Implementing the free HPV vaccination for eligible girls in Shenzhen, Guangdong: Experience, challenges, and lessons

Abstract Cervical cancer is a major public health concern in China, accounting for almost one-fifth of the global incidence and mortality. The recently prequalified domestic bivalent HPV vaccine offers a practical and feasible preventive measure. In response to the WHO's call for action, the National Health Commission established an Action Plan to eliminate cervical cancer by 2030, with the promotion of HPV vaccination for eligible girls as a critical step. Despite this, implementation of the vaccination programme has been patchy, with very low coverage among eligible girls. To address this, a demonstration project was launched in Shenzhen in December 2021 to promote the inclusion of HPV vaccine in the immunisation programme and to address existing barriers to implementation. Using multiple sources of data, this article presents a case study of the demonstration project, analysing its impact on increasing the HPV vaccination rate among eligible girls and identifying any challenges encountered during implementation. The demonstration project has shown promising results in increasing the HPV vaccination rate, promoting public awareness and acceptance of the domestic HPV vaccine, and establishing a model for scaling up the vaccination programme at the municipal level. The success of the project can be attributed to several factors, including the strong governmental commitment, sufficient funding, multi-sectoral collaboration, improved vaccine accessibility and affordability, enhanced capacity of primary care practitioners, and effective health education and communication strategies. Lessons learned from Shenzhen can provide valuable insights for future advocacy and implementation in other areas of China, but challenges must be addressed to achieve universal coverage. These challenges include vaccine hesitancy, expanding the programme to cover a broader age range, and ensuring consistent quality of vaccination services in primary care facilities. Overcoming these challenges will require innovative strategies, public-private partnerships, and sustained funding and resources. Future research should focus on evaluating the long-term effectiveness of the HPV vaccination programme and identifying contextual factors that may impact implementation in different settings. Overall, the effective control of cervical cancer in China will rely on the “political will” to ensure that preventive interventions are incorporated into policies and that programme coverage is equitable and universal.