From community mobilisation to school vaccination: experiences from Cameroon's first Expanded Programme on...

The HPV vaccine was introduced into Cameroon's Expanded Programme on Immunisation in 2020 targeting 9 year-old girls and later boys in 2023, however, implementation has relied mainly on community-and facility-based strategies, resulting in low coverage rates. School-based vaccination is an effective strategy for reaching adolescents; however, it had not previously been implemented nationally. This study describes the implementation and outcomes of the first EPI-led school-based HPV vaccination campaign in Cameroon.

The campaign was conducted in nine districts across the Centre, Littoral, South and West regions. A multisectoral coordination committee oversaw planning and implementation. Community engagement activities, school-based health talks and door-to-door sensitisation, were conducted prior to vaccination. Vaccination teams administered either quadrivalent or nonavalent HPV vaccines in schools. School participation and vaccination coverage among eligible adolescents were documented.

A total of 300 schools participated, including 245 primary schools (79%) and 55 secondary schools (63%). Community sensitisation activities reached 44,118 people, while 816 individuals attended community engagement meetings. Among adolescents identified by social mobilisers, 13,189 girls aged 9-14 years and 10,300 boys aged 9-11 years were identified. Of these, 9392 girls (48.3%) and 4963 boys (48.2%) received the HPV vaccine. Misclassifying previous vaccinees as part of the denominator contributed to underestimation of coverage.

This campaign demonstrates the feasibility of implementing a school-based HPV vaccination programme in Cameroon supported by strong community engagement and multisectoral collaboration. Integrating schools into HPV vaccination strategies could significantly improve adolescent vaccine uptake and contribute to cervical cancer prevention efforts.