Physicians’ role in recommending Human Papillomavirus Vaccination—a qualitative study in the context of national immunization rollout

In September 2025, Pakistan launched a nationwide HPV immunization campaign targeting 13 million girls aged 9–14 years. However, vaccine hesitancy and misconceptions remain significant barriers. This qualitative study aimed to explore physicians' role in recommending Human Papillomavirus (HPV) vaccination and identify sociocultural and professional factors influencing vaccine acceptance. A qualitative exploratory study was conducted using face-to-face, semi-structured interviews with 20 physicians from public and private healthcare settings in Islamabad and Rawalpindi between November 2025 and February 2026. Participants were recruited through convenience sampling. Interviews were audio-recorded, transcribed verbatim, and analyzed using the six-step thematic analysis approach of Braun and Clarke's framework. Thematic analysis revealed six key domains: (1) Awareness and knowledge gaps (profound public unawareness and physician knowledge deficits); (2) Perceptions of HPV as a public health issue (recognition of disease burden constrained by social taboos); (3) Views on vaccine safety and effectiveness (strong confidence in global safety data undermined by absence of Pakistan-specific evidence); (4) Barriers to vaccination (cultural and religious misconceptions, infertility myths, professional and systemic shortcomings); (5) Motivations for recommending the vaccine (prevention of cervical cancer and professional ethical duty); and (6) Strategies to reduce hesitancy (grassroots education campaigns, religious leader engagement, healthcare provider training, and multi-sectoral government-led approaches). Physicians in this study reported that HPV vaccination in Pakistan is challenged by knowledge gaps, sociocultural barriers, persistent misconceptions, and limited locally generated findings. Despite these challenges, respondents demonstrated strong motivation to recommend HPV vaccination based on professional responsibility and the perceived burden of cervical cancer. These findings suggest that culturally sensitive awareness initiatives, healthcare provider training, engagement of religious and community leaders, and investment in Pakistan-specific research may facilitate HPV vaccine acceptance during the national immunization campaign.