Why Kilifi residents are rejecting HPV vaccination

On the doorstep of her house, Kadzo Kalama turns away healthcare workers who had arrived to vaccinate her two daughters.

''Why only girls? I hear it causes infertility?'' says Kalama, standing her ground not to allow the workers into her house in Kasarani village, Kilifi North. 

She believes the myth doing the rounds in rural parts of the county that the human papillomavirus (HPV) vaccine makes girls sterile and encourages youth sexual activity.

"My daughters are 11, let them grow up to decide to accept the vaccine or reject it," she says with finality despite the fact that she attended two HPV vaccination awareness forums.

"They came here last year and told me that the vaccine is harmless, but I have heard from my neighbors that it is a family planning injection." 

According to the Kilifi County 2025 progress report, since 2019, only 129,231 girls aged between 10 and 14 have been vaccinated against HPV, the leading cause of cervical cancer.

The World Health Organization (WHO) recommends that the primary targets for HPV vaccination are girls aged nine to 14 years.

But due to misinformation and myths surrounding the vaccine, many immunisation workers who visit homes have been turned away. Some girls have also refused to take the vaccine at school, citing parental instructions.

To close the gap, the county administration has created 188 immunisation facilities across all seven sub-counties. In each facility, health workers have been trained in vaccine management, outreach planning, and communication skills.

"We started this vaccine in 2019, targeting girls aged 10-14, and we were administering two doses six months apart. The vaccine is also distributed in all the public and private hospitals for free," says Christine Mataza, a nurse at the Kilifi Referral Hospital who coordinates HPV vaccine distribution, noting that Covid 19 disrupted the programme after schools were closed.

Last year, Kenya introduced the single-dose HPV vaccine, replacing the previous two-dose regimen. Mataza notes that this will enable them reach more girls, adding that they are targeting 26,021 by the end of the year.

"Up to last year, 129,231 girls had been vaccinated with the HPV vaccine for the first dose, which represents 47 per cent. We are targeting 90 per cent of the girls, so we still have a gap. We hope to bridge the gap by the end of the year," she says.

''Our girls are our future; we must vaccinate as many as possible with the cervical cancer vaccine." 

To create more impact, healthcare workers have involved community stakeholders and gatekeepers, including chiefs, village elders, nyumba kumi elders, and cultural leaders.

Kilifi non-communicable disease focal person, John Mose, says nearly 70 per cent of women diagnosed with cervical cancer in the county are diagnosed at an advanced stage of the disease, making treatment difficult and survival rates lower.  

Cervical cancer remains the leading cancer in the country, followed by prostate and breast cancer.

"We are urging women to undergo regular cancer tests early enough to prevent further infections and improve chances of treatment," he says. 

He is also appealing to men to avoid multiple sexual partners, noting that such practices increase the risk of transmitting the HPV to women.

"We cannot ignore the role of lifestyle choices in fueling this crisis. Men must take responsibility because their actions directly affect women’s health," says Mose.

County Head of Division of Preventive and Promotive Health Services, Catherine Munyoki, says barriers to cervical cancer screening include stigma, lack of awareness, inadequate health facilities, and financial constraints.

"Vaccine hesitancy, misinformation, and cultural beliefs continue to hinder vaccination efforts. The priority is to close immunization gaps and plan catch-up strategies for HPV vaccination," she says.

Every year, about 60,000 women in Kilifi are screened for cervical cancer.

"For the past three years, our screening rates have been at 16 percent, but we climbed up to 31 percent by last year," he said.

Mose said screening services are available at the Malindi subcounty hospital, Kilifi referral hospital, Mariakani hospital, and other grassroots hospitals across the county.

The county is also in the process of establishing a 5-bed chemotherapy unit at Kilifi Referral Hospital to ease transport challenges for cancer patients who get chemotherapy services at the Coast General Hospital in Mombasa County.

Rural healthcare workers and 60 CHPs have also been trained on cervical screening and treatment.

According to the HPV Information Centre, Kenya records about 3,500 new cases of cervical cancer each year, resulting in more than 2,500 deaths annually.