Abstract 55: Exploring Heterogeneity in Determinants of Human Papillomavirus (HPV) Vaccination for Girls in Malawi

Abstract Purpose: Malawi has the second-highest burden of cervical cancer globally and introduced the HPV vaccine in 2019 using a school-based model among 9-year-old girls—but vaccine uptake remains suboptimal. To design effective programs for increasing HPV vaccine uptake, it is necessary to understand differences across different groups. We sought to identify differences in parent-level factors hypothesized to affect girls’ HPV vaccination status, in order to inform subsequent vaccination promotion interventions. Methods: A household survey was conducted from December 2022 to January 2023 in three districts of Malawi with parents of girls aged 9–13 years. The interviewer-administered survey explored factors hypothesized to influence their daughters’ HPV vaccination status across the domains of HPV vaccination knowledge, attitudes, trust, social factors, and access. We described and compared attitudes and knowledge about the HPV vaccine between different sociodemographic groups (e.g., gender, educational attainment, employment status). Results: A total of 299 parents completed the survey, and 39.0% reported their daughter(s) had received at least one dose of the HPV vaccine. Most parents agreed that vaccines are important and effective to protect their children’s health and stated more willingness to follow clinician recommendations for routine childhood vaccines than the HPV vaccine. We found some differences in vaccine attitudes by parent characteristic; for example, parents with secondary or higher education expressed more concerns about HPV vaccine safety and demonstrated lower HPV-related knowledge than their peers with less education (e.g., only 29.0% correctly identified that men can contract HPV compared to 67.3% of parents with no formal education); and women (79.4%) were more likely than men (63.2%) to report adherence to clinician recommendations for the HPV vaccine, as were unemployed parents (90.6%) compared to employed parents (74.4%). Conclusion: This analysis found differences in parent knowledge and attitudes toward HPV vaccination, based on education, gender, and employment status. Interestingly, highly educated parents expressed greater concerns about HPV vaccine safety and demonstrated lower HPV-related knowledge, suggesting that specific misinformation may be circulating within these communities. This highlights an important area for further investigation, as targeted interventions could improve HPV vaccine acceptance in Malawi. Citation Format: Priya Sarma, Pericles Kalande, Helen Liang, Tahira Abu, Symon Chibaka, Khumbo Phiri, Amos Makwaya, Risa M. Hoffman, Sam Phiri, Corrina Moucheraud. Exploring Heterogeneity in Determinants of Human Papillomavirus (HPV) Vaccination for Girls in Malawi [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 55.