Human Papillomavirus Vaccine Uptake and Its Associated Factors among Adolescent Girls in Kaduna North LGA, Nigeria: A Mixed-Methods Study

Abstract

Introduction: Cervical cancer, primarily attributed to persistent human papillomavirus (HPV), remains a critical public health concern globally, particularly in low- and middle-income countries like Nigeria. Despite the availability of an effective vaccine and its integration into the national immunization program, uptake continues to be low in Nigeria. Therefore, this study was designed to assess HPV vaccine uptake and its associated factors among adolescent school girls in Kaduna North LGA.

Methods: A mixed-methods cross-sectional study design was employed, targeting adolescent girls aged 10–19 years enrolled in public and private secondary schools within Kaduna North LGA. Using a multistage sampling approach, 418 respondents were systematically selected. Data, collected through a structured, pre-tested electronic questionnaire, were analyzed using SPSS version 25 and thematic content analysis.

Results: The results revealed that while 65.1% of respondents reported having heard of HPV, only 42.3% had adequate knowledge of the virus and its vaccine. Alarmingly, only 7.5% of the respondents had received at least one dose of the HPV vaccine. Bivariate analysis showed statistically significant associations between vaccine uptake and parental willingness to vaccinate, awareness of the vaccine's existence, cultural attitudes toward vaccination, and prior awareness of HPV-related health risks. Multivariate logistic regression confirmed these factors as independent predictors of uptake. The primary barriers to vaccination identified included misinformation, fear of adverse effects, parental disapproval, sociocultural misconceptions, and inadequate access to vaccination points. Qualitative data provided further insights into community perceptions, suggesting that mistrust of the health system, religious myths, and inadequate engagement with school authorities were major deterrents.

Conclusion: This study concludes that HPV vaccine uptake among adolescent school girls in Kaduna North LGA is significantly low and recommends multi-pronged strategies, including community-based sensitization, religious and parental engagement, school-based vaccination drives, and consistent communication through trusted channels. These measures are essential for improving coverage and contributing to cervical cancer prevention and eventual elimination.