Bhengu Phelele, Wiysonge Charles S, Katoto Patrick D M C, Ndwandwe Duduzile, Cooper Sara, Bhengu Sebenzile, Mazingisa Akhona V, Saber Theresa, Sithole Mandisi, Smith Darian, Tembe Lindiwe G, Kuodi Paul, Shey Muki S
Department of Medicine & CIDRI-Africa, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa.
Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa.
Vaccines (Basel). 2025 Jul 6;13(7):732. doi: 10.3390/vaccines13070732.
South Africa launched a school-based human papillomavirus (HPV) vaccination programme in 2014 and has achieved a national coverage of more than 80%. However, there is subnational variation in coverage, with eThekwini District in the province of KwaZulu-Natal having the lowest coverage at 40%. Knowledge of the factors associated with vaccine acceptance in this district would inform tailored strategies to improve coverage, which could be extrapolated to similar settings. We conducted this cross-sectional study to assess the factors associated with HPV vaccine acceptance in eThekwini District. We used stratified random sampling to select caregivers of children aged 9-14 years in the district. We interviewed participants in April-May 2023 and employed bivariate and multivariate logistic regression models to assess the factors associated with HPV vaccine acceptance. Of 793 individuals contacted, 713 (89.9%) participated. Most were women (86.1%) and had a mean age of 42.6 ± 11.6 years and secondary or lower education (83.8%). Most participants knew about the HPV vaccination programme (86.0%) and accepted HPV vaccination (93.5%). The latter includes 42.9% who had already vaccinated their daughters and 50.6% who were willing to allow their daughters to be vaccinated. A negligible proportion was either undecided (2.1%) or unwilling (4.4%) to accept HPV vaccination. Awareness of the programme (adjusted odds ratio [aOR] 5.22; 95% confidence interval [95%CI] 2.01-13.56), confidence in vaccine safety (aOR 19.69; 95%CI 5.86-66.15), and endorsement by religious leaders (aOR 5.06; 95%CI 1.56-16.45) were independent predictors of vaccine acceptance. Our findings highlight the critical role of the provision of information and education about the benefits and safety of HPV vaccination.
南非于2014年启动了一项基于学校的人乳头瘤病毒（HPV）疫苗接种计划，全国覆盖率已超过80%。然而，各地区的覆盖率存在差异，夸祖鲁-纳塔尔省的伊泰夸尼区覆盖率最低，为40%。了解该地区与疫苗接受度相关的因素将为制定有针对性的策略以提高覆盖率提供依据，这些策略可推广到类似环境中。我们开展了这项横断面研究，以评估伊泰夸尼区与HPV疫苗接受度相关的因素。我们采用分层随机抽样方法，在该地区选取9至14岁儿童的看护人。我们于2023年4月至5月对参与者进行了访谈，并采用双变量和多变量逻辑回归模型来评估与HPV疫苗接受度相关的因素。在联系的793人中，713人（89.9%）参与了研究。大多数是女性（86.1%），平均年龄为42.6±11.6岁，接受过中等及以下教育（83.8%）。大多数参与者了解HPV疫苗接种计划（86.0%）并接受HPV疫苗接种（93.5%）。后者包括42.9%已为女儿接种疫苗的人和50.6%愿意让女儿接种疫苗的人。只有微不足道的比例（2.1%）未做决定或（4.4%）不愿意接受HPV疫苗接种。对该计划的了解（调整优势比[aOR]5.22；95%置信区间[95%CI]2.01 - 13.56）、对疫苗安全性的信心（aOR 19.69；95%CI 5.86 - 66.15）以及宗教领袖的认可（aOR 5.06；95%CI 1.56 - 16.45）是疫苗接受度的独立预测因素。我们的研究结果凸显了提供关于HPV疫苗接种益处和安全性的信息与教育的关键作用。
