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Abstract
Previous research on human papillomavirus (HPV) vaccine acceptance has focused largely on parental acceptability. Adolescents are the target population and adolescence is a phase associated with increased independence. Understanding adolescents' perspectives regarding vaccine acceptance is therefore critically important. Objective: This paper presents young adolescent girls' perspectives on acceptability of HPV vaccine after a two-year demonstration project. Methods: We explored acceptability of HPV vaccine among girls aged 10 to 15 years during 2008 and 2009. Acceptability was qualitatively defined as the girls' willingness or reluctance to be vaccinated and to complete all three doses. Twenty-seven focus group discussions were conducted with girls who completed all three doses and 17 with those who did not. Girls were purposively sampled from areas where vaccine uptake was either high (greater than 90%) or low (less than 70%). Results: Girls independently made decisions and took actions that resulted in their vaccination or non-vaccination. Key influencers of their' acceptability were: their understanding of cancer, concerns about their future as mothers; understanding of the vaccinations; fears of the consequences of being vaccinated or not; their experiences with the first dose; and their understanding of the eligibility criteria for vaccination. Conclusion: Adolescents demonstrate an independent ability in deciding to be vaccinated or not. As this group is the suggested population to receive this vaccine, preparing them for vaccination becomes critical in helping them make informed decisions. Adequate preparation can foster acceptance of HPV vaccine among girls and eventually influence the success of a national HPV vaccination program.
Keywords: Human papillomavirus, HPV vaccine, acceptability, adolescents, girls
Introduction
Cervical cancer is the third most common cancer in women globally, with an estimated 530,000 new cases in 2008. It is the second most frequent cancer in women between 15 and 44 years of age in developing countries. High-risk regions include Eastern and Western Africa, where the age-standardized rate (ASR) is greater than 30 per 100,000 and it remains the most common cancer in women in Eastern Africa (1).
In Uganda, cervical cancer is the most frequent cancer among women (1). Current estimates indicate that every year 3,577 women are diagnosed with cervical cancer and 2,464 die from the disease. Approximately 74% of invasive cervical cancers are attributed to human papillomavirus (HPV) types 16 and...