Factors Associated with HPV Vaccine Hesitancy and Uptake among Parents of adolescent girls in selected Nigerian settings: a cross-sectional study

Abstract

Following Nigeria’s October 2023 HPV vaccine rollout, real-world evidence regarding parental vaccination behavior remains limited. This cross-sectional study surveyed 640 parents of adolescent girls (9–14 years) across Edo, Delta, Lagos, and Abuja. Data were collected using a 32-item questionnaire assessing sociodemographic characteristics, HPV knowledge, vaccine uptake, and hesitancy (adapted from the WHO SAGE framework). Factors associated with uptake and hesitancy were analyzed using multivariable binary logistic regression. Vaccine uptake among daughters was 44.4% (284/640), while 65.6% of parents reported moderate-to-high hesitancy. Good parental HPV knowledge was independently associated with higher odds of uptake (AOR 2.58, p<.001). Conversely, hesitancy was associated with different factors: lower income (AOR 3.44, p<.001) and no formal education (AOR 3.61, p=.003) correlated with higher hesitancy odds, whereas residing in Delta (AOR 0.50, p=.047) or Lagos (AOR 0.52, p=.035) correlated with lower hesitancy odds compared to Abuja. Perceived safety barriers correlated strongly with overall hesitancy (rho=.906, p<.001). Post-rollout HPV vaccine uptake remains suboptimal. Because the correlates of actual uptake differ from those of hesitancy, interventions should combine general HPV education with targeted, safety-focused risk communication, particularly for lower-income households.