The State of Human Papillomavirus (HPV) Vaccination Among Secondary School Adolescents in Nnewi, Nigeria Prior to Free Routine HPV Vaccine Rollout

Background: Human papillomavirus (HPV) has been linked to various cancers of the genital, oropharyngeal, and anal regions in both sexes. Objective: To assess the vaccination rate and factors influencing the uptake of the HPV vaccine among secondary school students in Nnewi, Nigeria, prior to the introduction of free HPV vaccine in the routine national immunisation program. Methods: A cross-sectional, descriptive survey was conducted among male and female students aged 10 to 18 years in public and private secondary schools between April and July 2023. A total of 200 participants were recruited using multi-stage sampling. Data on relevant sociodemographic characteristics, awareness about the HPV vaccine, details of HPV vaccination and reasons for not vaccinating were collected using pretested interviewer-administered questionnaires. Results: Nearly two-thirds (62.0%) of participants were aged 15 to 18 years. Sixty-five per cent had not previously heard about HPV infection or the HPV vaccine. However, only 3 (1.5%) female participants reported receiving the HPV vaccine. Significant associations were found between awareness of HPV infection and HPV vaccination status (p = 0.006). The major reasons for not receiving the HPV vaccine were a lack of information about the vaccine (100%), where to get the vaccine (27.9%]), and the cost of the vaccine (6.0%). Conclusion: The study revealed a low level of awareness about HPV infection or vaccine and a very low HPV vaccination rate among the participants. Public enlightenment and advocacy about HPV and the HPV vaccine should be prioritised to enhance knowledge and uptake after the free HPV vaccine rollout.