Scaling up HPV vaccination

Cervical cancer is the second most prevalent cancer among women in the Philippines. Twelve women die every day, and 7,897 cases diagnosed annually. Although preventable, the country now faces a crucial moment in the fight to stop it. The World Health Organization recommends two key strategies to prevent cervical cancer: vaccination for girls aged 9 to 14 and screening for women aged 30 to 65. 

Jhpiego, a global health leader affiliated with Johns Hopkins University, partners with the government’s vaccination efforts through the HPV Vaccine Acceleration Program Partners Initiative (HAPPI). This global initiative involving five international nongovernment organizations, including Jhpiego, aims to promote equity, program quality, and the rapid expansion of human papillomavirus (HPV) vaccination among girls.

To achieve this in the Philippines, it is imperative to take a closer look at vaccination trends from 2017 to 2023. We found that while some municipalities in select provinces have achieved impressive coverage, the bigger picture shows troubling gaps that need immediate attention. 

With every passing year, more Filipino women and girls are left vulnerable to cervical cancer. Clearly, scaling up our efforts on HPV vaccination is more urgent now than ever. While a handful of provinces have shown us what works, the reality is that the majority of provinces struggle to keep up. The COVID-19 pandemic resulted in school closures, which disrupted immunization programs and caused service interruptions. Logistical problems made it difficult to reach children, especially Grade 4 girls, who are the focus of the HPV immunization.

According to the Department of Health (DOH), combined data on community- and school-based HPV vaccine coverage plummeted from 75 percent in 2017 and 2018 to 27 percent in 2022 and 2023. The Department of Education (DepEd) posted an even more drastic drop in its school-based HPV vaccination coverage statistics, from 26.54 percent to only 4.8 percent over the same period. 

These numbers reflect more than just logistical problems. They point to a need to harmonize data reporting mechanisms between government agencies. While HPV vaccines have been available and reach select municipalities or cities, the variations in the number of targeted populations of girl children in the community and enrollment of Grade 4 girls in schools make implementing the vaccination program more challenging. 

Despite these, we have seen glimpses of hope in provinces which have achieved more than 80 percent vaccination coverage across multiple municipalities. This has been achieved due to persistent effort, demonstrated by good governance and local leadership, proactive collaboration between education and healthcare champions, and engagement from parents and the community. These are what we call “bright spots,” which prove that alignment and tailored strategies can make all the difference.

The challenge now is to replicate these bright spots nationwide. It is not enough for these to be found as isolated examples. We need to bring together the DOH, DepEd, Department of the Interior and Local Government, local government units (LGU), pediatric and medical societies, nursing, midwifery and allied health organizations, public health and school health practitioners, vaccine experts, and other stakeholders.

Through a strong partnership toward a contextualized and responsive HPV vaccination policy and guidelines, combined with a strategic plan for scaled-up implementation, unified data integration and information management, and monitoring activities, we can ensure that every girl will have access to the HPV vaccine, no matter where she lives.

The LGU bright spots offer a roadmap to success. However, to turn this vision into a countrywide reality requires decisive action. Policymakers, educators, health workers, and civil society must work together by building on these lessons and tackling the barriers head-on.  There is every reason to believe that the Philippines can recover from the cervical cancer pandemic. With strong partnerships, community engagement, and political will, eliminating cervical cancer is not just a dream—it’s within our reach.

—————-

Anthony P. Calibo, MD, DPPS, is a pediatrician and public health advocate, who is currently the technical advisor for immunization for Jhpiego’s HPV Vaccination Acceleration Program Partners Initiative (HAPPI). Geri Matthew Carretero is a communications specialist and multidisciplinary artist, serving as the communications and KM officer for Jhpiego in the Philippines.