HPV vaccination in Africa: Urgent action needed to tackle low uptake and rising hesitancy

By The Inspirer.

Johannesburg, South Africa – Thursday, 24 April 2025 — Cervical cancer continues to devastate lives across sub-Saharan Africa, driven by high rates of Human Papillomavirus (HPV) infection—yet the uptake of life-saving HPV vaccines remains alarmingly low. Health experts are sounding the alarm during World and Africa Immunisation Week (24–30 April), urging immediate action to confront growing vaccine hesitancy and strengthen immunisation coverage.

Despite the availability of safe and effective HPV vaccines, many communities are not taking full advantage. In South Africa alone, 71% of participants expressed hesitancy toward at least one vaccine, according to the Vaccine Confidence Report by MSD and Professor Hannelie Meyer, Head of the South African Vaccination and Immunisation Centre. The report was launched at the European Society of Clinical Microbiology and Infectious Diseases conference and during the SSA HPV Media Roundtable this week.

“HPV is a leading cause of cervical cancer, and we have the tools to prevent it,” Prof. Meyer stated. “But misinformation, distrust, and accessibility challenges continue to undermine our progress.”

The heavy burden of cervical cancer in Africa

Cervical cancer, caused by persistent HPV infection, is one of the leading causes of cancer-related deaths among women in sub-Saharan Africa. According to the World Health Organization (WHO), 94% of global cervical cancer deaths occur in low- and middle-income countries, with the African region disproportionately affected.

Globally, around 12% of women with normal cervical cytology test positive for HPV. In sub-Saharan Africa, that rate doubles to 24%. Among young women under 25, the prevalence is even more alarming—43.9% in Africa compared to 19.2% globally.

In Rwanda, prior to the national HPV vaccination rollout, 54% of girls aged 19 and younger tested HPV-positive. In Ghana, approximately 3,000 women are diagnosed with cervical cancer annually, with a staggering 2,000 losing their lives each year.

Why vaccine hesitancy persists?

Vaccine hesitancy—the delay in acceptance or refusal of vaccines despite their availability—is a growing concern. The Vaccine Confidence Report identifies major drivers: safety concerns, mistrust in health systems, and rampant misinformation, particularly via social media.

“Despite overwhelming scientific evidence, some still view vaccines with suspicion,” said Prof. Meyer. “This reluctance is troubling, especially when the link between HPV and cervical cancer is so clear.”

A 2023 study in Scientific Reports explored vaccine attitudes across six African nations—Ghana, Kenya, Nigeria, South Africa, Tanzania, and Uganda. It revealed low HPV vaccine uptake, with just 10% of respondents having received at least one dose. South Africa had the highest rate of hesitancy at 17.15%, while Kenya had the lowest at 8.3%.

Misinformation, funding gaps, and disruptions

Online misinformation has proven to be a powerful barrier to vaccine acceptance, often outweighing evidence-based health messaging. Coupled with funding shortages and disruptions to routine immunisation due to shifting global priorities, these challenges are threatening decades of public health gains.

“Routine immunisation has saved millions of lives,” said Dr. Alima Essoh, Regional Director at AMP Africa. “But if misinformation and resource constraints persist, we risk reversing hard-won progress.”

Vaccine hesitancy is not exclusive to HPV vaccines. It threatens broader immunisation efforts against diseases like measles, polio, and influenza. The WHO has set an ambitious goal: eliminate cervical cancer as a public health threat by 2030, with a target of 90% HPV vaccine coverage for girls by age 15.

“Vaccine confidence is key to achieving this,” Prof. Meyer warned. “Hesitancy could derail our mission.”

Community-based solutions

Experts agree that solutions must be rooted in communities. Dr. Sabrina Kitaka, Senior Lecturer at Makerere University, advocates for creative, youth-focused strategies such as educational comic books and school-based programmes. She also highlights the importance of SMS reminders and phone calls to ensure adolescents complete the multi-dose vaccine regimen.

“These tools are making a difference,” said Dr. Kitaka. “But to scale them up, we need coordination between governments, healthcare providers, civil society, and the private sector.”

Prof. Meyer emphasized the urgency: “There is no time to waste. We must work together to share accurate information, address concerns, and make vaccines truly accessible. Only then can we protect future generations from preventable diseases.”