Human papillomavirus (HPV) is the most common sexually transmitted infection, globally. Most HPV infections cause no symptoms and will resolve spontaneously within a couple of years. Over 200 types have been identified, with two high-risk strains in particular causing up to 70% of cervical cancers. Globally the fourth most common cancer in women, there were over 660,000 new cases of cervical cancer in 2022 and around 350 000 deaths in the same year. Over 90% of these deaths occurred in low- and middle- income countries, reflecting major inequities driven by lack of access to national HPV vaccination, cervical screening and treatment services. 

Prophylactic vaccination against HPV of adolescent girls in particular is extremely effective and the 6 vaccines available, all of which protect against the high-risk strains HPV-16 and HPV-18, have been shown to be safe and effective in preventing HPV infection and cervical cancer. As of 2023, over 140 countries have introduced the HPV vaccine into national immunisation programmes and excellent progress in reducing rates of HPV infection in young women has been seen; Australia is on target to be among the first countries in the world to eliminate cervical cancer, and hope to do so in the next decade.

Despite the availability of effective vaccines, several challenges hinder widespread vaccination efforts, including a lack of public awareness and vaccine hesitancy. Several studies published in Reproductive Health have aimed to investigate the reasons behind lack of vaccination. One such country that lacks a national vaccination campaign for HPV is Lebanon. Elissa et al. show that parents lack knowledge about the majority of statements about HPV infection and the HPV vaccine. 37% of surveyed mothers were unwilling or uncertain about immunising their child against HPV, with almost 20% only willing to vaccinate their children if it were free, highlighting cost as a factor in decision making. 

Similarly, Dera et al. surveyed female students at a school in Ethiopia and found that whilst almost all of the girls were aware of HPV and the associated vaccine, almost 40% did not intend to receive the vaccine with fears of major adverse effects a common reason for refusal. An additional study surveying parents of eligible girls revealed most had strong concerns over allowing their child to be vaccinated, with misinformation within the community a prevalent reason. 

These studies emphasise that the HPV vaccine programmes, with the help of the appropriate health care professionals, should work hard to maximise community awareness in order to significantly increase the uptake of the HPV vaccine. This is supported by a cross-sectional study by Olubodun et al. which found that whilst all 1012 respondents had heard of the vaccine, 82% had only learned of it during a 5-day HPV immunisation campaign in Ogun State, Nigeria. All the respondents had a positive attitude towards HPV vaccination, although 94.1% had heard messages discouraging people from vaccinating their wards, indicating the need for comprehensive messaging from trusted sources. Check out the accompanying blog post here.

By tackling these barriers through education, healthcare provider engagement, and supportive policies, we can enhance HPV vaccination rates and reduce the burden of HPV-related diseases worldwide.