Cervical cancer elimination: Kenya transitions to single-dose HPV vaccination schedule

"Many girls were missing their second dose due to distance, costs, or simply forgetting to return. Now with just one visit, we can fully protect them against HPV," explains Beatrice Dbwoge, a nurse at Kilifi County Hospital who received WHO training on the new protocol. She administers the vaccine to Jane Brian, 10, while she sits with her mother Christine Chibanza.

The Ministry of Health with support from WHO provided comprehensive training to 11,000 healthcare workers across the country at national, county, sub-county and health facility levels. "The Ministry of Health and WHO trained us on the new single-dose HPV vaccine protocol. We learned about the latest evidence showing that one dose provides the same protection as two doses," says Nurse Beatrice. The single-dose schedule doubles vaccine coverage capacity with existing resources.

The economic impact is substantial. "Transport costs money, and sometimes you can't get away from work. Now with one visit, Jane is fully protected. That gives me peace of mind," says Christine. The elimination of a second clinic visit reduces costs and time away from income-generating activities for families across Kenya.

Naomi Kembi, 69, sits with her daughter Selina in their Kilifi County home. Diagnosed with stage 3 cervical cancer in 2019, her treatment included 25 radiotherapy sessions, four chemotherapy rounds, and two months hospitalization in Nairobi. "We spent more than 500,000 shillings on my treatment. Our family contributed what they could, friends helped, and the church members of Kilifi Methodist Church were very supportive," she recalls.

Naomi now operates a small roadside business selling charcoal and vegetables. She requires MRI scans every six months but lacks funds for monitoring. "Right now, I haven't been able to go to the clinic because I don't have money for the required MRI," she explains, illustrating the sustained economic burden of cervical cancer.

"I lost two of my sisters to HIV back in 1995, when there was no treatment available. When I see my granddaughter vaccinated against HPV, I feel hopeful. No mother should have to watch her daughter suffer from cervical cancer when it can be prevented," says Naomi, who uses educational materials for community outreach.

Faith Gombeni Enokh, 65, sells fish at Kilifi Central Beach Management Unit, where she serves as chair. Diagnosed at stage 2 of cervical cancer in 2010, Faith underwent total hysterectomy requiring blood transfusions. "I had to be given blood, I got 3 pints. Luckily my firstborn child was studying in Mombasa at aviation school, so he got friends who came here and donated blood for me," she recalls.

Faith indicates a photograph of her sister who died from cervical cancer. She now leads a cancer support group established in 2020 and addresses vaccine hesitancy through peer education. "There's a school near my home where many parents didn't want their children vaccinated. So I took my papers, all my treatment documents, and went there. I told them these vaccines prevent this disease. Me, I was not given this vaccine and that's why I got the disease. I've explained to them and now they accepted," she states.

The transition supports WHO's Global Strategy to Accelerate the Elimination of Cervical Cancer, targeting 90% of girls fully vaccinated by age 15. Global HPV vaccination could prevent 60 million cervical cancer cases and 45 million deaths over the next century. Kenya's policy change, achieved through partnership between the Ministry of Health, WHO and Gavi the Vaccine Alliance, advances elimination efforts in sub-Saharan Africa, where HPV prevalence reaches 24%.

"I want to be a teacher when I grow up. My mother says this vaccine will help keep me healthy so I can achieve my dreams," says Jane.