Moucheraud Corrina, Ochieng Eric, Kweka Ansila, Wang Pengyun, Xie Shangkun, Ototo John, Golub Ginger, Kapindo Ellen, Banda Esau, Abdillahi Hawa, Szilagyi Peter G, Heng Siyu
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. 2025 May 10;55:127025. doi: 10.1016/j.vaccine.2025.127025. Epub 2025 Mar 26.
As more countries introduce the HPV vaccine, it is important to understand the validity of vaccination measures. This is especially true in low- and middle-income countries (LMICs) where public health monitoring of vaccination data may have delays or gaps, so alternative measurement approaches are often necessary. Parental report is a common approach for measuring routine childhood vaccination, but it has not been evaluated for HPV vaccination in LMICs.
We conducted household surveys in Kenya (n = 146) and Malawi (n = 98) with parents/guardians and their daughters who were age-eligible for HPV vaccination. We compared parents'/guardians' reports of HPV vaccination status to daughters' reports; the latter was assumed to be the "gold standard" measure.
88 % of Kenyan parents/guardians and 82 % of Malawian parents/guardians agreed with their daughters' reported HPV vaccination status. It was more common for parents/guardians to under-report (i.e., to say their daughter was unvaccinated but the girl said she had received dose(s)) than the inverse. Agreement with one's daughter was higher among parents/guardians who reported data from vaccination cards versus using recall, and among parents/guardians who expressed more versus less confidence in their knowledge. We did not find many differences in accuracy of report by parent/guardian characteristics, although in Kenya there were small and statistically significant negative associations with parental age, household income, and more girls in the household (the latter was also significantly negatively associated with report accuracy in Malawi).
In countries where surveys will commonly be used to measure HPV vaccination status, we found very high agreement of parents/guardians with their daughters' reported receipt of the vaccine. These results are similar to findings from the literature about routine childhood vaccination measurement. This suggests that researchers, clinicians, and practitioners can use parent/guardian-reported HPV vaccination of their daughter as a relatively good proxy of her own reported immunization status especially in settings without universal use of vaccination cards or registries.
随着越来越多的国家引入人乳头瘤病毒（HPV）疫苗，了解疫苗接种措施的有效性至关重要。在低收入和中等收入国家（LMICs）尤其如此，这些国家对疫苗接种数据的公共卫生监测可能存在延迟或缺口，因此通常需要采用替代测量方法。家长报告是衡量儿童常规疫苗接种的常用方法，但在低收入和中等收入国家尚未对其用于HPV疫苗接种的情况进行评估。
我们在肯尼亚（n = 146）和马拉维（n = 98）对符合HPV疫苗接种年龄的父母/监护人及其女儿进行了家庭调查。我们将父母/监护人报告的HPV疫苗接种状况与女儿的报告进行了比较；后者被视为“金标准”测量方法。
88%的肯尼亚父母/监护人和82%的马拉维父母/监护人同意其女儿报告的HPV疫苗接种状况。父母/监护人少报（即表示其女儿未接种疫苗，但女孩称已接种一剂或多剂）的情况比多报更为常见。与使用回忆法相比，报告来自疫苗接种卡数据的父母/监护人与其女儿的一致性更高，对自己的知识表示更有信心的父母/监护人也是如此。我们没有发现父母/监护人特征在报告准确性方面有很多差异，尽管在肯尼亚，父母年龄、家庭收入以及家庭中女孩较多与报告准确性存在小的、具有统计学意义的负相关（在马拉维，家庭中女孩较多也与报告准确性显著负相关）。
在通常使用调查来衡量HPV疫苗接种状况的国家，我们发现父母/监护人与其女儿报告的疫苗接种情况高度一致。这些结果与关于儿童常规疫苗接种测量的文献研究结果相似。这表明研究人员、临床医生和从业者可以将父母/监护人报告的其女儿的HPV疫苗接种情况作为其自身报告的免疫状况的相对良好替代指标，尤其是在没有普遍使用疫苗接种卡或登记册的情况下。
