Navigating through HPV stigma: an intersectional lens on community engagement for vaccine acceptance in Pakistan

Human papillomavirus (HPV) vaccination represents a significant milestone in global public health efforts to prevent cervical cancer. Yet its implementation in some countries such as Pakistan reveals complex sociocultural and geopolitical challenges. Since the staged introduction of the HPV vaccine in Pakistan in 2025, coverage did not fully reach the targeted 9-14-year-old girls-falling short of the national goal of 90% by 2027. This commentary critically examines the intersectional barriers shaping HPV vaccine uptake in Pakistan, arguing that mistrust, stigma, and inequity are rooted in historical, gendered, religious, and geopolitical power dynamics. Applying an intersectional lens, the analysis demonstrates how vaccine resistance is influenced by moral anxieties surrounding adolescent sexuality, diverse religious interpretations, socioeconomic disparities, weak health infrastructure, and digital disinformation. Comparative insights from the United Arab Emirates and Saudi Arabia challenge assumptions that Muslim-majority contexts inherently resist HPV vaccination, highlighting instead the importance of socioculturally responsive strategies. The commentary proposes three policy implications for Pakistan: localized communication tailored to socio-cultural context, investment in social infrastructure and community engagement, and equity-sensitive monitoring frameworks. Addressing hesitancy requires recognizing community concerns as rational responses to lived experience rather than ignorance, for achieving equitable immunization and safeguarding girls' health rights in comparable settings.