Even where the demand for HPV vaccines is high, opportunities are being missed to vaccinate girls. But there are ways to ensure girls receive the vaccines they need.

From reducing the number of out-of-school girls missing out on HPV vaccines, to implementing flexible supply chains and regular Technical Working Groups (TWGs), there are various ways to ensure more girls receive HPV vaccines that can protect them against cervical cancer. Even where demand is increasing, the right processes must be in place for HPV vaccine uptake to follow.

Increase HPV vaccine uptake for out-of-school girls

In some low- and middle-income countries (LMICs), millions of girls aged 9-14 are not in school. HPV vaccines are often delivered in schools, meaning many girls are not receiving the vaccine. The number of out-of-school girls can be underestimated too, with millions unaccounted for in some countries. This can lead to vaccinators not targeting them.

Using outdated population statistics sometimes up to a decade old can lead to out-of-school girl population underestimates. To avoid this, it is essential to develop more accurate estimates.

Flexible supply chains and delivery models

Even where demand is high, flexibility is crucial to ensure that girls do not miss out on HPV vaccines. There may be plans in place for vaccinators to visit some areas, but not others. Through critical monitoring and evaluation processes, it sometimes becomes known during campaigns that other locations have higher numbers of unvaccinated girls. Reviewing information daily and expanding vaccine delivery beyond planned locations ensures that more girls are reached. Whether it is farms or playgrounds, there are various sites where vaccines can be delivered.

Vaccinators did an excellent job of implementing flexible supply chains in Kebbi and Kano, Nigeria. After noticing that some areas had a higher demand than expected, vaccinators diverted HPV vaccines to the areas of higher uptake, away from lower demand locations. Where schools faced strikes, vaccinators also showed flexibility, using the knowledge of teachers to locate girls, before visiting communities to deliver vaccines.

Regular Technical Working Groups (TWGs)

Successful HPV vaccine programmes often have frequent TWG meetings in place. By ensuring that EPI and education stakeholders can review and improve plans on a regular basis, these meetings enable effective communication to take place regarding vaccination dates or changes that need making.

Conversely, states with sporadic TWG meetings often struggled to implement effective HPV vaccine campaigns. Meetings might not take place on campaign days, and valuable data to guide sessions was lacking even when they did take place.

Through reducing the number of out-of-school girls missing out on HPV vaccines, implementing flexible supply chains, and hosting regular TWGs, more girls can receive the vaccines they need. This is crucial for reducing the likelihood of women receiving cervical cancer later in life.