The Education and Sports Bureau of Changyuan City, Xinxiang, Henan Province, issued a document requiring all middle schools to achieve an HPV vaccination rate of over 80% by November 20. The bureau will rank schools based on their vaccination rates, and the principals of the bottom three schools will be summoned for talks by bureau leaders. Vaccination sites are operating 24 hours a day. Parents in many places have reported being pressured by homeroom teachers and principals.