One Dose at a Time: Mobilizing to Eliminate Cervical Cancer in Nigeria
Nigeria introduced the single-dose HPV vaccine into its routine immunization program in October 2023. This marked a historic milestone in the fight against HPV-related cancers, including cervical cancer, which is one of the leading causes of death for Nigerian women. This momentous vaccine introduction was made possible by the Nigerian Government, through the National Primary Health Care Development Agency (NPHCDA), with support and technical assistance from several key partners, including Gavi, the Vaccine Alliance, WHO, UNICEF, and IVAC.
The introduction marked the first phase of a multi-age cohort campaign to vaccinate 9–14-year-old girls across 16 Nigerian states, with girls in the country’s remaining 21 states to be targeted in phase two of the campaign later this year. Within the next two years, the program aims to reach over three million 9-year-old girls and 14 million girls between 10 to 14 years old, making it the largest roll-out of the single-dose schedule to date.
IVAC, led by Nigeria Country Director Dr. Chizoba Wonodi, played a pivotal role at various stages of HPV vaccine introduction such as offering technical assistance to the Nigeria Immunization Technical Advisory Group (NGI-TAG) during their evidence review to evaluate and recommend the vaccine and organizing a national stakeholder forum on cervical cancer elimination. With Gavi support, IVAC also identified and trained civil society organizations (CSOs) to address misinformation, mobilize young girls for vaccination, and ensure inclusivity for adolescent girls with disabilities. CSOs have extensive networks and are highly trusted within their communities, and so these sensitization efforts were crucial for vaccine demand generation and the ultimate success of the campaign.
Although the HPV vaccine launch was largely successful, the first phase of introduction faced several significant challenges. For example, there were complex issues surrounding parental consent and a national diphtheria outbreak that competed for attention from stakeholders and threatened to overburden an already strained healthcare system. Misinformation and rumors around HPV vaccination also ran rampant. “Vaccine acceptance is not something we can take for granted,” said Dr. Wonodi. “It can crop up in the most unusual of places, and the rise of social media makes people extremely vulnerable to misinformation.” IVAC and partners helped to navigate this issue, working with community and traditional leaders to address concerns and combat the spread of harmful misinformation. They used a variety of channels, including WhatsApp, social media, and radio shows, to provide accurate vaccine information to communities and build confidence in vaccine safety.
Following the campaign launch, the Nigerian government, alongside IVAC and other partners, are working to steadily incorporate the vaccine into routine immunization schedules within healthcare facilities, community outreach efforts, and school-based immunization programs. The NPHCDA and partners will continue their efforts to focus on equity and inclusion, with targeted strategies to reach out-of-school girls and those living with disabilities.