Islamabad: Misconceptions, weak advocacy and poor awareness campaigns by Pakistan’s immunisation authorities have driven massive resistance to the ongoing HPV vaccination drive, with over 3.6 million families refusing to vaccinate their daughters against cervical cancer, officials conceded on Sunday.
Out of the government’s target of 11.8 million girls aged 9-14, officials of the Federal Directorate of Immunisation (FDI) and provincial Expanded Programmes on Immunisation (EPIs) claim that 7.7 million have been vaccinated, yet experts doubt these figures, pointing to glaring contradictions and inflated percentages in official reports.
According to the FDI’s daily situation report, refusals account for nearly one-third of the target group. Punjab tops the list with 2.5 million refusals, Sindh follows with more than 850,000, while Islamabad and Azad Jammu and Kashmir recorded smaller but proportionally damaging numbers. In total, 4.4 million girls have so far been missed, and just 341,000 of these could be vaccinated later through follow-up visits.
Despite this grim picture, officials continue to trumpet figures that defy logic. Daily coverage is reported at 109 percent nationally, and an astonishing 129 percent in Punjab, raising immediate questions of how vaccinations can exceed the target population.
Experts argue such inflated claims are a desperate attempt to mask the failures of a campaign that has faltered in the face of misinformation and parental distrust.
The misinformation has been relentless as rumours that the vaccine causes infertility, is part of a foreign agenda, or is unsafe have spread widely. Religious hardliners and social media influencers have played a key role, while a viral video falsely showing schoolgirls collapsing after injections further fueled fear in communities. Although later proven unrelated to the campaign, the video caused widespread panic, particularly in Karachi.
Keamari district of Karachi remains the worst-performing area, where less than 20 percent of girls have been vaccinated. Coverage in Sindh overall stands at 66 percent, far below Punjab’s claimed 68 percent, despite the province’s far larger refusal numbers.
Islamabad has fared even worse, with only 36 percent of the target population vaccinated and school-based efforts almost non-existent. In AJK, cumulative coverage is stuck at 40 percent, with no fixed vaccination sites established and misinformation running unchecked.
The weakness of advocacy is evident in the campaign’s reliance on community mobilisers who were poorly trained and ill-equipped to handle the tide of myths and conspiracy theories.
Experts said many outreach workers failed to reach households, while others could not counter fears about infertility or suspicions of foreign agendas. The absence of trained social mobilisers in Islamabad, and the lack of fixed-site vaccination centres in AJK, compounded the failures.
Helpline data reflects the mood on the ground. In Sindh, callers spread rumours of girls fainting and vaccines being foreign-fabricated. In Punjab, fathers and community elders repeatedly demanded assurances on safety, infertility, and consent.
In Khyber Pakhtunkhwa, high call volumes sought clarity on eligibility, while in AJK parents questioned whether the vaccine was even meant for their daughters. Even in Islamabad, where most calls were simply information-seeking, misinformation had already shaped parental doubts.
The FDI insists that the vaccine is safe, noting only 29 mild adverse events nationwide, all of which resolved fully. But the reality is that safety assurances have not overcome fear. Experts warn that without serious investment in communication and visible advocacy by trusted figures, refusals will continue to overshadow progress.
The district-level breakdown underscores the patchy coverage. Out of 78 districts nationwide, 30 have achieved less than 60 percent coverage, while just 17 managed to cross the 80 percent threshold. In Punjab, 9 districts remain below 60 percent, while Sindh has 10. In Islamabad, no district has achieved more than half the target.
Even school-based vaccination, expected to anchor the campaign, has largely failed. Reports from 31 districts show less than 10 percent of vaccinations happening in schools, with thousands of front-line staff not reporting school activities at all. Instead, the campaign has leaned heavily on community outreach, which alone accounted for nearly 69 percent of total vaccinations, further evidence of weak planning around schools.
Immunization authorities stress that the campaign is still in catch-up mode and could extend for additional days in low-coverage districts. But experts argue that without correcting the communication strategy, extending deadlines will not change the reality on the ground. The very scale of refusals shows that families remain unconvinced, and inflated statistics only deepen public mistrust.
The FDI and provincial EPIs face a sobering reality: a vaccine that can protect girls from cervical cancer is being rejected by millions because of official complacency and poor advocacy. Unless the government abandons its self-congratulatory reporting and confronts the wave of misinformation with honesty and urgency, the HPV campaign risks being remembered not for saving lives, but for squandering trust.
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