Emelyne Ngiriyabandi (46) from Kibimba village in Gitega had never heard of cervical cancer until health workers came to speak to her at her home in early April.

“When they told us about the signs and symptoms, my heart sunk because I do believe many of our neighbours died of this disease without knowing,” Ngiriyabandi said.

Burundi was weeks away from the first national roll-out of the human papillomavirus (HPV) vaccine, a one-dose, lifetime shield against the cancer, and a major push to raise awareness of the disease and its prevention was underway. But it’s poorly understood by the general public, and with screening rates for the disease hovering at below 10%, diagnoses often land late.

Cervical cancer is both the most common and the deadliest cancer in the country. The World Health Organization (WHO) says more than 1,000 die of the disease annually, accounting for about 18.8% of Burundi’s total cancer deaths.

Fortunately for Ngiriyabandi’s two adolescent daughters, the risk looks set to drop precipitously. On a Wednesday in late April, she was at her daughters’ school during the vaccine’s national launch.

“I came to witness my girls getting vaccinated,” she told VaccinesWork. “Despite not having known this disease two weeks ago, I managed to sit and talk to my girls about the benefits because I trust our leaders who told us it is safe.”

One of those leaders was First Lady Angeline Ndayishmiye, who spoke at the event and urged parents to treat the misinformation about the HPV vaccine “with contempt”.

Dr Marthe Sylvie Essengue Elouma, Director of Priority Countries at Gavi, said during the HPV vaccine introduction that studies have shown an 87% reduction in the risk of cervical cancer in women following vaccination.

In May, 2023 the WHO said that a study by International Agency for Research on Cancer (IARC), showed that vaccination against HPV has more than halved the prevalence of high-risk HPV types in Rwanda in less than eight years, a substantial overall reduction of 52% in the prevalence of four high-risk vaccine-targeted HPV types (HPV6, 11, 16, and 18).

Still, Ngiriyabandi said that some parents hide their children at home to avoid vaccination: “In most cases it is because of the misinformation and lack of awareness.” She specified that a number of parents are operating under the mistaken impression that the HPV vaccine can cause infertility.

Combatting misinformation

Though the evidence from the pilot and from the many other countries with established HPV vaccination programmes definitively contradicts those rumours, misinformation about the HPV vaccine persists in pockets of the country.

A health ministry report disclosed that during the three-day campaign, 80 students from one primary school “fled under the influence of certain religious beliefs”.

Dr Polycarpe Ndayikeza, the spokesperson for the Burundian health ministry, said the government, through local administrative authorities and community leaders, is pushing back misinformation and raising awareness of the HPV vaccine among the population.

“We made direct outreach programmes in schools and communities to reassure people about the safety of the vaccine. At this stage we haven’t started using chatbots, but we are considering digital strategies including the use of WhatsApp or SMS,” said Dr Ndayikeza.

But health workers like Inarukundo Anitha and school teachers like Sibomana Maria Goreth said that still more work needs to be done to fight misinformation in the community if all girls are to have an equal shot at cervical cancer-free future.

The view from the vanguard

Lyse Raïssa Dukeze, now a 23-year-old mother of one, has seen a glimpse of that future.

She was 14 years old in 2018, when Burundi conducted a pilot HPV vaccination project in Ngozi and Rumonge provinces. She was one of a vanguard group of 12,000 Burundian girls to be immunised.

“Before I received the vaccine, my aunt had died of cervical cancer,” Dukeze said. “I witnessed her suffering and it is because of that I decided to get vaccinated.” 

It’s a decision she’s glad she made. “During that period there was a lot of misinformation – they said that if vaccinated, you will never give birth. But I was vaccinated, and today I have a child,” said Dukeze.

“I feel safe now”

According to Ministry officials, 84.4% of the target population were vaccinated during the April–May launch campaign, proving that for hundreds of thousands of Burundian girls, the opportunity to get protected was one to jump at.

Giraneza Darlene, a 13-year-old student at Kibimba Primary School was among those who received the vaccine. “They told us about the disease and we felt like it was the right time we got vaccinated. I feel safe now and I had no hesitation in taking the jab,” she said.

The Burundi government reported that the campaign’s conclusion marks the HPV vaccines’ introduction into the country’s routine immunisation schedule. It will continue to be available to girls aged between 9–14 in all vaccination centres nationwide, free of charge.

Gavi’s Elouma noted that the development marks a step towards a shared global resolution to vaccinate 90% of girls before the age of 15, screen 70% of women, and treat 90% of those diagnosed before 2030.

This article is republished from VaccinesWork under a Creative Commons license. Read the original article. VaccinesWork is an award-winning digital platform hosted by Gavi, the Vaccine Alliance covering news, features and explainers from every corner of global health and immunisation.