Determinants of HPV vaccine hesitancy among parents attending Kenyatta National Hospital outpatient clinics.

Abstract

Background: Cervical cancer is mainly caused by the oncogenic Human Papilloma Virus (HPV) infection which is prevented among pre-adolescent girls by prophylactic administration of the HPV vaccine prior to sexual debut. Kenya has recently rolled out the HPV vaccine in the national routine Immunization initiative. There are concerns that parents may be hesitant about taking their children for vaccination. Objective: The purpose of this study was to identify the prevalence, reasons and risk factors for HPV vaccination hesitancy among parents attending Kenyatta National Hospital (KNH) outpatient clinics. Methods: A prospective descriptive cross-sectional study was conducted in the Kenyatta National Hospital Medical clinics in the year 2020. The study participants included both male and female patients who were parents of adolescents. Participants were selected using quasi random sampling approach. Data collection was done using a structured questionnaire that was administered by face-to-face interviews. Data that was collected included participants’ socio-demographic, their knowledge and beliefs about the HPV vaccine as well as their reasons for vaccination acceptance. STATA 13 was used to analyze the data. Descriptive, inferential statistics and logistic regression analyses were done. The levels of significance were set at 0.05. Results: Cumulatively, 93.5% of the 195 parents recruited into the study were aged above 30 years. The largest age group were those aged above 40 years. Despite low knowledge levels about the HPV vaccine, and a high prevalence of negative beliefs (30%), parental willingness was high with 90% willing to have their children vaccinated. The main reasons given for hesitancy to have their children vaccinated were safety concerns (76%) and the feeling that the child was too young (48%). Positive beliefs, knowledge score and gender were positively associated with willingness to have the child vaccine. High education attainment was negatively associated and increasing age were negatively associated with willingness to have the child vaccinated. Male parents had lower levels of knowledge about the HPV infection, cervical cancer and the HPV vaccine compared to their female counter parts. The most widely cited source of information on HPV vaccine was fellow workers in the work place followed by the television. Education status was positively associated knowledge levels. The beliefs on the HPV vaccine were noted to be average. More females than males believe the vaccine is effective. Beliefs were positively influenced by knowledge and occupation. We found that 59% of parents would consult their daughters before initiating the vaccination process and 77% recommended adolescents sex education. Conclusion: Gender neutral interventions should be encouraged. Interventions that simultaneously involve both adolescents and parents should be designed and disseminated.