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. 2022 Nov 30;18(5):2045856.
doi: 10.1080/21645515.2022.2045856. Epub 2022 Mar 3.

Adolescent girls' recommendations for the design of a human papillomavirus vaccination program in Sindh, Pakistan: a qualitative study

Rozina Feroz Ali  1 , Danya Arif Siddiqi  2 , Amna Mirza  1 , Nowshaba Naz  1 , Sara Abdullah  1 , Gayatri Kembhavi  3 , Clarence C Tam  4 , Vittoria Offeddu  2 , Subhash Chandir  1   2
Affiliations

Adolescent girls' recommendations for the design of a human papillomavirus vaccination program in Sindh, Pakistan: a qualitative study

Rozina Feroz Ali et al. Hum Vaccin Immunother. .

Abstract

Purpose: Vaccination of adolescent girls against human papillomavirus (HPV) significantly reduces the incidence of cervical cancer. HPV vaccines are available in Pakistan but plans to develop HPV vaccination program are at a nascent stage. We conducted a formative study to explore adolescent girls' knowledge and perspectives on HPV and cervical cancer and collect their recommendations for implementing an HPV vaccination program in their community.

Methods: Using qualitative exploratory study design, we conducted four focus group discussions (FGDs) with 12 adolescent girls per group in District West, Karachi. We recruited unmarried girls aged 16-19 years from schools and community settings between May-December 2020. Data analysis was done using NVivo.

Results: Overall, participants displayed a positive attitude toward HPV vaccine. However, they were unfamiliar with basic concepts related to female reproductive health. Female relatives were indicated as girls' preferred point of contact for discussions on HPV and cervical cancer, but fathers were portrayed as decision-making authority on vaccination. Participants indicated vaccine hesitancy among parents may affect HPV vaccination uptake. Girls suggested individual household visits and community-based camps as strategies for successful implementation of HPV vaccination program. A solid foundation of trust between girls' families, program managers, and other stakeholders emerged as a key asset for the program's success.

Conclusion: Adolescent girls' suggestions of informing key decision-makers in the family (particularly fathers) of the benefits of HPV vaccination, establishing trust with vaccine providers, and increasing accessibility of vaccinations should be explored for successful implementation of an HPV vaccination program in Pakistan.

Keywords: HPV; Human papilloma virus; adolescents; cervical cancer; vaccination programs; vaccine hesitancy.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Participant recruitment chart between September and December 2020, recruitment was conducted at two secondary schools and through household visits in District West, Karachi. Unmarried girls aged 16 to 19 years were included. FGD= Focus group discussion.
Figure 2.
Figure 2.
Fueling and mitigating factors for vaccine hesitancy and refusal.
Figure 3.
Figure 3.
Participant suggestions for implementation of a HPV vaccination program.
See this image and copyright information in PMC

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