Background
Vaccination against human papillomavirus (HPV) is a cornerstone of primary prevention of cervical cancer and a key component of the global elimination strategy led by the World Health Organization (WHO). A pilot HPV vaccination programme in Kazakhstan (2013–2015) was discontinued due to widespread misinformation, insufficient risk communication, and limited preparedness of key stakeholders. This experience necessitated a fundamental reassessment of the approach to programme re-initiation.
Programme implementation and communication measures
Between 2021 and 2023, Kazakhstan undertook a comprehensive preparatory phase prior to reintroducing HPV vaccination into the National Immunization Programme. This phase included national studies assessing knowledge, attitudes, and barriers related to HPV vaccination among healthcare workers, parents, and teachers. The findings indicated that awareness of HPV vaccination, cervical cancer, and other HPV-associated diseases among healthcare workers—as key actors in vaccine delivery—and their willingness to recommend the vaccine (72.6%) remained suboptimal. Parental awareness (55.9%) and intention to vaccinate their children (up to 53.3%) were also low, as was awareness among teachers (55.9%). Concerns about vaccine safety and lack of reliable information remained the primary drivers of parental hesitancy. Nevertheless, healthcare workers continued to be identified by parents as the most trusted source of information. These findings, together with an analysis of international best practices from countries that have achieved high HPV vaccination coverage, informed the development of a national roadmap and an evidence-based communication strategy.
HPV vaccination was initiated nationwide in 2024 under the coordination of the Ministry of Health of the Republic of Kazakhstan, and support from international partners including WHO and UNICEF. The target population for routine HPV vaccination includes girls aged 11–14 years. Vaccination is delivered using a mixed strategy with school-based vaccination as the predominant delivery platform.
Communication was formally embedded as a core policy component alongside vaccine procurement and logistics. Activities included multi-level training of healthcare workers, information sessions for parents and teachers, and the development of scientifically grounded materials in Kazakh and Russian. These materials were disseminated through schools, primary healthcare facilities, official digital platforms, and social media. Active engagement with mass media and crisis communication mechanisms was implemented, and methodological guidance for healthcare workers was developed. A distinctive feature of the strategy was the involvement of young women vaccinated during the earlier pilot programme, whose personal testimonies contributed to rebuilding public trust. Opinion leaders from medical, scientific, and educational communities were also engaged to reach and involve the broader public.
Early outcomes and conclusion
By the end of 2025, mean first-dose HPV vaccination coverage in Kazakhstan reached 73.7% (95% CI: 65.2–82.2 across regions), indicating recovery of public acceptance following programme re-initiation. Expansion of the HPV vaccination programme to include boys is planned from 2026, reflecting a transition toward a gender-neutral vaccination strategy.
Kazakhstan’s experience demonstrates that successful re-initiation of HPV vaccination is achievable even after a trust crisis when scientific evidence, structured communication, and school-based delivery are prioritised. The planned expansion to boys further strengthens alignment with long-term cancer prevention goals.