Knowledge of human papillomavirus vaccine as a determinant of uptake among guardians of adolescent girls: A single hospital experience in nairobi, kenya

Cervical cancer is one of the most common preventable cancers, causing significant morbidity and mortality in women, especially in Sub-Saharan Africa. Despite the availability of free HPV vaccination, the proportion of adolescent girls vaccinated against HPV remains low. Our aim was to identify knowledge and factors influencing HPV vaccine uptake among parents of adolescent girls and to determine the proportion of adolescent girls vaccinated within three months after the provision of additional information on cervical cancer and HPV vaccine. We undertook a mixed methods study design, with an initial cross-sectional part followed by a prospective cohort study among guardians of adolescent girls aged 9-18 years attending Aga Khan University Hospital Nairobi, Kenya. Guardians of adolescent girls who had not received the HPV vaccine were provided with standardized written information regarding cervical cancer, HPV vaccine availability, and utility. Guardians were then contacted three months later to evaluate subsequent HPV vaccine uptake. A total of 432 guardians participated in the study. The majority (94.7%) knew about cervical cancer, 84.9% of them had heard about the HPV vaccine, and 48% were aware of the free vaccination campaign. Only 13.2% (n=57) of the participants reported that their daughters had been vaccinated prior to this study. Factors associated with vaccine uptake included the level of knowledge (p≤ 0.001) and the age of the parents (p=0.030). Reasons commonly cited for not taking the vaccine included lack of information (73%), lack of awareness (45%), safety concerns (13%) and concerns about affordability (7%). A total of 306 participants were followed up three months later, and 9.2% (n=28) of them reported that their daughters had been vaccinated. The knowledge of the HPV vaccine was good at 67%. However, uptake of the HPV vaccine was low in this study population despite providing them with additional information about the HPV vaccine. Higher levels of parental knowledge and older age were associated with a greater likelihood of HPV vaccine uptake. Innovative methods to reassure hesitant parents about HPV vaccination for their daughters are urgently needed in the Kenyan general population.