What factors were associated with human papillomavirus vaccine hesitancy among parents of adolescent girls? A mixed-methods study in Southwestern Nigeria.

Introduction: Vaccine hesitancy contributes to the dampened public enthusiasm for vaccination in several countries, including Nigeria. Human papillomavirus (HPV) vaccine acceptance is influenced by various factors; studies have examined some of these factors in sub-Saharan Africa, including Nigeria. This study aimed to examine HPV vaccine hesitancy and associated factors among parents of adolescent girls in Ibadan North East Local Government Area based on the WHO 3C model. Methods: A cross-sectional mixed-methods study was conducted, comprising four Focus Group Discussion sessions with parents and semistructured, interviewer-administered questionnaires, using a multistage sampling procedure to select 402 parents. Quantitative data were analysed using descriptive statistics, χ Results: The mean age of parents was 43.7±7.4 years, 66.9% were women, 50.7% identified as Christians and 95.0% belonged to the Yoruba ethnic group. Respondents were knowledgeable about HPV infection (51.5%) and HPV vaccine (64.7%); 61.4% had a positive attitude towards HPV vaccination. About 27.4% were hesitant to receive the HPV vaccine. The perceived necessity of vaccine (adjusted OR (AOR)=4.61, CI 1.14 to 18.72), trust in the efficacy of vaccines (OR=3.54, CI 1.09 to 11.51) and HPV vaccine safety (AOR=8.46, CI 2.73 to 26.18) had a higher influence on HPV vaccine hesitancy, while availability of the vaccine (AOR=0.23, CI 0.11 to 0.50) had a lesser influence. Conclusions: There was a significant level of HPV vaccine hesitancy among parents of adolescent girls, and associating factors included limited knowledge about HPV and its vaccine, as well as concerns about vaccine safety, vaccine necessity and vaccine availability. There is a need for targeted public health interventions that contribute to the prevention of HPV-related diseases.