Predictors of willingness of HPV vaccine uptake across Eight States in Nigeria
Background
The Nigerian Federal Government planned to launch the Human Papillomavirus (HPV) vaccine on September 25, 2023. We therefore aimed to assess caregiver awareness and willingness regarding HPV vaccine uptake for girls aged 9–14 across eight states (Abia, Adamawa, Bayelsa, Benue, Enugu, FCT, Jigawa, and Taraba), evaluating public readiness for the vaccine rollout.
Methods
A cross-sectional telephone survey was conducted in the eight states using a structured questionnaire. Stratified random sampling was employed to ensure representation from each state’s three senatorial districts. Adult participants’ socio-demographic characteristics—including their relationship to the child, gender, settlement type (rural/urban), and age group—were analyzed. Local Government Area and Senatorial Zone were used solely for geographical representation. Awareness, perceived severity, susceptibility, and willingness for HPV vaccine uptake were calculated based on questionnaire responses. Descriptive statistics, correlation analyses, ordinal and linear regression, and mediation regression were applied to derive results.
Results
Our findings indicated low general HPV awareness but high willingness for vaccine uptake among caregivers. Northern states exhibited higher awareness, perceived severity, susceptibility, and willingness compared to Southern states. Significant differences emerged across states in awareness and willingness, with positive correlations observed among awareness, severity, susceptibility, and willingness. Multiple linear regression revealed that awareness does not directly predict willingness, while mediation regression demonstrated that awareness indirectly influences willingness through severity and susceptibility. The study’s implications were analyzed using the Health Belief Model (HBM).
Conclusion
Our survey found geopolitical disparities in HPV awareness and willingness across Nigeria. Future interventions should prioritize emphasizing the severity and susceptibility of HPV-related diseases, particularly in low-resource settings. Providing accurate information from trusted sources and addressing misconceptions through evidence-based strategies can enhance informed decision-making regarding HPV vaccination.
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