Post Introduction Evaluation of HPV & TCV Vaccination in Nepal December 2025

“Strengthening Immunization for Adolescent Girls and Children”

Overview

Nepal successfully introduced the Human Papillomavirus (HPV) vaccine in 2025 and the Typhoid Conjugate Vaccine (TCV) in 2022 as part of national strategies to reduce cervical cancer and typhoid fever. A Post‑Introduction Evaluation (PIE) was conducted by national and international partners in late 2025 to assess programme performance, identify gaps, and guide future vaccine introductions.

Key Achievements

High Coverage & Strong Delivery Systems

• HPV campaign coverage: ~94% nationally.
• TCV campaign: reached 7.7 million children; routine coverage stabilized at 86%.
• Effective school‑based delivery, complemented by outreach and facility‑based sessions.

HPV Multi‑Age Cohort Coverage (2025)

TCV Coverage Trends (2021–2025)

Programme Strengths

1. Strong Political Commitment

High-level leadership enabled rapid decision‑making, intersectoral coordination, and mobilization of health and education structures.

2. Effective School–Health Collaboration

Schools played a central role in microplanning, student mobilization, consent processes, and communication.

3. Well‑Trained Frontline Workforce

Health workers, teachers, and Female Community Health Volunteers (FCHVs) received cascaded training covering eligibility, schedules, AEFI management, and communication.

4. Reliable Cold‑Chain & Logistics

Cold‑chain integrity was consistently maintained with twice‑daily temperature monitoring, functional equipment at most levels and robust supply planning supported by e‑LMIS.

5. High Acceptance Among Communities

Girls, caregivers, teachers, and community leaders reported strong trust in the vaccines, supported by clear communication and trusted frontline workers.

Challenges Identified

1. Limited Preparation Time

Compressed timelines for HPV reduced readiness, particularly among private schools and subnational teams.

2. Hard‑to‑Reach Populations

Reaching out‑of‑school girls, migrants, and unregistered religious schools remained challenging.

3. Misinformation & Rumors

Concerns about infertility, experimentation, and vaccine safety persisted in some communities.

4. Waste‑Management Gaps

Inconsistent implementation of immunization‑specific waste‑management SOPs across facilities.

5. Surveillance Limitations

Cervical cancer registries and typhoid surveillance systems are not fully integrated with immunization programmes.

Recommendations for Future Action

Strengthen Planning & Readiness

• Provide adequate lead‑time for planning, microplanning, and school readiness assessments.

Improve Communication & Rumor Management

• Tailor messages to teachers, religious leaders, migrant communities, and adolescents.

Enhance Equity

• Expand strategies to reach out‑of‑school girls, mobile populations, and unregistered schools.

Institutionalize Digital Monitoring

• Scale up real‑time dashboards, GPS tools, and digital coverage validation mechanisms.

Build Long‑Term Sustainability

• Develop post‑Gavi financing strategies and reinforce supervisory and surveillance systems.

Conclusion

The PIE confirms that Nepal’s introduction of HPV and TCV vaccines was successful, well‑coordinated, and widely accepted. Continued investments in communication, equity, digital monitoring, and sustainability planning will ensure long‑term impact in preventing cervical cancer and typhoid fever.

Photos of the PIE

Interview with community/municipal leaders

Interview with female community health volunteer

Interview with schoolgirls