ISLAMABAD: Misconceptions, weak advocacy, and poor communication by Pakistan’s immunisation authorities have triggered massive resistance to the ongoing Human Papillomavirus (HPV) vaccination campaign, with over 3.6 million families refusing to vaccinate their daughters against cervical cancer, according to the Federal Directorate of Immunisation’s (FDI) daily situation report issued on Sunday.
Out of the government’s target of 11.73 million girls aged 9 to 14, officials claim that 7.7 million have been vaccinated. Experts, however, question the credibility of these figures, pointing to inflated percentages and contradictions in official reporting.
Refusals account for nearly one-third of the target group. Punjab tops the list with 2.56 million refusals, followed by Sindh with 854,000, while Islamabad and Azad Jammu and Kashmir (AJK) reported smaller but proportionally damaging figures. In total, 4.4 million girls remain unvaccinated, and only 341,000 doses were administered later through follow-up visits.
Despite widespread resistance, official reports continue to cite figures that defy logic. On day 12, performance was reported at 109 per cent nationally and 129 per cent in Punjab — percentages experts say are impossible. “The numbers don’t add up. Claims of over 100 per cent coverage make little sense in a campaign facing millions of refusals,” an immunisation expert told this correspondent.
Misinformation that the vaccine causes infertility, is unsafe, or part of a foreign agenda has fuelled refusals. Religious hardliners and social media influencers amplified these fears, while a viral video of girls collapsing after injections — later proven unrelated — sparked panic in Karachi.
Keamari district remains the worst-performing in Sindh, with coverage below 20 per cent. Overall coverage in Sindh stands at 66 per cent, slightly behind Punjab’s claimed 68 per cent. Islamabad has fared worse, with only 36 per cent of the target vaccinated and school-based efforts almost non-existent. In AJK, cumulative coverage is stuck at 40 per cent, with no fixed vaccination sites established.
Poorly trained mobilisers have been unable to counter parental fears, while helpline records highlight widespread suspicion. Parents across provinces questioned safety, raised infertility concerns, or doubted eligibility.
The FDI insists the vaccine is safe, noting only 29 mild adverse reactions — all fully resolved. But experts argue that without stronger communication and visible advocacy by trusted figures, refusals will continue to overshadow progress.
District-level data underscores patchy performance: out of 78 districts, 30 have achieved less than 60 per cent coverage, while only 17 crossed 80 per cent. School-based vaccination, expected to anchor the drive, has largely failed, with less than 10 per cent of doses delivered in schools across 31 districts.
While officials stress the campaign is in “catch-up mode” and may be extended in low-performing areas, experts warn deadlines won’t change realities. “The issue is not time — it’s trust. Until families are convinced, the campaign will limp from one target to another,” an expert said.
“Some people have refused, closed their gates on us, and even hid information about their daughter´s age,” vaccinator Ambreen Zehra told AFP while going door to door in a lower-middle-income neighbourhood in Karachi.
Only around half the intended vaccines had been administered, according to a federal health department official who spoke to AFP on condition of anonymity.
“Many girls we aimed to reach are still unvaccinated, but we are committed to ensuring the vaccine remains available even after the campaign concludes so that more women and girls get vaccinated,” they said on Friday.
A teacher told AFP on condition of anonymity that not a single vaccine had been administered in her school on the outskirts of Rawalpindi because parents would not give consent, something she said other rural schools had also experienced.
A health official who asked not to be named said some private schools had resorted to closing for several days to snub vaccine workers.
“On the first day we reached 29 percent of our target, it was not good, but it was fine,” said Syeda Rashida Batool, Islamabad´s top health official who started the campaign by inoculating her daughter.
“The evening of that first day, videos started circulating online and after that it dipped. It all changed.”
A video of schoolgirls doubled over in pain after teargas wafted into their classroom during a protest several years ago was re-shared online purporting to show the after-effects of the vaccine.
“My husband won´t allow it,” said Maryam Bibi, a 30-year-old mother in Karachi who told AFP her three daughters would not be vaccinated.
“It is being said that this vaccine will make children infertile. This will control the population.”
Humna Saleem, a 42-year-old housewife in Lahore, said she thought the vaccine was “unnecessary”.
“All cancers are terrible. Why don´t we tell our boys to be loyal to their wives instead of telling our girls to get more vaccines?” she told AFP.
The popular leader of a right-wing religious party, Rashid Mehmood Soomro, said last week the vaccine, which is voluntary, was being forced on girls by the government.
“In reality, our daughters are being made infertile,” he told a rally in Karachi.
In 95 percent of cases, cervical cancer is caused by persistent infection with Human Papillomavirus (HPV) -- a virus that spreads through sexual activity, including non-penetrative sex, that affects almost everyone in their lifetime.
Cervical cancer is particularly deadly in low and middle income countries such as Pakistan, where UNICEF says around two-thirds of the 5,000 women diagnosed annually will die, although the figure is likely under-reported.
In Europe, where the HPV vaccine has been highly effective, there were around 30,000 diagnoses across all 27 EU nations in 2020, of which around one-third of women died, according to the European Commission.
nated. Experts, however, question the credibility of these figures, pointing to inflated percentages and contradictions in official reporting.
Refusals account for nearly one-third of the target group. Punjab tops the list with 2.56 million refusals, followed by Sindh with 854,000, while Islamabad and Azad Jammu and Kashmir (AJK) reported smaller but proportionally damaging figures. In total, 4.4 million girls remain unvaccinated, and only 341,000 doses were administered later through follow-up visits.
Despite widespread resistance, official reports continue to cite figures that defy logic. On day 12, performance was reported at 109 per cent nationally and 129 per cent in Punjab — percentages experts say are impossible. “The numbers don’t add up. Claims of over 100 per cent coverage make little sense in a campaign facing millions of refusals,” an immunisation expert told this correspondent.
Misinformation that the vaccine causes infertility, is unsafe, or part of a foreign agenda has fuelled refusals. Religious hardliners and social media influencers amplified these fears, while a viral video of girls collapsing after injections — later proven unrelated — sparked panic in Karachi.
Keamari district remains the worst-performing in Sindh, with coverage below 20 per cent. Overall coverage in Sindh stands at 66 per cent, slightly behind Punjab’s claimed 68 per cent. Islamabad has fared worse, with only 36 per cent of the target vaccinated and school-based efforts almost non-existent. In AJK, cumulative coverage is stuck at 40 per cent, with no fixed vaccination sites established.
Poorly trained mobilisers have been unable to counter parental fears, while helpline records highlight widespread suspicion. Parents across provinces questioned safety, raised infertility concerns, or doubted eligibility.
The FDI insists the vaccine is safe, noting only 29 mild adverse reactions — all fully resolved. But experts argue that without stronger communication and visible advocacy by trusted figures, refusals will continue to overshadow progress.
District-level data underscores patchy performance: out of 78 districts, 30 have achieved less than 60 per cent coverage, while only 17 crossed 80 per cent. School-based vaccination, expected to anchor the drive, has largely failed, with less than 10 per cent of doses delivered in schools across 31 districts.
While officials stress the campaign is in “catch-up mode” and may be extended in low-performing areas, experts warn deadlines won’t change realities. “The issue is not time — it’s trust. Until families are convinced, the campaign will limp from one target to another,” an expert said.
“Some people have refused, closed their gates on us, and even hid information about their daughter´s age,” vaccinator Ambreen Zehra told AFP while going door to door in a lower-middle-income neighbourhood in Karachi.
Only around half the intended vaccines had been administered, according to a federal health department official who spoke to AFP on condition of anonymity.
“Many girls we aimed to reach are still unvaccinated, but we are committed to ensuring the vaccine remains available even after the campaign concludes so that more women and girls get vaccinated,” they said on Friday.
A teacher told AFP on condition of anonymity that not a single vaccine had been administered in her school on the outskirts of Rawalpindi because parents would not give consent, something she said other rural schools had also experienced.
A health official who asked not to be named said some private schools had resorted to closing for several days to snub vaccine workers.
“On the first day we reached 29 percent of our target, it was not good, but it was fine,” said Syeda Rashida Batool, Islamabad´s top health official who started the campaign by inoculating her daughter.
“The evening of that first day, videos started circulating online and after that it dipped. It all changed.”
A video of schoolgirls doubled over in pain after teargas wafted into their classroom during a protest several years ago was re-shared online purporting to show the after-effects of the vaccine.
“My husband won´t allow it,” said Maryam Bibi, a 30-year-old mother in Karachi who told AFP her three daughters would not be vaccinated.
“It is being said that this vaccine will make children infertile. This will control the population.”
Humna Saleem, a 42-year-old housewife in Lahore, said she thought the vaccine was “unnecessary”.
“All cancers are terrible. Why don´t we tell our boys to be loyal to their wives instead of telling our girls to get more vaccines?” she told AFP.
The popular leader of a right-wing religious party, Rashid Mehmood Soomro, said last week the vaccine, which is voluntary, was being forced on girls by the government.
“In reality, our daughters are being made infertile,” he told a rally in Karachi.
In 95 percent of cases, cervical cancer is caused by persistent infection with Human Papillomavirus (HPV) -- a virus that spreads through sexual activity, including non-penetrative sex, that affects almost everyone in their lifetime.
Cervical cancer is particularly deadly in low and middle income countries such as Pakistan, where UNICEF says around two-thirds of the 5,000 women diagnosed annually will die, although the figure is likely under-reported.
In Europe, where the HPV vaccine has been highly effective, there were around 30,000 diagnoses across all 27 EU nations in 2020, of which around one-third of women died, according to the European Commission.