Factors influencing intention to obtain the HPV vaccine in South East Asian and Western Pacific regions: A systematic review and meta-analysis

Diviya Santhanes,Pui San Saw,Yan Ye Yap,Tahir Mehmood Khan,Nathorn Chaiyakunapruk,Che Pui Yong

doi:10.1038/s41598-018-21912-x

Abstract

Since licensing in 2006, there has been poor uptake of the HPV vaccine among the targeted population in the South East Asia Region (SEAR) and Western Pacific Region (WPR). A systematic review was conducted to identify the studies exploring the relationship between factors and intention for HPV vaccination among women in SEAR and WPR countries. Nineteen studies were identified as suitable for qualitative synthesis, and three as suitable for meta-analysis. Most women had a positive intention to have an HPV vaccine (range 57%–85%). Having a positive intention to vaccinate was significantly higher among women not aware of HPV infection (OR: 1.34, 95% CI: 1.02–1.76) and HPV vaccine (OR: 1.57, 95% CI: 1.26–1.96). Lower knowledge level and less confidence in safety and efficacy of the vaccine, negatively affected intention to vaccinate. Perceiving the vaccine to be expensive, low perception of contracting HPV infection and cervical cancer, and lack of concrete recommendations from healthcare providers also negatively affected intention to vaccinate. This review suggests the decision-making processes of women in SEAR and WPR is influenced by the cost of vaccination, perceived efficacy and safety of vaccine, provision of information on vaccination, and the awareness about HPV infection and the HPV vaccine.

Highlights

Human papillomavirus (HPV) has been recognised as the leading cause of cervical cancer, which in turn is the fourth-most prevalent cancer among women worldwide[1]
A total of 5,546 research articles were identified through the initial search, of which 5,483 did not meet the inclusion criteria and were excluded
In regions of high cervical cancer mortality such as South East Asia Region (SEAR) and Western Pacific Region (WPR), this review revealed that young women and female parents generally have positive intentions (57% to 65% of respondents) to get themselves or their children vaccinated against HPV

Summary

Introduction

Human papillomavirus (HPV) has been recognised as the leading cause of cervical cancer, which in turn is the fourth-most prevalent cancer among women worldwide[1]. None have demonstrated a clear association between influences and intention to vaccinate These systematic reviews have not explored the factors leading to vaccine hesitancy among women from the SEAR and WPR. The findings from this review will be valuable as the provision of statistical and qualitative data synthesis will further strengthen the association of factors that influence women’s decision-making regarding vaccination against HPV.

Methods

Results

Discussion

Conclusion