Abstract
BackgroundThere are few data on factors influencing human papillomavirus (HPV) vaccination uptake in sub-Saharan Africa. We examined the characteristics of receivers and non-receivers of HPV vaccination in Tanzania and identified reasons for not receiving the vaccine.MethodsWe conducted a case control study of HPV vaccine receivers and non-receivers within a phase IV cluster-randomised trial of HPV vaccination in 134 primary schools in Tanzania. Girls who failed to receive vaccine (pupil cases) and their parents/guardians (adult cases) and girls who received dose 1 (pupil controls) of the quadrivalent vaccine (Gardasil™) and their parents/guardians (adult controls) were enrolled from 39 schools in a 1∶1 ratio and interviewed about cervical cancer, HPV vaccine knowledge and reasons why they might have received or not received the vaccine. Conditional logistic regression was used to determine factors independently associated with not receiving HPV vaccine.ResultsWe interviewed 159 pupil/adult cases and 245 pupil/adult controls. Adult-factors independently associated with a daughter being a case were older age, owning fewer household items, not attending a school meeting about HPV vaccine, and not knowing anyone with cancer. Pupil-factors for being a case included having a non-positive opinion about the school de-worming programme, poor knowledge about the location of the cervix, and not knowing that a vaccine could prevent cervical cancer. Reasons for actively refusing vaccination included concerns about side effects and infertility. Most adult and pupil cases reported that they would accept the HPV vaccine if it were offered again (97% and 93% respectively).ConclusionsSensitisation messages, especially targeted at older and poorer parents, knowledge retention and parent meetings are critical for vaccine acceptance in Tanzania. Vaccine side effects and fertility concerns should be addressed prior to a national vaccination program. Parents and pupils who initially decline vaccination should be given an opportunity to reconsider their decision.
Highlights
Infection with human papillomavirus (HPV) is the primary cause of cervical cancer, with approximately 70% of cases caused by HPV genotypes 16 and 18 [1,2]
As part of a project to demonstrate the feasibility, acceptability and costs of delivering HPV vaccine in primary schools in Tanzania, we examined the characteristics of receivers and nonreceivers of HPV vaccination and reasons for receiving or not receiving the vaccine
HPV vaccination project activities A phase IV cluster-randomised trial (NCT01173900) was conducted in Tanzania to compare two different vaccine delivery strategies in primary schools; age-based delivery, where the quadrivalent HPV vaccine, GardasilTM, was offered to all girls in the school who were born in 1998, and a class-based strategy where girls who were enrolled in primary school class 6 in 2010 were offered vaccination [12]
Summary
Infection with human papillomavirus (HPV) is the primary cause of cervical cancer, with approximately 70% of cases caused by HPV genotypes 16 and 18 [1,2]. The vaccines protect against HPV type 16 and 18 infections and associated cervical pre-cancerous lesions and, in the case of the quadrivalent vaccine, against HPV 6 and 11, the main cause of genital warts [4,5,6]. Vaccination is typically targeted at young adolescent or pre-adolescent girls before they can acquire HPV after sexual debut [7]. This is not an age group that is routinely targeted by vaccination programmes in developing countries. We examined the characteristics of receivers and non-receivers of HPV vaccination in Tanzania and identified reasons for not receiving the vaccine
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
