North-South Disparities in Human Papillomavirus Vaccine Uptake and Willingness among Female Secondary School Students in Nigeria: Evidence from Ekiti and Gombe States

Background: Cervical cancer remains a major public health concern, especially in low- and middle-income countries like Nigeria, where it is the second leading cause of cancer-related deaths among women. The disease is mainly caused by the Human Papillomavirus (HPV), and vaccination of girls aged 9–14 years is strongly recommended by the World Health Organization as an effective preventive measure. However, despite the vaccine’s proven safety and effectiveness, uptake in Nigeria is still low. This study assessed HPV vaccine uptake, willingness, and predictors among female secondary school students in Ekiti and Gombe States.Material and methods: A comparative cross-sectional study was conducted among 576 female secondary school students selected through multistage sampling. Data was collected using semi-structured, interviewer-administered electronic questionnaires and analysed using SPSS version 26. Chi-square tests was used to test for associations, while binary logistic regression identified predictors of uptake. Statistical significance was set at p < 0.05.Results: Overall HPV vaccine uptake was low at 83 (14.4%), with slightly higher uptake in Ekiti at 45 (15.6%) compared to Gombe at 38 (13.2%), but this was not statistically significant (p= 0.406). Willingness to receive the vaccine was relatively high, with 219 (76%) in Ekiti and 197 (68.4%) in Gombe, with a significant difference between the states (p < 0.001). In multivariate analysis, only knowledge (AOR = 9.027), age of respondents (AOR = 6.782), and perception (AOR = 2.036) emerged as predictors of uptake.Conclusion: Despite high willingness, HPV vaccine uptake among respondents was low. Knowledge, perception, and age were key determinants. Strengthening school-based health education and expanding access through school vaccination programs are essential in improving uptake and reducing cervical cancer burden in Nigeria.