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Vaccine Champions Program – strengthening HPV vaccine confidence in Tonga
An immunisation program in Tonga is promoting vaccination against human papillomavirus (HPV), with strong leadership from the Tonga Ministry of Health and ongoing support from UNICEF Pacific and ARIA partners helping protect women and girls from HPV infection and cervical cancer.
Initial seed funding was provided by the Australian Government through a Regional Immunisation Strengthening and Engagement (RISE) grant in 2023, but the Vaccine Champions Program has since evolved into a locally owned, sustainable community engagement model that is strengthening HPV vaccination awareness, confidence and uptake across the Tongan islands.
Building local capacity through community-led training
The Vaccine Champions model – originally developed in Australia and subsequently adapted for use in Fiji, PNG, Indonesia and Vietnam – focuses on training healthcare professionals and trusted community leaders to become skilled communicators and advocates for vaccination.
To adapt the program for Tonga, the Australian Government funded ARIA teams from the Murdoch Children’s Research Institute (MCRI), the University of Sydney and UNSW to work alongside the Tonga Ministry of Health, UNICEF Pacific and Tupou Tertiary Institute in 2023.
It was first time the Vaccine Champions model has been applied specifically to HPV vaccination.
This year, UNICEF funded the Ministry of Health to expand that work by adopting a ‘train‑the‑trainer’ model to further strengthen program reach and sustainability.
MCRI researchers trained 12 master trainers from multiple island groups in early 2025. These master trainers have since delivered 3 Vaccine Champions trainings, with more planned for 2026.
This locally led adaptation has enabled scalable capacity building and strengthened community engagement efforts, particularly for improving HPV vaccine uptake among adolescent girls.
Under the leadership of the Ministry of Health, the HPV Champions Program continues to build strong community-level momentum.
Champions reported high levels of confidence in facilitating HPV vaccination conversations, with feedback pointing to increased awareness, reduced hesitancy, and strengthened community trust.
Although more detailed estimates of HPV coverage are forthcoming, early indicators suggest the program is contributing to strong progress alongside other complementary, ministry-led approaches.
New HPV awareness videos to support community engagement
With UNICEF’s support, a suite of culturally grounded promotional videos was developed in 2025 by Bright Sunday and MCRI to strengthen HPV vaccine awareness and acceptance.
The videos feature Tongan health experts answering common questions, and mothers, daughters and extended families sharing stories of protection, health and community, set against the backdrop of traditional dress and dance.
These are now being used widely in training sessions and community outreach to reinforce key messages on HPV prevention and vaccination.
Learn more: Tonga Ministry of Health YouTube channel
A model for sustained community‑driven vaccination efforts
The ongoing success of the Vaccine Champions Program reflects the strong partnership between ARIA, MCRI, the Tonga Ministry of Health, UNICEF Pacific and local educational partners.
With growing evidence of sustainability through Ministry-led ownership, Tonga is demonstrating how community‑driven strategies can play a vital role in improving HPV vaccine acceptance and coverage.
In one district with high vaccine hesitancy, a champion shared her personal experience of losing a family member to cervical cancer, highlighting how vaccination can prevent such tragedies.
Her openness created a strong emotional connection within the community, prompting several individuals initially opposed to the HPV vaccine to seek further information from local healthcare providers.
… As a result, interest in vaccination increased, directly reflecting the champions’ role in building trust through personal storytelling.
– Local Project Manager
ARIA remains committed to supporting locally led approaches that strengthen vaccine confidence and contribute to long-term cervical cancer prevention across the region.
Research outputs highlight implementation success
The Tonga program has generated a series of peer‑reviewed publications led by PhD researcher Yasmin Mohamed that provide information on the program’s design, implementation, and outcomes, and offer valuable insights to inform scale-up in other settings.
- Vaccine Champions and HPV vaccination implementation in Tonga: program outcomes and implications for scale-up. Vaccine (2025). https://doi:10.1016/j.vaccine.2025.127280
- HPV vaccination: a mixed-methods evaluation. Health Expectations (2024). https://doi:10.1371/journal.pgph.0005467
- Strengthening HPV vaccination delivery through a Vaccine Champions model in Tonga. PLOS Global Public Health (2024);4:e0005467. https://doi:10.1111/hex.70422
Funding
The National Health and Medical Research Council and the ARIA‑RISE initiative supported PhD research Yasmin Mohamed’s research. UNICEF Pacific funded the 2025 Program. ARIA RISE-2 is being implemented from July 2024 to June 2027 as part of the Australian Government’s Partnerships for a Healthy Region (PHR) initiative and will continue to support ongoing research in Tonga over this period.