Stakeholders' perspectives on lessons learnt from HPV mass vaccination in Nigeria.
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BACKGROUND: To effectively reduce the risk of cervical cancer, Nigeria launched the HPV vaccine introduction using a phased approach; first phase in October 2023 across 16 states and the second phase across 21 states in May 2024. This initiative aimed to protect girls aged 9-14 from HPV infections, a primary cause of cervical cancer, through strategic planning and targeted implementation. This paper aims to share the Stakeholders' perspectives from nine states in Nigeria on lessons learnt during HPV vaccination that could be adopted in future campaigns and vaccinations. METHODS: The study adopted a qualitative research design to evaluate the strategies deployed, challenges encountered, and lessons learned from the HPV Phase II vaccination campaign. Key informant interviews and in-depth interviews were conducted with officers of the healthcare agencies at the national, state, local government and ward levels and representatives of CSOs, who had key information about the strategies and those who implemented policies during the HPV mass vaccination in nine states in Nigeria. The qualitative data was validated, transcribed, coded and analyzed thematically. RESULTS: Key components of the campaign included the establishment of fixed and temporary vaccination posts, strategic school and community engagement, and targeted communication efforts via social media, influencers, and local leaders. Cultural sensitivity, trained health workers, and data-driven micro plans were emphasized to enhance the program's effectiveness. The campaign successfully raised awareness and increased vaccination coverage across the nine targeted states. Effective strategies included leveraging cultural sensitivity, utilizing trained health workers, and employing data-driven micro plans to address logistical challenges. Despite these successes, significant challenges were encountered. Vaccine hesitancy fueled by misinformation about sterility, limited resources, security concerns, and difficulties accessing remote areas posed barriers to achieving wider coverage. Key lessons from the campaign highlighted the importance of early planning, effective rumor management through existing networks, and the crucial role of influential community members in amplifying the message and encouraging participation. CONCLUSION: The findings highlight critical lessons for future vaccination programs. Early planning, proactive social mobilization, effective rumor management, and leveraging community networks were instrumental in enhancing vaccine acceptance and coverage. These strategies serve as a model for overcoming barriers to public health interventions and should be prioritized in future efforts to improve HPV and other vaccination programs in Nigeria.