Objectives: HPV infection is associated with the development of cervical and oropharyngeal cancer. HPV vaccination prevents cervical cancer, but is still not part of Lebanon's routine vaccination schedule. As such, understanding physicians' practice towards HPV vaccination is essential. Material and Methods: We conducted a cross-sectional study in Greater Beirut, Lebanon to assess the barriers, attitudes and clinical approach of Lebanese physicians towards HPV vaccination. We also aimed to analyze the factors associated with physicians' barriers to HPV vaccination. Results: In total, 228 physicians completed the survey. Our results show that physicians and parents consider the cost of HPV vaccination to be a main barrier (58.9% and 80.7% respectively). Also, parents tend to have concerns about vaccine safety (78.1%), efficacy (68.6%), and lack education concerning HPV infection (81.8%). Furthermore, female physicians tend to have fewer barriers when compared to male physicians (aOR = 0.39; p-value = 0.007). Additionally, physicians who completed residency programs in the USA also showed fewer barriers when compared to physicians who completed Lebanese residency programs (aOR = 0.24; p-value = 0.040). Finally, physicians with higher knowledge score have fewer barriers when compared to those with lower knowledge scores (aOR = 0.42; p-value = 0.018). Conclusions: Physician gender, residency program and level of knowledge play a role in HPV vaccine barriers and recommendation in Lebanon. Future improvements in cost and awareness about HPV might improve vaccination rates. Creating uniform practices towards HPV vaccine is warranted to improve patient care.

The recent Lebanese port explosion came as a continuation of a series of socioeconomic disasters the country has been facing during the past year. In addition, the massive impact of the coronavirus disease-19 (COVID-19) pandemic further hastened the collapse of the Lebanese healthcare system. In light of all those events, the Lebanese healthcare sector has faced major blows that will be difficult to recuperate from. In the aftermath of the Beirut port explosion, Lebanon received immense financial and medical support from the international community in a timely fashion, which secured first level care to victims of the explosion. Nevertheless, this forced Lebanon, which was considered a prominent tertiary medical hub in the Middle East, to slowly regress into an exclusive primary care provider. As such, it is crucial for local and regional stakeholders to build strong collaborations, and shape a unified vision of Lebanon's future healthcare system.