Building HPV vaccine acceptance: Insights from a global Cochrane qualitative evidence synthesis
1
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
2
School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
3
Department of Global Health, Stellenbosch University, Cape Town, South Africa
4
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
5
School of Public Health, University of the Western Cape, Cape Town, South Africa
6
Equality Unit, Stellenbosch University, Cape Town, South Africa
7
South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South Africa
8
JBI Cameroon Centre for Evidence-Based Health Care, Yaounde, Cameroon
Popul. Med. 2026;8(Supplement Supplement 1):A3920
ABSTRACT
INTRODUCTION:
The human papillomavirus (HPV) vaccine is one of the most powerful tools in cancer prevention and central to global efforts to eliminate cervical cancer as a public health challenge. Yet worldwide many people are reluctant to receive the vaccine. To understand the drivers of HPV vaccine acceptance, we conducted a global Cochrane qualitative evidence synthesis of factors influencing caregivers’ and adolescents’ HPV vaccination views and practices1.
METHODS:
We used standard Cochrane methodologies for qualitative evidence synthesis. We searched MEDLINE, Embase, CINAHL, PsycInfo, Scopus until October 2024. We assessed study quality using an adapted Critical Appraisal Skills Programme tool; synthesised the evidence using thematic analysis; and assessed confidence in review findings using GRADE-CERQual.
RESULTS:
Of 206 studies included in the review, 71 were sampled for analysis. Studies came from diverse geographic and socioeconomic settings worldwide. Caregivers’ and adolescents’ HPV vaccination views and practices were found to be multifactorial, carrying complex social, political, economic, ideological and moral meanings. Factors include cultural norms and values about adolescence, sexuality and gender; complex familial dynamics and the often ambiguous and contestable role of caregivers in HPV vaccine decision-making; views and practices of wider social networks and communities; political issues and power relations, particularly the impact these have on (mis)trust of those associated with vaccination programmes; and supply and delivery logistics related to vaccine access, language, and the widespread feminization of vaccination programmes. We synthesised these findings to produce a new conceptual framework which provides a comprehensive understanding of the multidimensional, interacting factors shaping HPV vaccination acceptance.
CONCLUSIONS:
Our review provides insights into the complex social drivers of HPV vaccination, extending understanding beyond dominant individualistic and psychological theoretical models. These insights can be used to build acceptance of HPV vaccination in ways that are more socially resonant and inclusive, sustainable, and ultimately effective.
The human papillomavirus (HPV) vaccine is one of the most powerful tools in cancer prevention and central to global efforts to eliminate cervical cancer as a public health challenge. Yet worldwide many people are reluctant to receive the vaccine. To understand the drivers of HPV vaccine acceptance, we conducted a global Cochrane qualitative evidence synthesis of factors influencing caregivers’ and adolescents’ HPV vaccination views and practices1.
METHODS:
We used standard Cochrane methodologies for qualitative evidence synthesis. We searched MEDLINE, Embase, CINAHL, PsycInfo, Scopus until October 2024. We assessed study quality using an adapted Critical Appraisal Skills Programme tool; synthesised the evidence using thematic analysis; and assessed confidence in review findings using GRADE-CERQual.
RESULTS:
Of 206 studies included in the review, 71 were sampled for analysis. Studies came from diverse geographic and socioeconomic settings worldwide. Caregivers’ and adolescents’ HPV vaccination views and practices were found to be multifactorial, carrying complex social, political, economic, ideological and moral meanings. Factors include cultural norms and values about adolescence, sexuality and gender; complex familial dynamics and the often ambiguous and contestable role of caregivers in HPV vaccine decision-making; views and practices of wider social networks and communities; political issues and power relations, particularly the impact these have on (mis)trust of those associated with vaccination programmes; and supply and delivery logistics related to vaccine access, language, and the widespread feminization of vaccination programmes. We synthesised these findings to produce a new conceptual framework which provides a comprehensive understanding of the multidimensional, interacting factors shaping HPV vaccination acceptance.
CONCLUSIONS:
Our review provides insights into the complex social drivers of HPV vaccination, extending understanding beyond dominant individualistic and psychological theoretical models. These insights can be used to build acceptance of HPV vaccination in ways that are more socially resonant and inclusive, sustainable, and ultimately effective.
| eISSN: | 2654-1459 |
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