Navigating stigma, faith, and fear: understanding HPV vaccine acceptance among adolescent girls in rural parts of Central Ethiopia

Cervical cancer is a leading cause of mortality among women in Ethiopia, particularly in rural areas where sociocultural and religious norms significantly influence health behaviour. Despite the inclusion of the HPV vaccine in the national immunisation program, uptake among adolescent girls remains low. This study explored sociocultural and religious factors that shape vaccine acceptance among adolescent girls in rural Ethiopia. Data were collected through in-depth interviews, key informant interviews, and focus group discussions with adolescent girls (vaccinated and unvaccinated), parents, public health workers, and community leaders in Gurage and Hadiya zones. Thematic analysis was conducted. Five key themes were developed: (1) limited knowledge and awareness; (2) cultural stigma surrounding reproductive health; (3) religious resistance to biomedical interventions; (4) parental and community influence; and (5) fear of vaccine-related side effects such as infertility. Parental and community influence appeared to both facilitate and discourage vaccine acceptance, while lack of knowledge and awareness, cultural stigma, and fear of vaccine-related side effects acted as discouragers. HPV vaccine acceptance in rural Ethiopia is shaped by complex social, cultura and religious factors. Interventions must go beyond awareness campaigns to include community engagement, religious leader advocacy, and parental education to improve vaccine uptake.