Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey
Uptake of the human papillomavirus (HPV) vaccine is suboptimal globally. Effective interventions are needed to meet the global goal of vaccinating 90% of girls against HPV, and this requires a robust understanding of barriers to vaccine uptake. Using a household survey in three communities of Malawi...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Human Vaccines & Immunotherapeutics |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/21645515.2025.2485651 |
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| author | Corrina Moucheraud Pericles Kalande Symon Chibaka Khumbo Phiri Amos Makwaya Maame Duah Mei Li Muxin Liu Risa M. Hoffman Sam Phiri |
| author_facet | Corrina Moucheraud Pericles Kalande Symon Chibaka Khumbo Phiri Amos Makwaya Maame Duah Mei Li Muxin Liu Risa M. Hoffman Sam Phiri |
| author_sort | Corrina Moucheraud |
| collection | DOAJ |
| description | Uptake of the human papillomavirus (HPV) vaccine is suboptimal globally. Effective interventions are needed to meet the global goal of vaccinating 90% of girls against HPV, and this requires a robust understanding of barriers to vaccine uptake. Using a household survey in three communities of Malawi with parents/guardians of girls aged 9–13 years, we collected and analyzed data about intervention-amenable factors hypothesized to be associated with girls’ HPV vaccination status. The 299 parent/guardian respondents provided information on 382 girls aged 9–13 years, of whom 39.0% (n = 149) had received ≥ 1 dose of the HPV vaccine. More than half of parents/guardians were concerned about the HPV vaccine’s safety. Greater HPV vaccine hesitancy was associated with having an unvaccinated daughter in adjusted multilevel models (aOR 0.69 [95% CI 0.50–0.93]). Higher odds of being vaccinated were found among daughters of respondents with greater knowledge about the HPV vaccine and who knew someone who had cervical cancer. Speaking with more people about cervical cancer/HPV vaccination, and perceiving that other parents are vaccinating their daughters against HPV, were strongly associated with daughters’ HPV vaccination status (aOR 2.03 [95% CI 1.59–2.62] and 3.68 [95% CI 1.97–7.18, respectively). Most parents/guardians had not experienced, or did not anticipate experiencing, challenges accessing HPV vaccination services, but those who did also had daughters with lower odds of vaccination. Interventions that leverage social networks and norms, increase confidence in the vaccine’s safety, and work to improve access to HPV vaccination services, may increase coverage of the HPV vaccine in Malawi. |
| format | Article |
| id | doaj-art-57dc58eff915487bb9ecb535663a4f18 |
| institution | OA Journals |
| issn | 2164-5515 2164-554X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj-art-57dc58eff915487bb9ecb535663a4f182025-08-20T01:55:57ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2485651Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household surveyCorrina Moucheraud0Pericles Kalande1Symon Chibaka2Khumbo Phiri3Amos Makwaya4Maame Duah5Mei Li6Muxin Liu7Risa M. Hoffman8Sam Phiri9School of Global Public Health, New York University, New York, USAImplementation Science Department, Partners in Hope, Lilongwe, MalawiEnvironmental Education, Children in the Wilderness, Lilongwe, MalawiImplementation Science Department, Partners in Hope, Lilongwe, MalawiPartners in Hope, Lilongwe, MalawiSchool of Global Public Health, New York University, New York, USASchool of Global Public Health, New York University, New York, USASchool of Global Public Health, New York University, New York, USADavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, USAPartners in Hope, Lilongwe, MalawiUptake of the human papillomavirus (HPV) vaccine is suboptimal globally. Effective interventions are needed to meet the global goal of vaccinating 90% of girls against HPV, and this requires a robust understanding of barriers to vaccine uptake. Using a household survey in three communities of Malawi with parents/guardians of girls aged 9–13 years, we collected and analyzed data about intervention-amenable factors hypothesized to be associated with girls’ HPV vaccination status. The 299 parent/guardian respondents provided information on 382 girls aged 9–13 years, of whom 39.0% (n = 149) had received ≥ 1 dose of the HPV vaccine. More than half of parents/guardians were concerned about the HPV vaccine’s safety. Greater HPV vaccine hesitancy was associated with having an unvaccinated daughter in adjusted multilevel models (aOR 0.69 [95% CI 0.50–0.93]). Higher odds of being vaccinated were found among daughters of respondents with greater knowledge about the HPV vaccine and who knew someone who had cervical cancer. Speaking with more people about cervical cancer/HPV vaccination, and perceiving that other parents are vaccinating their daughters against HPV, were strongly associated with daughters’ HPV vaccination status (aOR 2.03 [95% CI 1.59–2.62] and 3.68 [95% CI 1.97–7.18, respectively). Most parents/guardians had not experienced, or did not anticipate experiencing, challenges accessing HPV vaccination services, but those who did also had daughters with lower odds of vaccination. Interventions that leverage social networks and norms, increase confidence in the vaccine’s safety, and work to improve access to HPV vaccination services, may increase coverage of the HPV vaccine in Malawi.https://www.tandfonline.com/doi/10.1080/21645515.2025.2485651HPV vaccinationglobal healthvaccine acceptabilityvaccine hesitancypublic healthMalawi |
| spellingShingle | Corrina Moucheraud Pericles Kalande Symon Chibaka Khumbo Phiri Amos Makwaya Maame Duah Mei Li Muxin Liu Risa M. Hoffman Sam Phiri Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey Human Vaccines & Immunotherapeutics HPV vaccination global health vaccine acceptability vaccine hesitancy public health Malawi |
| title | Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey |
| title_full | Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey |
| title_fullStr | Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey |
| title_full_unstemmed | Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey |
| title_short | Human papillomavirus vaccination in rural Malawi: Identifying factors associated with vaccine uptake using a community-based household survey |
| title_sort | human papillomavirus vaccination in rural malawi identifying factors associated with vaccine uptake using a community based household survey |
| topic | HPV vaccination global health vaccine acceptability vaccine hesitancy public health Malawi |
| url | https://www.tandfonline.com/doi/10.1080/21645515.2025.2485651 |
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