{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:56:45Z","timestamp":1782917805535,"version":"3.54.5"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>The World Health Organization (WHO) estimated 660,000 new cervical cancer cases and 350,000 deaths globally in 2022, with over 90% occurring in low- and middle-income countries (LMICs). Global elimination targets call for vaccination of &amp;gt;90% of girls against human papillomavirus (HPV) by age 15 by 2030. While Botswana's national policy aligns with these targets, progress monitoring is constrained by fragmented, predominantly paper-based health information systems. We describe our experience verifying individual-level HPV vaccination status among adolescent girls and young women living with HIV (AGYWLWH) in Botswana. This activity was conducted to determine eligibility for the HOPE II trial, a randomized controlled study evaluating the efficacy of a single-dose nonavalent HPV vaccine. Verification followed the national rollout of school-based HPV vaccination in 2015, targeting girls aged 9\u201313 years. Participants provided pre-screening consent for review of vaccination records held in school health systems, Ministry of Health (MoH) registers, and participant-held vaccination cards where available. We sought HPV vaccination records for 80 potential participants across 80 schools and 68 clinics. Only 15 participants (18.8%) had verifiable records: 2 (2.5%) retained vaccination cards, 4 (5.0%) had documentation in school records, and 9 (11.3%) had entries in MoH registers. Most school records were incomplete or missing, and several sites reported loss or disposal of records due to relocation, fire damage, or storage constraints. These findings highlight critical gaps in HPV vaccination documentation. Strengthening electronic immunization registries, standardizing record transfer, and improving data integration could enhance monitoring and support equitable progress toward cervical cancer elimination.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1821335","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:31:30Z","timestamp":1782916290000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Individual-level HPV vaccination verification in Botswana: lessons learned from implementation of the HOPE II trial"],"prefix":"10.3389","volume":"14","author":[{"given":"Swetha Bindu","family":"Jammalamadugu","sequence":"first","affiliation":[{"name":"Botswana Harvard Health Partnership","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesedi","family":"Tirelo","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Youssouf","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership","place":["Gaborone, Botswana"]},{"name":"London School of Hygiene and Tropical Medicine","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Umutesi","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington","place":["Seattle, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meighan Leta","family":"Krows","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Mass General Brigham","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesego","family":"Kuate","sequence":"additional","affiliation":[{"name":"Ministry of Health","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keatlaretse","family":"Siamisang","sequence":"additional","affiliation":[{"name":"Ministry of Health","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruanne V.","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Mass General Brigham","place":["Boston, MA, United States"]},{"name":"Harvard Medical School","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Luckett","sequence":"additional","affiliation":[{"name":"Botswana Harvard Health Partnership","place":["Gaborone, Botswana"]},{"name":"Harvard Medical School","place":["Boston, MA, United States"]},{"name":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center","place":["Boston, MA, United States"]},{"name":"Department of Obstetrics and Gynecology, University of Botswana","place":["Gaborone, Botswana"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1186\/s13063-021-05608-8","article-title":"Single-dose HPV vaccination efficacy among adolescent girls and young women in Kenya (the KEN SHE Study): study protocol for a randomized controlled trial.","volume":"22","author":"Barnabas","year":"2021","journal-title":"Trials"},{"key":"B2","doi-asserted-by":"publisher","first-page":"EVIDoa2100056","DOI":"10.1056\/EVIDoa2100056","article-title":"Efficacy of single-dose HPV vaccination among young African women","volume":"1","author":"Barnabas R","year":"2022","journal-title":"NEJM Evidence"},{"key":"B3","unstructured":"Cervical cancer"},{"key":"B4","unstructured":"Cervical Cancer Elimination Initiative"},{"key":"B5","unstructured":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"297","DOI":"10.3390\/vaccines13030297","article-title":"Human papilloma virus vaccination as a strategy to eliminate cervical cancer: challenges and opportunities","volume":"13","author":"Avila-Aguero","year":"2025","journal-title":"Vaccines."},{"key":"B7","doi-asserted-by":"publisher","first-page":"16182","DOI":"10.1038\/s41598-023-43467-2","article-title":"Point-of-care testing with Xpert HPV for single-visit, screen-and-treat for cervical cancer prevention: a demonstration study in South Africa","volume":"13","author":"Denny","year":"2023","journal-title":"Sci Rep."},{"key":"B8","doi-asserted-by":"publisher","first-page":"428","DOI":"10.9745\/GHSP-D-18-00090","article-title":"Human papillomavirus vaccine introduction in south africa: implementation lessons from an evaluation of the national school-based vaccination campaign","volume":"6","author":"Delany-Moretlwe","year":"2018","journal-title":"Glob Health Sci Pract."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-4741668\/v1","article-title":"Assessing users' experiences and integration of digital health interventions for Human Papilloma Virus vaccination and cervical cancer services in Rwanda","author":"Sibomana","year":"2024","journal-title":"BMC Digit Health."},{"key":"B10","doi-asserted-by":"publisher","first-page":"106399","DOI":"10.1016\/j.ypmed.2020.106399","article-title":"HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010\u20132019","volume":"144","author":"Bruni","year":"2021","journal-title":"Prev Med."},{"key":"B11","unstructured":""},{"key":"B12","doi-asserted-by":"publisher","first-page":"e25481","DOI":"10.1371\/journal.pone.0025481","article-title":"Cross-sectional study of HPV vaccine acceptability in Gaborone, Botswana","volume":"6","author":"DiAngi","year":"2011","journal-title":"PLoS ONE."},{"key":"B13","doi-asserted-by":"publisher","first-page":"239","DOI":"10.3389\/fonc.2015.00239","article-title":"Cervical cancer in Botswana: current state and future steps for screening and treatment programs","volume":"5","author":"Grover","year":"2015","journal-title":"Front Oncol Front Res Found."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e52411","DOI":"10.2196\/52411","article-title":"Clinical data flow in botswana clinics: protocol for a mixed-methods assessment","volume":"13","author":"Faulkenberry","year":"2024","journal-title":"JMIR Res Protoc."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e210","DOI":"10.5210\/ojphi.v7i2.5630","article-title":"Development of the National health information systems in Botswana: pitfalls, prospects and lessons","volume":"7","author":"Seitio-Kgokgwe","year":"2015","journal-title":"Online J Public Health Inform."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1821335\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:31:44Z","timestamp":1782916304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1821335\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":15,"alternative-id":["10.3389\/fpubh.2026.1821335"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1821335","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"article-number":"1821335"}}