Regional Disparities in HPV Vaccination Coverage Among Girls Aged 9 to 14 Years in Togo: Lessons Learned from the...

Human papillomavirus (HPV) vaccination is a critical intervention to prevent cervical cancer, especially in settings where screening is limited. In Togo, cervical cancer is the second most common cancer in women. Togo conducted an HPV vaccination campaign for girls aged 9-14 from 27 November to 1 December 2023, followed by introduction of the vaccine into routine immunization. This study aimed to assess regional disparities in vaccination coverage during this campaign.

A cross-sectional study was conducted using data from the nationwide HPV vaccination campaign. The target population included girls aged 9-14, following school and community-based enumeration. The campaign employed school-based, health facility-based, and community-based vaccination strategies. Data were collected via multiple tools, and monitoring was carried out through daily reports and digital tracking.

Out of the estimated 654,402 eligible girls, 304,457 (46.5%) were vaccinated. Vaccine coverage varied significantly by region, ranging from 76% in Kara to 15% in Grand Lomé. In-school settings accounted for 91.3% of vaccinations, with the fixed strategy covering 55.4%. In total, 11 districts exceeded 80% vaccine coverage, while 15 districts had <50%. The highest rate of adverse events following immunization was observed in the Maritime region, primarily involving minor symptoms.

Although progress was made in HPV vaccination coverage in Togo, regional disparities highlight the need for targeted interventions. Strategies such as expanding vaccine access, enhancing awareness campaigns, and integrating HPV vaccination into routine immunization could improve coverage. Addressing logistical and cultural barriers is also crucial for equitable vaccination, aiming to achieve international benchmarks and reduce HPV-related disease burdens. Further research should explore qualitative factors influencing vaccine acceptance.