Uptake and Barriers of HPV Vaccine by 10-Year-Old School-Going Girls in Kisumu County, Kenya

Abstract

Background: Cervical cancer is the most common gynaecological cancer and a significant cause of Disability-Adjusted Life Years (DALYs). It is estimated that 85% of cervical cancer cases are in low- and middle-income countries. Kenya became the 16th African country to introduce the HPV vaccine into its routine immunization schedule. The main hindrance was initially the cost, but even as the vaccine has been rolled out free of charge, we still have acceptability and uptake challenges. Objectives: To determine the uptake of the HPV vaccine by 10-year-old school-going girls in Kisumu County and to assess the factors associated with parental acceptability of the HPV vaccine in Kisumu County, using the Health Belief Model. Methods: We conducted a mixed-method analysis of the uptake of the HPV vaccine by 10-year-old school-going girls in Kisumu County and the factors affecting parental acceptability. The study’s first phase was a cross-sectional quantitative study, where secondary data of randomly sampled 384 girls, ten years of age, was collected from the school registry retrospectively between December 2019 and December 2021. A descriptive analysis was conducted. The results were presented in frequency and percentage. 34 parents purposively sampled for the FGDs. Transcripts were analyzed from the four focus groups in rural and urban Kisumu. Results: The average uptake of the HPV vaccine in Kisumu County was (252) 65.63% (n=384). Only (119) 30.98% were fully vaccinated, while 26.82% (103) were partially vaccinated. 34.37% were not vaccinated during the study period. Upon analysis of the qualitative data from the focused group discussion (FGDs), four main themes emerged as regards the HBM: the lack of knowledge and misinformation about Human Papillomavirus, cervical cancer, and the HPV vaccine, the fear of the HPV vaccine side effects, non-vaccine costs like transportation cost and institutional barriers like availability of the vaccine and proximity to a facility offering the vaccine services. Conclusion: The study confirms that the HPV vaccination uptake is low, especially for the two doses. The study findings indicate that many parents and guardians did not possess vital information regarding the HPV vaccine that would enable them to allow their daughters to receive the vaccine. Recommendations: It is, therefore, imperative that policymakers investigate and verify the efficacy of a single dose of the HPV vaccine and shift to one dose, and also employ other modalities of HPV vaccination campaigns to include door-to-door campaigns. Moreover, vital information regarding the causal relationship between the HPV cervical cancer and the HPV vaccine, and the side effects should be part of the disseminated information to the target groups.