It was a sunny autumn morning in the courtyard of an Islamic educational institution in the Jamalpur district of Bangladesh, nearly a hundred miles from the capital, Dhaka. I asked the school principal how his adolescent female students were participating in the HPV vaccination campaign.
He said that the girls who wished to receive the vaccine registered online, printed their vaccination cards, and submitted them to their teachers in time for vaccination day. As a result, when the vaccinators arrived, the process went smoothly for everyone.
While the vaccination team was finishing up their work for the day, a female teacher at the institute called a fifth-grade girl via mobile phone who had been absent that day. The girl arrived soon after and received the shot alongside her classmates.
When I asked the girl what she thought about the HPV vaccine, she said it would protect her from cervical cancer. Her older sister, a ninth grader at another school, was also registered for the vaccine and would receive it the following day. Excitement and proactivity were evident among both the girls and the teachers. Despite ongoing global trends related to HPV vaccine hesitancy, there were no signs of reluctance here.
The story was similar in other educational institutions in the district, where many schoolgirls wore their finest outfits instead of their usual uniforms. This made the experience feel festive and helped them feel more at ease when receiving the vaccine. They even joked about their courage to take the shot. There are many reasons for Bangladeshi public health practitioners to feel proud of these vaccine-friendly communities.
“When I learned that the HPV vaccine prevents cervical cancer, I informed my students about the importance of getting vaccinated,” said Ms. Chamely Khatun, a physical education teacher at another local school. “Some parents expressed concerns about potential infertility after receiving the vaccine. I clarified that this is false; the vaccine is safe, and I educated both the students and their parents about its benefits.”
“When I learned that the HPV vaccine prevents cervical cancer, I informed my students about the importance of getting vaccinated.”— Ms. Chamely Khatun, teacher in Jamalpur, Bangladesh
Meanwhile, the health care workers were working tirelessly. If any technical problems related to online vaccine registration arose, they promptly resolved them by contacting their supervisors or confirming the identifying information of the vaccine recipients. To maintain the cold chain for the vaccine, their efforts represented a race against time.
No one left behind
Bangladesh recently joined global efforts to eliminate cervical cancer, which includes a goal of achieving 90 percent HPV vaccination coverage among 15-year-old girls by 2030. Millions of adolescent girls in the country are actively advocating for their protection against this disease.
After successfully completing the first phase of the HPV vaccine rollout in the Dhaka Division last year, these new campaigns are expanding access to this lifesaving vaccine for more adolescent girls in the remaining seven divisions of Bangladesh, including rural and impoverished areas.
The Expanded Programme on Immunization (EPI) in Bangladesh is also conducting a catch-up HPV vaccination campaign at educational institutions and through fixed and outreach centers for girls in the Dhaka Division who missed the vaccine last year or have become eligible this year.
Bangladesh administers the World Health Organization (WHO)-endorsed single-dose HPV vaccination schedule, targeting a multi-age cohort that includes students in grades 5 to 9 from all types of educational institutions, both formal and informal, including religious institutions.
After completing the campaigns in educational institutions, the EPI is conducting campaigns from its fixed and outreach centers for girls aged 10 to 14 years in communities across the seven divisions for an additional eight days.
A girl receiving an HPV vaccine in Jamalpur, Bangladesh, on November 4, 2024. Photo: PATH/Maksudur Rahman.
Following the catch-up campaign in Dhaka Division, community-level HPV vaccination continues for a month, with the vaccine being integrated into the division’s routine immunization program. These efforts will specifically focus on girls who are not in school or are experiencing homelessness to improve coverage and ensure equitable distribution of the vaccine. Community-based organizations are assisting these girls in registering online for the vaccine.
At this moment, let us not forget that cervical cancer is the third leading cause of cancer-related deaths among women in Bangladesh. Almost all cases of cervical cancer can be attributed to HPV, as long-term HPV infection can lead to the disease.
Unfortunately, many women in Bangladesh have limited access to preventative and screening measures for cervical cancer, making HPV vaccination a critical tool for prevention. These campaigns should leave no one behind.
Future investment
A country’s future lies in the well-being of its daughters. For Bangladesh, these HPV vaccination campaigns offer a unique opportunity to invest in the future of millions of girls across the nation.
To ensure sustainability, Bangladesh is gradually integrating the HPV vaccine into its routine immunization program for girls in grade five, as well as for 10-year-old girls who are not enrolled in the education system.
With support from Gavi, the Vaccine Alliance, PATH is proud to collaborate with the EPI of the Directorate General of Health Services of Bangladesh on this second phase of the HPV vaccine rollout alongside Gavi, WHO, and UNICEF. Our work with the EPI on the first phase in Dhaka Division was supported in part by the HPV Vaccine Acceleration Program Partners Initiative (HAPPI) Consortium (led by JSI).
We congratulate the people of Bangladesh for their strong commitment to preventing cervical cancer for future generations of women. We are confident that every girl in Bangladesh will soon be protected from cervical cancer throughout her lifetime.
A team of health care workers visiting an educational institution in the Jamalpur district of Bangladesh for the HPV vaccination campaign on November 4, 2024. Photo: PATH/Maksudur Rahman.
