International Journal of Adolescent Medicine and Health

How can the uptake of HPV vaccination be increased in school going girls? a qualitative study with multiple stakeholders in Ganjam, Odisha

Abstract Objectives Cervical cancer remains a significant public health challenge in low- and middle-income countries like India. Despite the efficacy of HPV vaccination, its uptake remains suboptimal. This qualitative study aimed to explore parental attitudes, knowledge, and decision-making regarding HPV vaccination for school-going adolescents in Ganjam, Odisha, to inform effective intervention strategies. Methods This qualitative study utilized semi-structured interviews, conducting Focus Group Discussions (FGDs), In-Depth Interviews (IDIs), and Key Informant Interviews (KIIs) of total 47 participants. Data were collected from December 2024 to January 2025 in Ganjam, Odisha. Data were analyzed using thematic analysis, aided by MAXQDA 2020 software. Results Five core themes emerged: Knowledge and Awareness Gaps (low awareness, confusion with other vaccines, information needs); Attitudes Towards HPV Vaccination (mixed institutional trust, accountability demands); Barriers to HPV Vaccination (cultural/social hesitancy, fear-driven hesitancy, individual and systemic barriers); Role of School Authorities (education and communication gaps); and Potential Collaborative Strategies (community engagement, policy and systems alignment). Participants showed positive sentiments towards trusted sources and community engagement, while negative sentiments were associated with fear, cultural norms, and systemic challenges. Conclusions HPV vaccine uptake is hindered by knowledge gaps, cultural/fear-driven hesitancy, and systemic barriers. Improving coverage and health literacy in resource-limited settings requires intensive communication, school-based education, paternal involvement, intersectoral collaboration, and policy changes, including UIP integration.

HPV vaccination: analysis of acceptability among mothers – a study of 160 cases

Abstract Objectives To assess Tunisian mothers’ knowledge, attitudes, and perceptions regarding HPV vaccination, in order to better understand the factors influencing their acceptance. Methods A multicenter, cross-sectional analytical study was conducted between December 2024 and January 2025 among 160 mothers residing in Tunisia, each with at least one daughter aged 10–12 years. Data were collected using an anonymous self-administered questionnaire covering socio-demographic information, knowledge of cancer, HPV, and vaccination, as well as attitudes and factors influencing acceptability. Results Almost all participants (99.4 %) had heard of cervical cancer, but only 16.3 % were aware of HPV. Knowledge about the HPV vaccine was low (13.1 %). More than half (59.4 %) expressed concerns about side effects. Acceptance of the vaccine was low, with only 21.9 % expressing favorable opinions and 57.5 % unfavorable. In univariate analysis, a higher level of education and knowledge of HPV were associated with a favorable attitude; however, no independent predictors were identified in the multivariate analysis. Conclusions This study reveals a low level of knowledge and acceptance of HPV vaccination among Tunisian mothers, mainly due to insufficient information and safety concerns. Culturally adapted educational campaigns and active involvement of healthcare professionals are essential to improve vaccination coverage.

Parental perspectives: a mixed method study on perceived risk, self-efficacy, vaccine response efficacy, and willingness for adolescent HPV vaccination in Puducherry, South India

Abstract Background Cervical cancer is the second most common cancer among women in India. To reduce its incidence, the government is set to roll out a Human papillomavirus (HPV) vaccination for adolescent girls. Objectives To find the association between risk perception, self-efficacy, vaccine response efficacy and willingness to vaccinate adolescents (9–18 years) against HPV and to explore factors associated with willingness for vaccination among adolescent girls, their parents and healthcare workers. Methods A mixed-method study was conducted among parents of adolescent girls aged 9–18 using multistage simple random sampling in Puducherry. After a brief education session, a self-developed and validated questionnaire was used to assess perceived risk, self-efficacy, vaccine response efficacy and willingness for HPV vaccination. Chi-squared and Fisher’s exact tests were used for analysis. Results Out of 388 participants, majority (78.1 %) had heard of cervical cancer, and 6.2 % were aware of HPV infection. Of the participants, 44.8 % (95 % CI: 39.9–49.8 %) had a high perceived risk, 49 % (95 % CI: 44.0–53.9 %) had low self-efficacy, and 70.9 % (95 % CI: 66.2–75.2 %) believed in high vaccine response efficacy. Additionally, 91.5 % of participants were willing to vaccinate under a universal immunisation schedule, and only 44.1 % from private providers. Participants who were willing to vaccinate had a higher risk perception of HPV infection and cervical cancers, high belief in vaccines and low self-efficacy in their own health (p<0.001) compared to those who were not willing for HPV vaccination.