Lessons Learned From Bhutan on extending Girls-Only HPV Vaccination Program to Boys: A Qualitative Study.

This article focuses on Bhutan's pioneering implementation and evaluation of a school-based gender-neutral (GN) human papillomavirus (HPV) vaccination program, which achieved a 96% coverage rate by 2021. Using qualitative methods including interviews and focus groups with stakeholders and vaccinated boys, the study identified key enablers such as multisectoral collaboration, school-based vaccine delivery, political commitment with donor support, and effective immunization program management supported by digital tracking systems. Challenges included vaccine delivery delays, difficulties reaching out-of-school adolescents (e.g., monks and migrants), and gaps in knowledge and attitudes about male vaccination. The findings demonstrate that extending girls-only HPV vaccination programs to include boys is feasible and acceptable in Bhutan, offering lessons that may inform similar efforts in other lower-middle-income countries.