Bulletin of the World Health Organization

Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries

D Scott LaMontagne, Sandhya Barge, Nga Thi Le, Emmanuel Mugisha, Mary E Penny, Sanjay Gandhi, Amynah Janmohamed, Edward Kumakech, N Rocio Mosqueira, Nghi Quy Nguyen, Proma Paul, Yuxiao Tang, Tran Hung Minh, Bella Patel Uttekar & Aisha O Jumaan

Volume 89, Number 11, November 2011, 821-830B

Table 4. Parents’ and guardians’ reasons for accepting or not accepting human papillomavirus (HPV) vaccination, India, Peru, Uganda and Viet Nam, 2008–2010

Vaccine delivery strategy Peru
Uganda
Viet Nam
India
School-based
School-based
Combined with Child Days Plus programme
School-based
Health-centre-based
School- and health-centre-based, pulsed campaign at three time points
School- and health-centre-based, monthly delivery
2008 2008 2009 2008–2009 2009 2008–2009 2009–2010 2008–2009 2009–2010 2009–2010 2009–2010
Survey respondents, no. 575 400 280 361 448 500 285 280 219 1948 1973
Reason for accepting full
vaccinationa,b
Responses, no. 475 362 249 190 272 415 274 263 216 1617 1487
Protection against cervical cancer, no. (%) 369 (78) 248 (69) 152 (61) 104 (55) 143 (53) 203 (49) 118 (43) 116 (44) 111 (51) 859 (53) 649 (44)
Prevention of disease or infection, no. (%) 13 (3) 203 (56) 109 (44) 107 (56) 144 (53) 217 (52) 208 (76) 137 (52) 144 (67) 307 (19) 176 (12)
Vaccines thought good for health or wanted girl to be healthy, no. (%) 20 (4) 218 (60) 138 (55) 124 (65) 154 (57) 199 (48) 117 (43) 111 (42) 96 (44) 696 (43) 520 (35)
Any of the three reasons above, no. (%) 388 (82) 294 (81) 210 (84) 180 (95) 228 (84) 380 (92) 253 (92) 241 (92) 203 (94) 1530 (95) 1010 (68)
Other reasons for accepting full vaccination, no. (%)
Government programme 3 (< 1) 66 (18) 51 (21) 13 (7) 56 (21) 81 (20) 79 (29) 31 (12) 69 (32) 11 (< 1) 97 (7)
Vaccine is free 129 (27) 8 (2) 7 (3) 22 (12) 19 (7) 53 (13) 38 (14) 36 (14) 31 (14) 59 (4) 163 (11)
Followed others’ advice 81 (17) 85 (23) 15 (6) 43 (23) 81 (30) 151 (36) 77 (28) 8 (3) 41 (19) 273 (17) 772 (52)
Information was convincing 85 (18) 0 0 0 0 0 0 0 0 0 0
School was providing it to every child 11 (2) 0 0 0 0 0 0 0 0 28 (2) 348 (23)
Fear of cancer NA NA 61 (24) NA 80 (29) 0 0 0 0 0 0
Knows someone who had cervical cancer 0 18 (5) 26 (10) 10 (5) 12 (4) 16 (4) 0 10 (4) 0 0 5 (< 1)
Reason for partial or non-vaccinationa
Responses, no. 100 38 31 171 176 85 11 17 3 331 486
School absenteeism, no. (%) 21 (21) 23 (61) 29 (94) 64 (37) 73 (41) 14 (17) 3 (27) 2 (12) 1 (33) 60 (18) 86 (18)
Programme-related issues, no. (%)
Was not aware of the programme 9 (9) 3 (8) 3 (10) 50 (29) 41 (23) 5 (6) 0 2 (12) 0 99 (30) 195 (40)
Eligibility was difficult to determine 4 (4) 0 0 59 (35) 30 (17) 2 (2) 0 5 (29) 0 7 (2) 16 (3)
Vaccine-related issues, no. (%)
Concerns about safety 7 (7) 0 1 (3) 3 (2) 10 (6) 28 (33) 5 (45) 1 (6) 0 23 (7) 17 (3)
Vaccine is new 0 0 0 0 0 13 (15) 0 2 (12) 0 0 0
Vaccine is experimental 26 (26) 1 (3) 0 0 0 4 (5) 0 3 (18) 0 0 0
Impact on fertility 1 (1) 0 1 (3) 1 (< 1) 1 (< 1) 10 (12) 0 0 0 0 1 (< 1)
Insufficient information about the vaccine 5 (5) 0 0 0 0 0 0 0 0 0 0
Fear of injections 8 (8) 0 0 0 0 0 0 0 0 7 (2) 52 (11)
Do not believe vaccine is good for health 0 0 0 0 0 27 (32) 2 (18) 1 (6) 0 12 (4) 4 (1)
Allergic to vaccines 23 (23) 0 0 0 0 0 0 0 0 0 0
Followed the advice of others 20 (20) 0 0 0 0 0 0 0 0 0 0
Vaccine encourages early sexual activity 0 0 0 0 0 0 0 0 0 0 0

NA, not available.

a More than one response was allowed. Only the most frequently reported responses are presented and non-responses are not included. As a result, totals may not add to 100% of all responses.

b Full vaccination was defined as the receipt of all three vaccine doses.