Bangladesh’s first public HPV vaccine roll-out gathers momentum

Almost 5,000 women in Bangladesh die each year of cervical cancer – but following the introduction this month of the HPV jab into the routine vaccination schedule, the next generation will be forearmed.

  • 27 October 2023
  • 4 min read
  • by Mohammad Al Amin
A recipient of the HPV vaccine holds up her vaccination card. Credit: Gavi/Ashraful Arefin
A recipient of the HPV vaccine holds up her vaccination card. Credit: Gavi/Ashraful Arefin
 

 

Ariba Khandaker Adrita, aged 12 and a student at Banani Bidyaniketan School and College in Dhaka, received her vaccine against the cervical cancer-causing human papillomavirus (HPV) at the school on 15 October.

"This vaccine will protect her from a deadly disease. During my time, I didn’t get this vaccine. Thanks to the authorities for providing this vaccine free of cost."

– Lavli Khatun, mother of Ariba Khandaker Adrita, aged 12

"After taking this vaccine, I'm feeling happy and protected from a cancer disease," she said. Her mother, Lavli Khatun, echoed her. "This vaccine will protect her from a deadly disease. During my time, I didn't get this vaccine. Thanks to the authorities for providing this vaccine free of cost."

Ariba Khandaker Adrita, student of Banani Bidya Niketon and a HPV vaccine receipent.
Ariba Khandaker Adrita, student of Banani Bidya Niketon and a HPV vaccine recipient.
Credit: Mohammad Al Amin

Adrita is among the first volley of girls countrywide to receive the cancer-blocking jab as part of a government-led roll-out.  Shamsunnahar Begum, a vice principal at the school, described herself as "glad" that her students were being protected and said, "Twelve years ago I had managed [to get] the vaccine from private hospital in the city for my two daughters. And now the girls are getting it free of cost and at the doorstep."

"Milestone" in the battle against a silent killer

Directorate General of Health Services (DGHS) officials said a total of 1,895,677 girls aged ten to 14 years, including 98,300 who are not in school, would be administered with the HPV vaccine in the Dhaka division. The capital region is the focus of phase one of the three-part campaign that kicked off on 2 October.

Speaking at the launch function, Minister of Health and Family Welfare Zahid Maleque said: "The HPV vaccination will be another milestone of vaccination and health services in the country. Cervical cancer is a dangerous disease. It is a silent killer. Around 5,000 women die of the cancer in Bangladesh every year."

Sounding a note of confidence about the HPV vaccine introduction, Maleque described the population of Bangladesh as "vaccine-centred," referencing high immunisation coverage rates across antigens, including COVID-19.

The current roll-out builds on a pilot project that was conducted in 2016 in Gazipur, in which they rolled out the vaccine to 30,000 girls aged ten.

Aiming for 100%

Dr Mohammed Nizam Uddin, Line Director (MNC & AH) of the DGHS said, "Our target is 100% coverage of the HPV vaccination among the targeted children. We hope we can cover more than 95% of the targeted population within [this campaign's] time."

The current campaign is set to run for 18 working days, from mid-October to mid-November, with a possibility of extension.

"The vaccination at school level will create early protection for the girls to prevent cervical cancer," he added. "We have arranged vaccination in schools for students. And we have also arranged the vaccination in EPI and outreach centres for the girls dropped out from schools."

Making strides

While the DGHS couldn't confirm how many girls had been administered the vaccine by October 26, local officials in Dhaka suggested encouraging progress.

Talking to VaccinesWork, Dr Feroze Alam, Assistant Health Officer of DNCC (Dhaka North City Corporation) said "We are not facing any challenge in running the HPV vaccination programme in the city. Initially, we faced a little bit of problems regarding online registration. Later, we overcame it.

"Our target was inoculating 994 girls in the Banani Bidyaniketon School and College. We have been able to administer the jabs among 814 girls in a two-day campaign. We will inoculate the dropped-out 181 girls on another convenient day," he added.

Campus vaccination

At Banani Bidyaniketan School and College, preparations had begun in earnest over a week before the vaccinators set up their makeshift booths. Girls were notified during classes that the vaccine would be available and had been asked to fill out online registration together with their guardians, said Vice Principal Shamsunnahar Begum.

Shamsunnahar Begum, Vice Principal of the Banani Bidyaniketan School and College.
Shamsunnahar Begum, Vice Principal of the Banani Bidyaniketan School and College.
Credit: Mohammad Al Amin

Wasima Jahan, one of the vaccinators present at the school on the mid-October Tuesday that immunisation kicked off, noted that students had broadly seemed keen to be immunised.

"Twelve years ago I had managed [to get] the vaccine from private hospital in the city for my two daughters. And now the girls are getting it free of cost and at the doorstep."

–Shamsunnahar Begum, vice principal at Banani Bidyaniketan School and College, Dhaka

"Though very few of the schoolgirls were fearing pain due to injecting the vaccine with needle, they were enthusiastic and seen happy in getting the vaccine," she said.

Rasheda Molla, another vaccinator, said the campaign would roll out to schools on a rotating schedule. Eligible girls who missed their chance to get inoculated at their own educational institutions could always go and get the vaccine from other designated centres, Molla confirmed.

Schoolgirls line up for vaccination.
Schoolgirls line up for vaccination.
Credit: Gavi/Ashraful Arefin

Talking to VaccinesWork, S. M. Abdullah Al Murad, Program Manager (EPI) of Directorate General of Health Services (DGHS) said that in the second phase of the roll-out, which will kick off in April 2024, HPV vaccination will be conducted in two other areas of the country: Chattogram and Barishal. Remaining divisions will get access to the vaccine in August next year.

"We need over one crore [ten million] of the vaccine to cover all the 10- to 14-year-old girls of the country," he said.