Understanding the roots of hesitancy to unlock the game-changing impact of HPV vaccination: Insights from a global qualitative evidence synthesis.

چکیده اصلی

The human papillomavirus (HPV) vaccine is one of the most powerful tools in cancer prevention and is central to global efforts to eliminate cervical cancer as a public health problem. Yet worldwide uptake remains suboptimal. Our 2025 Cochrane qualitative evidence synthesis - comprising 71 studies from diverse geographic and socioeconomic settings - provides the most comprehensive global understanding to date of caregivers' and adolescents' views and practices regarding HPV vaccination, and the reasons why some are reluctant to receive the vaccine. Our review found HPV vaccine decision-making to be influenced by a complex web of socio-cultural, political and trust-related factors, beyond awareness or a simple evaluation of vaccine benefits and risks. We synthesized these factors into eight overarching themes. Together these provide a novel conceptual framework of the multi-level, interacting influencing factors, distinguishing it from more narrow, individual HPV vaccination acceptance frameworks. In this commentary we describe this conceptual framework and propose how it might be used to inform strategies for improving HPV vaccine uptake in ways that are more person-centered, equitable and ultimately effective. As countries worldwide aim to upscale and optimize HPV vaccination programs, incorporating insights from this review into HPV vaccination policy, program design and service delivery is essential and urgent.

متن کامل اصلی