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. 2025 Sep 4;13(9):948.
doi: 10.3390/vaccines13090948.

Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia

Jacqueline Yap  1 , Fauzi Budi Satria  2 , Ivana Alona  2 , Indo Mora Siregar  2 , Shu Chen  3   4 , Chee Fu Yung  5   6   7 , Courtney Davis  5   6   7 , Inke Nadia Diniyanti Lubis  2 , Shenglan Tang  4   7
Affiliations

Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia

Jacqueline Yap et al. Vaccines (Basel). .

Abstract

Background: Indonesia launched a nationwide school-based HPV immunization program in August 2023. Despite this, regional disparities in vaccine uptake persist. Therefore, we undertook a study in North Sumatra Province to assess HPV vaccination coverage and analyze the main factors affecting the uptake of HPV vaccination.

Methods: This study employed a mixed-methods approach and was carried out in Medan and Deli Serdang of North Sumatra Province. Quantitative data were used to examine HPV coverage rates among school-aged girls in 2024, while qualitative interviews with parents, teachers, and health officers explored administrative, social, and behavioral barriers and facilitators.

Results: In 2024, HPV vaccine coverage in Deli Serdang reached 62.09%, while Kota Medan lagged behind at just 27.20%. High-coverage schools in the Galang subdistrict benefited from proactive engagement between Puskesmas (community health clinics) and parents. In contrast, lower-coverage areas experienced logistical and communication challenges. Parents expressed a preference for face-to-face communication over written consent forms and emphasized the importance of clear, empathetic messaging.

Conclusions: The stark contrast in coverage-particularly the low uptake in urban Kota Medan-highlights the need for more responsive and localized implementation strategies. Strengthening direct communication, addressing administrative inefficiencies, and fostering trust through tailored community engagement are critical. These findings suggest a need for targeted improvements in urban settings and further research across diverse regions to inform policy development and strategies for improved coverage of HPV vaccinations.

Keywords: human papillomavirus vaccines; influencing factors; vaccine coverage.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of schools interviewed in the Deli Serdang and Medan districts, their respective sub-districts, and affiliations.
Figure 2
Figure 2
Factors influencing parental decision-making.
See this image and copyright information in PMC

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