Noreen Khola, Khalid Samina Naeem, Javaid Mohsin, Khan Shahzad Ali
Associate Professor, Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Professor Public Health, Health Services Academy, Islamabad, Pakistan.
PLoS One. 2025 May 22;20(5):e0323826. doi: 10.1371/journal.pone.0323826. eCollection 2025.
Cervical cancer is a preventable illness, and early vaccination can serve as a primary prevention strategy. Currently, HPV vaccination has not been introduced at the national level in Pakistan, and the vaccine remains unavailable in most regions. However, efforts are underway to launch the HPV vaccination program soon. For a successful roll-out, it is essential to address circumstantial challenges and mitigate vaccine hesitancy, which stems from a complex interplay of sociocultural and contextual factors. Therefore, this study aims to comprehensively evaluate the multifaceted sociocultural, contextual, and demographic factors influencing the uptake of HPV vaccination at the community level.
1.To assess the current level of knowledge, belief, and factors associated with the acceptability of HPV vaccination among potential vaccine recipients and their parents/caregivers 2. To explore stakeholders' perspectives on the launch of HPV vaccination, considering the dynamics of the local population in the resource-constrained country, Pakistan (OBJ 2). 3.To identify the social and behavioral factors that influence HPV vaccination acceptance and hesitancy within a local community (Punjab) (OBJ 3).
The ethical approval of the study has been already obtained from the ethical review board of Rawalpindi Medical University (843 IREF/RMU/2024). Data will be collected after obtaining informed written consent from parents and assent from daughters. Data collection will start from April 2025 and will be completed in six months. Data compilation and results are expected by December 2025. A convergent mixed methods design will be used as it will enable the merging of qualitative and quantitative data. Data collection will involve a quantitative phase in which data will be collected from potential vaccine recipients (girls between 9-16 years) and their parents/caregivers to assess the current level of knowledge, belief, and HPV vaccine hesitancy. The qualitative phase aims to explore key stakeholders' perspective on the health system's preparedness and capacity for launch and uptake of HPV vaccination. The quantitative findings will be integrated with the qualitative data via the merging and expanding integration techniques to generate confirmed, expanded, and discordant meta-inferences.
This study will comprehensively identify the multilevel contextual and health system factors that influence HPV vaccine uptake. This study will significantly contribute in field of Public Health by providing a foundational basis of first step of cultural adaptation and validation of BeSD tool specifically for HPV Vaccination.
宫颈癌是一种可预防的疾病，早期接种疫苗可作为主要预防策略。目前，巴基斯坦尚未在国家层面引入人乳头瘤病毒（HPV）疫苗接种，大多数地区仍无法获得该疫苗。然而，相关工作正在推进，以便尽快启动HPV疫苗接种计划。为了成功推行该计划，必须应对各种实际挑战并减少疫苗犹豫情绪，而疫苗犹豫情绪源于社会文化和背景因素的复杂相互作用。因此，本研究旨在全面评估影响社区层面HPV疫苗接种接受度的多方面社会文化、背景和人口因素。
1.评估潜在疫苗接种者及其父母/照顾者对HPV疫苗接种的知晓程度、信念以及与可接受性相关的因素。2.考虑资源有限的国家巴基斯坦当地人口的动态情况，探讨利益相关者对启动HPV疫苗接种的看法（目标2）。3.确定影响当地社区（旁遮普省）HPV疫苗接种接受度和犹豫情绪的社会和行为因素（目标3）。
本研究已获得拉瓦尔品第医科大学伦理审查委员会的伦理批准（843 IREF/RMU/2024）。在获得家长的知情书面同意和女儿的同意后收集数据。数据收集将于2025年4月开始，并将在六个月内完成。预计2025年12月完成数据汇编和得出结果。将采用收敛性混合方法设计，因为它能够合并定性和定量数据。数据收集将包括一个定量阶段，在此阶段将从潜在疫苗接种者（9至16岁女孩）及其父母/照顾者收集数据，以评估当前的知晓程度、信念和HPV疫苗犹豫情况。定性阶段旨在探讨关键利益相关者对卫生系统为启动和推广HPV疫苗接种所做准备和能力的看法。定量研究结果将通过合并和扩展整合技术与定性数据相结合，以生成经确认、扩展和不一致的元推论。
本研究将全面确定影响HPV疫苗接种率的多层次背景和卫生系统因素。本研究将通过提供专门针对HPV疫苗接种的行为、社会和环境决定因素（BeSD）工具文化适应和验证第一步的基础，为公共卫生领域做出重大贡献。
