Moucheraud Corrina, Ochieng Eric, Ogutu Vitalis, Chang L Cindy, Golub Ginger, Crespi Catherine M, Szilagyi Peter G
New York University, School of Global Public Health, 708 Broadway, New York, NY 10003, USA.
Innovations for Poverty Action Kenya, P.O. Box 72427-00200, Nairobi, Kenya.
Vaccine. 2024 Dec 2;42(26):126410. doi: 10.1016/j.vaccine.2024.126410. Epub 2024 Oct 9.
Coverage of human papillomavirus (HPV) vaccination remains suboptimal in many countries, but the determinants are not well-understood particularly in low- and middle-income countries. We undertook a random digit dialed phone survey across Kenya between July-October 2022, with parents/caregivers of preadolescent girls, to identify intervention-amenable factors associated with respondents' daughter's HPV vaccination status.
Informed by the World Health Organization Behavioral and Social Drivers of Vaccination framework, we collected information about respondents' knowledge about and hesitancy toward HPV vaccine, perceived risk of cervical cancer, social norms around HPV vaccination, trust in institutions, and access to HPV vaccination services.
1416 parents/caregivers completed the survey (97.4 % of those eligible), of whom 38.2 % said that age-eligible girl(s) in their household had received any doses of the HPV vaccine. Knowledge/perceptions: In multivariable models adjusted for sociodemographic characteristics, respondents with less HPV vaccine hesitancy and fewer concerns about safety were more likely to have vaccinated daughter(s), as were those with greater knowledge about HPV vaccine and knowing someone who had died from cervical cancer. Social norms: Having spoken with others about HPV vaccination, although reported by less than half of respondents, and believing that other parents have vaccinated their daughters were associated with having vaccinated daughter(s). Respondents with more trust in information about HPV vaccination from health systems, and with higher trust in institutions, had greater odds of having vaccinated daughter(s). Access: One-fifth of respondents had experienced, or anticipated experiencing, challenges accessing HPV vaccination services, and these respondents had approximately half the odds of having a vaccinated daughter compared to their counterparts.
Promising areas for intervention include: targeted messaging about safety of the HPV vaccine, increasing parents'/caregivers' knowledge about the vaccine, and leveraging trusted messengers including health workers, faith leaders, and peer parents/caregivers.
在许多国家，人乳头瘤病毒（HPV）疫苗的接种覆盖率仍不理想，但在低收入和中等收入国家，其决定因素尚未得到充分了解。2022年7月至10月期间，我们在肯尼亚对青春期前女孩的父母/照顾者进行了一项随机数字拨号电话调查，以确定与受访者女儿HPV疫苗接种状况相关的可干预因素。
根据世界卫生组织疫苗接种的行为和社会驱动因素框架，我们收集了有关受访者对HPV疫苗的了解和犹豫程度、宫颈癌感知风险、HPV疫苗接种的社会规范、对机构的信任以及HPV疫苗接种服务可及性的信息。
1416名父母/照顾者完成了调查（占符合条件者的97.4%），其中38.2%表示其家庭中符合年龄的女孩接种了任何剂量的HPV疫苗。知识/认知：在根据社会人口学特征进行调整的多变量模型中，HPV疫苗犹豫程度较低且对安全性担忧较少的受访者，以及对HPV疫苗了解较多且认识因宫颈癌去世者的受访者，其女儿接种疫苗的可能性更大。社会规范：与他人谈论过HPV疫苗接种（尽管不到一半的受访者报告有此情况）以及认为其他父母已为其女儿接种疫苗，与女儿接种疫苗相关。对卫生系统提供的HPV疫苗接种信息信任度更高以及对机构信任度更高的受访者，其女儿接种疫苗的几率更大。可及性：五分之一的受访者曾经历或预计会在获取HPV疫苗接种服务方面遇到挑战，与未遇到此类挑战的受访者相比，这些受访者女儿接种疫苗的几率约为其一半。
有前景的干预领域包括：针对HPV疫苗安全性的定向宣传、增加父母/照顾者对疫苗的了解，以及利用包括卫生工作者、宗教领袖和同龄父母/照顾者在内的可信传播者。
