From campaign to continuity: stakeholders’ recommendations for integrating HPV vaccination into Nigeria’s healthcare system

Abstract

For Human Papillomavirus (HPV) vaccination to be delivered effectively, countries must transition from campaign-based introduction to integration within the routine immunization schedule. While existing literature provides insights into the effectiveness of HPV campaigns and barriers to initial vaccine acceptance, there is a dearth of stakeholder-informed implementation research around the transition from campaign to routine delivery. This study aimed to explore the experiences and perspectives of key stakeholders involved in the HPV vaccine campaign in Nigeria to generate stakeholder-driven recommendations for the effective and sustainable integration of the vaccine into the country’s routine immunization schedule and strengthen national capacity for introducing and sustaining future new vaccines. This study adopted a qualitative, exploratory research design. The research was conducted across nine Nigerian states, representing five of the six geopolitical zones. Participants were purposively sampled, encompassing 140 stakeholders (30 Key Informant Interviews, 110 In-depth Interviews). Data were collected using semi-structured interview guides, audio-recorded, transcribed verbatim, and thematically analysed. Stakeholder recommendations emphasize that effectively integrating the HPV vaccine into routine immunization in Nigeria demands a multi-pronged strategy. This includes comprehensive strategies for awareness, engagement, and mobilization; continuous workforce training and motivation; robust data systems and reporting; effective management of misinformation; and intensification campaign. Additionally, early and thorough planning, fostering government ownership, optimizing operational logistics, ensuring consistent funding, and maintaining vaccine availability are critical. These insights provide valuable, transferable lessons for the introduction and sustained implementation of future vaccines. The transition of the Human Papillomavirus (HPV) vaccine from a campaign-driven approach to routine immunization in Nigeria represents a critical juncture, offering both significant challenges and unparalleled opportunities to strengthen the national health system. Policy priorities should include institutionalizing periodic intensification programs, strengthening community engagement, standardizing immunization data systems, securing sustainable financing, and enhancing primary healthcare infrastructure. By addressing these priorities, Nigeria can achieve equitable HPV vaccine coverage and strengthen its capacity for future vaccine initiatives, ensuring a lasting public health impact. Not applicable.