dc.description.abstract |
The development of Human Papillomavirus (HPV) vaccines provides new opportunities in the fight against cervical cancer.
Many acceptability studies have revealed high interest in these vaccines, but acceptance is only a precursor of behavior, and
many factors, at personal, community and provider level, may inhibit the translation of willingness to vaccinate into actual
uptake. Through a longitudinal study in Eldoret, Kenya, HPV vaccine acceptability was measured before a vaccination
program (n = 287) and vaccine uptake, as reported by mothers, once the program was finished (n = 256). In between
baseline and follow-up, a pilot HPV vaccination program was implemented via the GARDASIL Access Program, in which
parents could have their daughter vaccinated for free at the referral hospital. The program was promoted at schools: Health
staff informed teachers who were then asked to inform students and parents. Even though baseline acceptance was very
high (88.1%), only 31.1% of the women reported at follow-up that their daughter had been vaccinated. The vaccine was
declined by 17.7%, while another 51.2% had wanted the vaccination but were obstructed by practical barriers. Being well-
informed about the program and baseline awareness of cervical cancer were independently associated with vaccine uptake,
while baseline acceptance was correlated in bivariate analysis. Side effects were of great concern, even among those whose
daughter was vaccinated. Possible partner disapproval lowered acceptance at baseline, and women indeed reported at
follow-up that they had encountered his opposition. In Kenya, women prove to be very willing to have their daughter
vaccinated against cervical cancer. However, in this study, uptake was more determined by program awareness than by HPV
vaccine acceptance. School-based vaccination might improve coverage since it reduces operational problems for parents. In
addition, future HPV vaccination campaigns should address concerns about side effects, targeting men and women, given
both their involvement in HPV vaccination decision-making |
en_US |