Cultural and structural barriers to HPV vaccine acceptance among young women in the United Arab Emirates

BACKGROUND: Human papillomavirus (HPV) is a common sexually transmitted virus, and oncogenic genotypes are linked to cervical cancer. Vaccination reduces cervical cancer burden, yet uptake remains suboptimal in the United Arab Emirates (UAE) despite national immunisation initiatives. This exploratory study aimed to identify and characterize potential cultural and structural barriers that may impede vaccine uptake among educated, digitally connected women in the UAE to inform future, more representative research. METHODS: A cross-sectional, descriptive study surveyed 1455 women aged 18-30 years across all emirates regarding vaccination status, cultural beliefs, and institutional factors influencing vaccine acceptance and uptake. RESULTS: The participants were predominantly educated, non-Emirati, digitally connected young women (mean age 22.4 years, 77.7% non-Emirati, 44.8% healthcare-affiliated). While 58.8% respondents viewed vaccination as culturally acceptable, only 26.2% admitted to being vaccinated. The most commonly reported barriers to vaccination included concerns about side effects, feeling too young for vaccination, and fear of family judgment (47.5%, 28.4%, 27.8%, respectively). The most reported reason for receiving the vaccine was its inclusion in the immunisation schedule (37.9%), followed by parental consent and encouragement (36.6%), and for self-protection purposes (25.6%). Furthermore, acceptance increased when the vaccine was presented as a cancer prevention strategy (64.6%), offered at more convenient location (63.8%) or made more affordable (61.5%). CONCLUSION: Overall, the primary barriers to vaccination included concerns regarding the fear of public judgment, reflecting a combination of informational gaps, timing-related considerations, and sociocultural influences affecting HPV vaccine uptake. Future research employing representative sampling is needed to determine whether these barriers generalize to broader UAE populations including non-digitally connected, non-healthcare workers, and Emirati women. Once population level barriers are identified through representative research, public health strategies can be designed to address context-appropriate concerns through targeted education on vaccine safety and culturally sensitive engagement with families and young women to improve uptake.