Acceptance of human papillomavirus vaccination and parents’ willingness to vaccinate their adolescents in Ethiopia: a systematic review and meta-analysis

Abstract

Introduction Despite the global vaccination campaign to prevent HPV-related morbidity, HPV vaccination uptake remains unacceptably low in the developing world, like Ethiopia. For strong interventional measures, compiled data in the field is required which is otherwise missed in the Ethiopian context. Therefore, this systematic review aimed to provide an estimate of the HPV vaccination uptake, mothers‘ willingness to vaccinate their adolescent girls, and associated factors in Ethiopia. Methods Articles were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Two reviewers assessed study eligibility, extracted data, and assessed the risk of bias independently. Meta-analysis was performed using STATA v 14 to pool the vaccination uptake and mothers‘ willingness toward HPV vaccination in Ethiopia. Results We included 10 articles published between 2019 and 2022 covering reports of 3,388 adolescent girls and 2,741 parents. All the included articles had good methodological quality. The pooled estimate of the proportion of good knowledge about HPV vaccination and the agreement of girls to get the vaccine was 60% (95%CI: 59–62) and 65% (95%CI: 64–67), respectively. The pooled estimate of vaccination uptake of at least one dose of HPV vaccine among girls was 55% (95%CI: 53–57). Positive attitudes to the vaccine, higher maternal education, and having knowledge about HPV and its vaccine were reported as statistically significant predictors. On the contrary, not having adequate information about the vaccine and concerns about possible side effects were reported as reasons to reject the vaccine. Likewise, the pooled estimate of mothers who were knowledgeable about HPV vaccination, who had a positive attitude, and willing to vaccinate their children were 38% (95%CI: 36–40) 58% (95%CI: 56–60), and 74% (95%CI: 72–75), respectively. Conclusions Knowledge about the HPV vaccine among girls and their vaccination uptake is suboptimal that falls short of the 2030 WHO targets. Therefore, stakeholders need major efforts in rolling out vaccination programs and monitoring their uptake. Social mobilization towards primary prevention of HPV infection should focus on adolescents. The existing strategies need to address the predictors of uptake by educating girls and parents.

Acceptance, Hesitancy, and Refusal Among Parents of Young Girls in Relation to Human Papillomavirus Vaccination: A Study From the Mohammed VI University Hospital Center in Oujda, Morocco

“…In our sample, 43% of parents relied on healthcare personnel as the primary source of information about HPV, which is consistent with the results found in a survey conducted in the Appalachian region of the USA [27] but contradictory to those reported in a French survey of high-school and university-aged women in the Provence-Alpes-Côte d'Azur region [28]. Lack of sufficient information about the vaccine and fear of side effects were the primary concerns of parents in our study population, which had also been noted in other studies [18,29]. Many studies highlighted the role of parents' socioeconomic status and cultural factors in vaccine acceptability [8,14,15].…”

“…HPV vaccination rates have also been reported to be low in several African countries [18]. A study conducted in Nigeria showed that only 2.1%-4% of adolescent girls had received the HPV vaccine, with the most common reason for not receiving the vaccine being the lack of knowledge about it [19,20].…”