“When you get the HPV vaccine, it will prevent cervical cancer; it will act as a shield”: adolescent girls’ knowledge and perceptions regarding the human papillomavirus vaccine in Zambia

Abstract

IntroductionThe human papillomavirus (HPV) vaccination is an important preventive measure for HPV-related conditions such as cervical cancer. In 2019, Zambia introduced a free national HPV vaccination program for 14-year-old girls. However, the adolescents’ knowledge and perceptions regarding the HPV vaccine are not well understood. Therefore, this study aimed to understand adolescent girls’ knowledge and perceptions regarding the HPV vaccine and discuss its acceptability and uptake implications.MethodsWe conducted a qualitative study in the Lusaka district between June 2021 and November 2021 using semi-structured interviews with adolescent girls aged 15–18 years regardless of their HPV vaccination status. Interviews were transcribed verbatim, and NVIVO 12 was used for data management and analysis. We coded transcripts deductively and inductively based on emerging themes. Perceptions were coded using the health belief model constructs.ResultsWe interviewed 30 adolescent girls to reach saturation. Seventeen girls reported having received at least one dose of the HPV vaccine. Participants expressed variable knowledge and awareness about HPV and the HPV vaccine. Participants exhibited positive attitudes towards the HPV vaccine and perceived it as beneficial. However, there were multiple perceived barriers to vaccination, such as the need for parental consent, not being in school, concerns about vaccine side effects, and belief in myths and misinformationConclusionThe adolescent girls in this study showed variable knowledge and positive attitudes toward the HPV vaccine despite the many perceived barriers. To support increased HPV vaccine acceptability and uptake among adolescent girls in Zambia, it is critical to actively engage stakeholders involved in HPV vaccination, such as adolescents and their parents, and debunk myths and misconceptions about HPV vaccination. Health education in schools and communities should be implemented to increase knowledge about HPV and HPV vaccination among adolescents and their parents.

Determinants of the Implementation of Human Papillomavirus Vaccination in Zambia: Application of the Consolidated Framework for Implementation Research

“…Parents of adolescent girls should consent to the vaccination of their children, who are usually below the age of legal consent [ 12 ], even when most countries are implementing an opt-out approach [ 38 ]. On the other hand, adolescents themselves should be knowledgeable about the vaccine and have good attitudes towards it [ 39 , 40 ], hence it is necessary to improve their knowledge [ 41 ].…”

Ethics and strategy in vaccination: A review of public health policies and practices

“…These programs often target adolescents, with the goal of establishing immunity before the onset of sexual activity. HPV vaccination campaigns involve extensive public awareness efforts to dispel myths, address concerns, and promote the long-term benefits of preventing HPV-related cancers (Lubeya et al, 2023, Okunade et al, 2023.…”

Human Papillomavirus Vaccination Acceleration and Introduction in Sub-Saharan Africa: A Multi-Country Cohort Analysis

“…For Tanzania, following a successful pilot program, Tanzania scaled-up and introduced the HPV vaccine into the NIP in April 2018 for 14-year-old girls, using the routine immunization delivery strategy, and not via campaigns or other point-in-time delivery strategies. In Zambia, the HPV vaccine introduction was in June 2019, and vaccination coverage since then has dropped significantly from 75% in 2019 to 39% in 2021 [47]. The stakeholders attributed the decline essentially to vaccine hesitancy and misinformation.…”