Feasibility and acceptability of nationwide HPV vaccine introduction in Senegal: Findings from community-level cross-sectional surveys, 2020

Abstract

In Senegal, cervical cancer is the most common cancer among women and the leading cause of morbidity and mortality from all cancers. In 2018, Senegal launched a national human papillomavirus (HPV) vaccination program with Gavi, the Vaccine Alliance (Gavi), support. HPV vaccination was incorporated into the national immunization program as a two-dose schedule, with a 6-12-month interval, to nine-year-old girls via routine immunization (RI) services at health facilities, schools and community outreach services throughout the year. During February to March 2020, we conducted interviews to assess the awareness, feasibility, and acceptability of the HPV vaccination program with a cross-sectional convenience sample of healthcare workers (HCWs), school personnel, community healthcare workers (cHCWs), parents, and community leaders from 77 rural and urban health facility catchment areas. Participants were asked questions on HPV vaccine knowledge, delivery, training, and community acceptability of the program. We conducted a descriptive analysis stratified by respondent type. Data were collected from 465 individuals: 77 HCW, 78 school personnel, 78 cHCWs, 152 parents, and community leaders. The majority of HCWs (83.1%) and cHCWs (74.4%) and school personnel (57.7%) attended a training on HPV vaccine before program launch. Of all respondents, most (52.5–87.2%) were able to correctly identify the target population. The majority of respondents (60.2–77.5%) felt that the vaccine was very accepted or accepted in the community. Senegal’s HPV vaccine introduction program, among the first national programs in the African region, was accepted by community stakeholders. Training rates were high, and most respondents identified the target population correctly. However, continued technical support is needed for the integration of HPV vaccination as a RI activity for this non-traditional age group. The Senegal experience can be a useful resource for countries planning to introduce the HPV vaccine.

Improving HPV Vaccination Uptake Among Adolescents in Low Resource Settings: Sociocultural and Socioeconomic Barriers and Facilitators

“… 13 Gender-specific immunization has been historically challenging and has resulted in many stigmatizing HPV rumors targeted toward girls. 39 , 40 It may not be best for HPV vaccine campaigns to focus solely on vaccinating girls and prioritizing reducing cervical cancer as the main goal of the vaccine. Focusing on communicating the HPV vaccine’s cervical cancer benefits increases the stigma that HPV is a female disease and places the blame and burden of the issue on females when both genders could benefit.…”

“… 72 The plan should include training programs with frequent refreshers for educators and health workers, customized school messages, and parental vaccine information materials. 39 Health stakeholders must ensure that consistent scheduling and coordination are employed between the education sector and those providing the HPV vaccine so that all stakeholders can provide persistent and holistic vaccine messaging and timely vaccination. 73 , 74 …”

Correlates of Parental Consent to Human Papillomavirus Vaccine Uptake by Their Adolescent Daughters in ZAMBIA: Application of the Health Belief Model

“…This approach may improve knowledge levels among parents. Additionally, at the policy level, the feasibility of having ongoing HPV vaccination should be explored as it may improve access; Zambia can take a leaf from countries like Senegal [ 44 ].…”

“…Further, ODK collect allows building forms in multiple languages, which can be used interchangeably within and between participants with a button click [42]. Due to its multiple advantages, ODK has been widely used in HPV vaccination research in other resource-constrained regions like Tanzania [43] and Senegal [44].…”

Global perspectives of determinants influencing HPV vaccine introduction and scale-up in low- and middle-income countries

“…Additionally, academic institutions have been at the forefront in leading research and generating essential data needed by stakeholders and policy-makers to inform the introduction of HPV vaccines [22,23]. While research has been conducted evaluating factors influencing HPV vaccine introduction in LMICs, these studies have focused primarily on obtaining national stakeholder and community perspectives, with a lesser focus on obtaining global stakeholder perspectives, namely perspectives from academic institutions and international stakeholders and organizations [24][25][26]. This study aimed to address this gap by exploring global stakeholder perspectives regarding determinants affecting HPV vaccine introduction and scale-up in LMICs through key informant interviews.…”