Knowledge and awareness of HPV vaccination uptake and recommendations in gulf cooperation council countries 2009-2025: a systematic review.

Cervical cancer, largely caused by persistent infection with human papillomavirus (HPV), remains a preventable disease through timely vaccination. However, in the Gulf Cooperation Council (GCC) countries, the uptake of the HPV vaccine has been inconsistent, and public knowledge remains limited. This systematic review aims to synthesise available evidence on HPV vaccine awareness, uptake, barriers, enablers, and recommendations in the GCC region.Methods A systematic search of peer-reviewed literature was conducted across major databases to identify studies published till March 2025. Eligible studies included cross-sectional, quasi-experimental, and descriptive studies reporting on HPV-related knowledge, attitudes, vaccine uptake, barriers, enablers, and recommendations in the six GCC countries. Data were extracted and synthesised thematically. The screening process followed PRISMA guidelines, and 52 studies were included in the final analysis.Results The study included 52 articles. While awareness of cervical cancer was moderate to high in several studies, knowledge of HPV infection and the HPV vaccine was generally low. Actual vaccine uptake rates were poor across all countries, with most reporting rates below 10%, except for Abu Dhabi, which reported the highest uptake (> 95%) through its school-based programme. Key barriers included lack of knowledge, safety concerns, cultural and religious beliefs, cost, and the absence of national immunisation programmes. Enablers included personal willingness, trust in healthcare providers, prior health education, and availability of free vaccination. The studies recommended urgent policy change across GCC countries to incorporate the HPV vaccine into national vaccination programmes.Conclusion Despite the established link between HPV and cervical cancer, vaccine uptake remains low across the GCC due to persistent knowledge gaps, sociocultural barriers, and systemic limitations. This review highlights the urgent need for coordinated public health strategies that prioritise education, equitable access, and national policy integration.