as vaginal, vulvar, anal, penile, and even throat cancers.
In Pakistan alone, over 5,000 new cervical cancer cases are diagnosed annually, with nearly 3,000 deaths each year — figures that experts say are vastly under-reported due to poor screening.
The Vaccine and Its Promise
How the HPV Vaccine Works
The HPV vaccine protects against the most dangerous virus strains responsible for the majority of cervical cancers. It is most effective when administered before the onset of sexual activity, which is why Pakistan’s campaign targets girls aged 9–14 years.
A two-dose schedule spaced six months apart provides long-term immunity. The vaccine has been part of routine immunisation programmes in over 120 countries, including neighbouring nations like Bangladesh, Nepal, and Sri Lanka.
A Global Public Health Success
Countries that introduced the HPV vaccine years ago have reported dramatic declines in cervical cancer rates. For example, Australia and the United Kingdom are on track to virtually eliminate cervical cancer within a decade thanks to widespread HPV immunisation.
WHO officials hoped Pakistan’s campaign would mark a similar turning point — but instead, it has revealed deep societal divides.
Why the Backlash?
1. Misconceptions About the Vaccine
As with past immunisation efforts, Pakistan’s HPV rollout has been plagued by rumours and conspiracy theories. False claims that the vaccine causes infertility, promotes promiscuity, or contains “foreign substances” have spread rapidly, especially across social media platforms and WhatsApp groups.
Public health workers report that in several districts, parents refused to send their daughters to school on vaccination days, fearing “hidden agendas.”
“Many people think this vaccine is linked to Western attempts to control our population,” said a health worker from Punjab. “We face the same kind of resistance we saw during the early polio campaigns.”
2. Cultural and Religious Sensitivities
The fact that HPV is sexually transmitted makes open discussion of the disease challenging in Pakistan’s conservative society.
Many parents associate the vaccine with sexual activity, which is considered taboo. The idea of administering a vaccine to pre-teen girls to prevent a sexually transmitted infection (STI) has therefore been misinterpreted as an endorsement of early sexual behaviour.
Religious leaders and local influencers have been divided — some have publicly supported the campaign, while others have questioned its morality.
A senior health official in Sindh explained:
“We are fighting not only misinformation but also a culture of silence. Parents are uncomfortable discussing a vaccine linked to sexual transmission.”
3. Echoes of the Polio Misinformation Crisis
Pakistan’s struggle with vaccine misinformation is not new. The country remains one of the few in the world where polio is still endemic, largely due to distrust, fake rumours, and extremist propaganda claiming vaccines are “Western plots.”
The HPV campaign has encountered a similar pattern of suspicion — a mix of distrust toward international organisations, misinformation about ingredients, and fear of foreign interference.
In some regions, health officials have been verbally abused or denied entry to schools, forcing local authorities to deploy police protection — a scenario reminiscent of the early polio drive.
4. Communication Gaps and Community Engagement
Public health experts argue that poor communication strategy worsened the problem.
The campaign’s initial outreach did not adequately explain the purpose, safety, or long-term benefits of the HPV vaccine in local languages. In some areas, posters and awareness material simply mentioned “a new vaccine for girls,” without clarifying its role in preventing cervical cancer.
This lack of clarity allowed rumours to flourish unchecked.
Health advocacy groups are now urging the government to involve teachers, female health workers, religious leaders, and media outlets in spreading accurate information.
The Medical Community’s Response
WHO and UNICEF Support
International partners like WHO and UNICEF have reaffirmed their commitment to Pakistan’s HPV programme.
Dr Dapeng Luo (WHO Pakistan) said in a recent statement:
“Every day, eight women in Pakistan die from cervical cancer — a disease that is entirely preventable. The HPV vaccine is a proven tool to save lives.”
UNICEF Pakistan has also launched community outreach initiatives, focusing on trust-building and education, particularly in rural areas where literacy rates are low.
Local Health Experts Step In
Pakistani gynaecologists and oncologists have spoken out strongly in favour of vaccination. Dr. Shazia Naz, a leading oncologist at the Aga Khan University Hospital, Karachi, noted:
“We have one of the highest cervical cancer mortality rates in Asia. Without HPV vaccination and early screening, the numbers will only rise.”
Medical experts have also emphasised that the vaccine is completely safe, backed by decades of global data from millions of recipients.
Lessons from Other Muslim-Majority Countries
Public acceptance of the HPV vaccine has been mixed across the Muslim world.
- Indonesia initially faced similar backlash but overcame resistance through fatwas by religious authorities declaring the vaccine halal and necessary.
- Malaysia successfully integrated HPV vaccination into its school system after partnering with female teachers and parent councils.
- Bangladesh introduced the vaccine quietly through existing immunisation structures, avoiding controversy by framing it as a cancer-prevention tool rather than an STI vaccine.
Pakistan’s policymakers are studying these models as they prepare to scale up the programme nationwide.
The Cost of Inaction
Without widespread vaccination, experts warn that Pakistan risks facing a public health crisis.
Cervical cancer is not only deadly but also economically devastating. Treatment costs are high, and most women are diagnosed at late stages, when recovery chances are slim.
According to the Pakistan Institute of Medical Sciences (PIMS), only about 15 percent of women undergo regular cervical screening, and HPV awareness levels remain below 10 percent among rural populations.
The HPV vaccine, if widely administered, could prevent 70–80 percent of future cervical cancer cases.
Overcoming the Backlash
Building Trust Through Education
Public health experts stress that community engagement is the key to countering vaccine resistance.
Engaging religious scholars, female community leaders, and teachers to explain the vaccine’s purpose — prevention of cancer, not promotion of sexual activity — can help shift public perception.
Transparent Messaging
Authorities are now revising their communication strategy to ensure consistent, transparent, and science-based messaging. Plans include:
- Dedicated media campaigns explaining how HPV causes cancer.
- Workshops for journalists to counter fake news.
- Town-hall meetings with parents and community elders.
Collaboration with Influencers
Social media influencers, doctors, and educators are being mobilised to share personal stories and accurate information about the vaccine’s benefits, particularly on platforms like Facebook, X (Twitter), and TikTok, where misinformation tends to spread rapidly.
Hope for the Future
Despite initial resistance, the government remains optimistic. Health officials say that in pilot districts like Islamabad and Karachi, vaccination rates have exceeded expectations.
“Once people understood the vaccine prevents cancer, not encourages immorality, acceptance improved dramatically,” said a federal health officer involved in the rollout.
The second phase, planned for 2025, aims to include additional districts in Punjab, Sindh, and Khyber Pakhtunkhwa, with enhanced community outreach and partnerships with Lady Health Workers (LHWs) — the same network that helped eradicate neonatal tetanus.
Conclusion
Pakistan’s HPV vaccination campaign has laid bare a recurring challenge in public health — the battle between science and misinformation, progress and taboo.
While the vaccine represents a milestone in women’s healthcare, resistance rooted in cultural sensitivity, religious misunderstanding, and misinformation threatens to derail its life-saving potential.
The success of this campaign will depend not only on logistics or funding, but on winning hearts and minds — building trust through education, dialogue, and empathy.
If Pakistan can overcome these barriers, it could save thousands of women’s lives and move closer to WHO’s goal of eliminating cervical cancer by 2030.
Until then, the HPV vaccine remains more than a medical intervention — it is a test of Pakistan’s ability to balance faith, culture, and science in public health.
