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Vaccines
Special Issues
Promoting HPV Vaccination in Diverse Populations
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Promoting HPV Vaccination in Diverse Populations

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Papillomavirus Vaccines".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 11875

Special Issue Editors

Prof. Dr. Celia Fisher

E-Mail Website
Guest Editor
Department of Psychology, Fordham University, New York, NY 10458, USA
Interests: vaccine hesitancy; COVID-19 pandemic; research ethics; health disparities; informed consent; vulnerable populations
Dr. Aaliyah Gray

E-Mail Website
Guest Editor Assistant
Department of Epidemiology, Florida International University, Miami, FL 33199, USA
Interests: vaccine hesitancy; health promotion; sexual and reproductive health; adolescent and women’s health; vulnerable populations

Special Issue Information

Dear Colleagues,

Human papillomavirus (HPV) infection is a well-established cause of cancer among women and men. HPV is responsible for nearly all cases of cervical cancer, which is the fourth most common type of cancer among women worldwide. It is estimated that 1 in every 100 women in developing countries will have cervical cancer before the age of 75. HPV infection also underlies a significant proportion of penile, anal, and head and neck cancers among men.

Primary prevention of HPV-related cancer is dependent on HPV vaccination of girls aged 9 to 15, and older adolescents and young adults up to the age of 26. A key goal of the 2020 Global Strategy to Accelerate the Elimination of Cervical Cancer is the complete vaccination against HPV of 90% of girls between the ages of 9 and 15 by the year 2030, as young girls are the primary target population of HPV vaccine programs worldwide. However, we are not on track to meet these goals. Only 60% of WHO member states have introduced the HPV vaccine, with a majority of these countries being located in the Americas and Europe. Furthermore, global HPV vaccination efforts have been reduced as a consequence of the COVID-19 pandemic. As such, improving HPV vaccination coverage in a variety of at-risk populations is a critical public health initiative for this goal.

This Special Issue seeks original research articles and reviews on HPV vaccination coverage and programs in diverse populations. We welcome research focused on groups underrepresented in HPV vaccine research including racial/ethnic minorities, adolescent males, sexual/gender minorities, vulnerable populations, and low- and middle-income countries. Topics of interest include, but are not limited to, the following:

  • Vaccine coverage in underrepresented populations;
  • HPV vaccination knowledge and awareness;
  • Multilevel facilitators and/or challenges to HPV vaccination and programs;
  • Impact of public health policy on HPV vaccination and programs;
  • Implementation and evaluation of HPV vaccination programs;
  • Cultural adaptations of evidence-based strategies to promote HPV vaccination;
  • Interventions and programs supporting HPV vaccine acceptance.

Prof. Dr. Celia Fisher
Guest Editor

Dr. Aaliyah Gray
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HPV vaccination
  • HPV prevention
  • vaccine uptake
  • HPV vaccine programs
  • evidence-based interventions
  • implementation science
  • health disparities

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Published Papers (8 papers)

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21 pages, 283 KiB  
Article
Understanding HPV Vaccine Initiation and Intention Among Central American Immigrant Parents in the United States: The Role of Vaccine Literacy and Healthcare Provider Recommendations
by Doris Lucero, Virginia A. Moreno, Denisse Delgado, Axel Hernandez Nieto, Nachalie Rodriguez-Cruz, Qun Le and Ana Cristina Lindsay
Vaccines 2025, 13(2), 130; https://doi.org/10.3390/vaccines13020130 - 27 Jan 2025
Viewed by 436
Abstract
Background/Objectives: The HPV vaccine is key to preventing HPV-related cancers, yet vaccination rates are low, particularly among immigrant and ethnic minority groups. This study explored factors influencing HPV vaccine initiation and intention among Central American immigrant parents in the U.S. Methods: [...] Read more.
Background/Objectives: The HPV vaccine is key to preventing HPV-related cancers, yet vaccination rates are low, particularly among immigrant and ethnic minority groups. This study explored factors influencing HPV vaccine initiation and intention among Central American immigrant parents in the U.S. Methods: A cross-sectional study with parents of children aged 11 to 17 years. Results: Among the 168 parents (53.8% mothers, 46.2% fathers) in this study, 20% reported that their children had initiated the HPV vaccine and 23% of parents of unvaccinated children intended to vaccinate within the next 12 months. Sociodemographic factors, including the parent’s gender and length of U.S. residence, were significant predictors of HPV vaccine initiation and intention. Higher vaccine literacy was also a key factor, with parents with higher vaccine literacy scores being more likely to initiate vaccination and express intent to vaccinate their children. HCP communication strongly predicted both vaccine initiation and intention, yet fewer than 30% of parents received HPV vaccine information from a HCP, and less than 28% received a vaccine recommendation. In the multiple logistic regression analysis, receiving HPV vaccine information from a HCP was the strongest predictor of vaccine initiation (AOR = 93.23, 95% CI = 14.50–599.63, p < 0.001), adjusting for other variables. For vaccination intention, significant predictors included the length of U.S. residence (AOR = 0.84, 95% CI = 0.75–0.95, p < 0.01), having a U.S.-born child (AOR = 10.47, 95% CI = 1.51–72.68, p < 0.05), and receiving vaccine recommendation from a HCP (AOR = 14.73, 95% CI = 1.77–122.32, p < 0.05). Conclusions: To improve vaccination rates, interventions should enhance HCP training, strengthen provider–patient communication, and address vaccine literacy through culturally tailored strategies and community engagement. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
13 pages, 233 KiB  
Article
Indonesian Mothers’ Experience of Their Daughter’s HPV Vaccination, and Factors Associated with Their Willingness to Recommend HPV Vaccination for Girls
by Setiyani Marta Dewi, Ariane Juliana Utomo, Linda Rae Bennett, Siswanto Agus Wilopo and Anna Barrett
Vaccines 2024, 12(9), 998; https://doi.org/10.3390/vaccines12090998 - 30 Aug 2024
Viewed by 1470
Abstract
In Indonesia, knowledge of parents’ experiences of their daughters’ HPV vaccination in school settings is limited. As Indonesia seeks to scale up its HPV vaccination program nationwide, parents’ perspectives hold important insights into how elements of the vaccination model can be sustained and [...] Read more.
In Indonesia, knowledge of parents’ experiences of their daughters’ HPV vaccination in school settings is limited. As Indonesia seeks to scale up its HPV vaccination program nationwide, parents’ perspectives hold important insights into how elements of the vaccination model can be sustained and improved. This study explored mothers’ experiences of their daughters’ HPV vaccination experiences, their knowledge of HPV risks and prevention, and factors associated with willingness to recommend HPV vaccination for girls. A cross-sectional online survey was conducted with 143 mothers of schoolgirls who had received HPV vaccination at schools in Yogyakarta and Jakarta. Multivariate logistic regression was used to assess factors associated with willingness to recommend HPV vaccination. Chi-square and independent t-tests were performed to assess relationships between variables. One-way ANOVA was used to test mean differences in knowledge scores among mothers with different education levels. Many respondents (62.4%) received key health information before their daughters’ HPV vaccination. Mothers’ average knowledge score was 6.07/10 (SD 2.35). Receiving satisfactory information was significantly associated with willingness to recommend HPV vaccination for girls to others. A significant association was found between mothers’ willingness to recommend HPV vaccination and having ever participated in cervical cancer screening themselves. Providing consistent health information that addresses the knowledge gaps and affirms the benefits and safety of HPV vaccines can improve the likelihood of mothers recommending HPV vaccination to others. The benefit of a synchronized approach to promoting primary and secondary prevention was supported by the findings. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
19 pages, 1383 KiB  
Article
Applying a Participatory Action Research Approach to Engage an Australian Culturally and Linguistically Diverse Community around Human Papillomavirus Vaccination: Lessons Learned
by Kathleen Prokopovich, Annette Braunack-Mayer, Jackie Street, Biljana Stanoevska, Leissa Pitts and Lyn Phillipson
Vaccines 2024, 12(9), 978; https://doi.org/10.3390/vaccines12090978 - 28 Aug 2024
Cited by 1 | Viewed by 811
Abstract
Globally, migrant and culturally and linguistically diverse (CALD) communities are known to have inequitable access to HPV vaccination. One participatory research approach used to engage CALD communities around vaccination is participatory action research (PAR), but we know little about the use of PAR [...] Read more.
Globally, migrant and culturally and linguistically diverse (CALD) communities are known to have inequitable access to HPV vaccination. One participatory research approach used to engage CALD communities around vaccination is participatory action research (PAR), but we know little about the use of PAR to engage priority migrant and CALD communities around school and HPV vaccination. To address this gap, we partnered with our local Multicultural Health Service to understand how the largest CALD group in our region of New South Wales, Australia, engages with their local school and HPV vaccination program. Through a long-standing PAR relationship, we used a participatory research method (World Café) approach to explore the level of awareness and engagement a multi-generational community member had concerning HPV vaccination. We acted by sharing a co-designed information website to answer the community’s questions about HPV vaccination. We then evaluated these engagements with surveys, focus groups and online analytic platforms. Last, we reflected with project partners and health service stakeholders on the overall project outcomes and shared our learnings. In our discussion, we shared our lessons learned and contributed to a wider conversation about the benefits, challenges, and practicalities of using PAR to engage a priority CALD community around HPV vaccination. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
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16 pages, 1206 KiB  
Article
“That Was an Eye Opener for Me”: Mixed-Methods Outcomes Educating Texas Community Health Workers on HPV Vaccination Using Project ECHO®
by Shaylen Foley, Ashleigh Flowers, Tralisa Hall, Matthew T. Jansen and Michelle Burcin
Vaccines 2024, 12(7), 806; https://doi.org/10.3390/vaccines12070806 - 20 Jul 2024
Viewed by 1181
Abstract
Human papillomavirus (HPV) is known to cause six different types of cancer. HPV vaccination can prevent over 90% of these cancers. Community health workers (CHWs) have the potential to drive HPV vaccination demand through education and navigation by addressing vaccine hesitancy and dis/misinformation [...] Read more.
Human papillomavirus (HPV) is known to cause six different types of cancer. HPV vaccination can prevent over 90% of these cancers. Community health workers (CHWs) have the potential to drive HPV vaccination demand through education and navigation by addressing vaccine hesitancy and dis/misinformation and by reaching non-English speaking, vulnerable, or rural populations. Despite their possible reach, there is limited research on HPV vaccination education programs for CHWs. In 2020–2021, the American Cancer Society (ACS) HPV Cancer Free Texas (HPVCFT) Project implemented the eight-session Mission: HPVCFT Vaccination ECHO–CHW Program ten times. This manuscript details the program’s implementation processes and outcomes. The program used the Project ECHO model and was offered in both English and Spanish. One hundred and forty-six Texan CHWs completed pre- and post-training surveys. The participants demonstrated significant HPV vaccination knowledge increases and desirable shifts in their foundational HPV vaccination beliefs, including the belief that the HPV vaccine is for cancer prevention. The participants also reported increased confidence in communicating about the HPV vaccine in the community. Improving knowledge, beliefs, and confidence in HPV vaccination is the first step in addressing concerns and increasing uptake. Future research and interventions are needed to better understand how CHWs can be more systematically linked to vaccination opportunities or provided with clearer paths for directing patients to providers that vaccinate. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
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16 pages, 274 KiB  
Article
Stakeholders’ Perceptions on the Implementation of the HPV Vaccine School-Entry Requirement in Puerto Rico during the COVID-19 Pandemic
by Coralia Vázquez-Otero, Diana T. Medina-Laabes, Derick Pérez-Guzmán, Olga L. Díaz-Miranda, Alondra K. Mercado-Andino, Erika I. Escabí-Wojna and Vivian Colón-López
Vaccines 2024, 12(7), 760; https://doi.org/10.3390/vaccines12070760 - 10 Jul 2024
Viewed by 1260
Abstract
This study explored the implementation of the human papillomavirus (HPV) vaccine school-entry requirement in Puerto Rico during the COVID-19 pandemic. We conducted 26 semi-structured interviews with stakeholders and community-based organizations from August 2021 to March 2022. The interview guide was developed using the [...] Read more.
This study explored the implementation of the human papillomavirus (HPV) vaccine school-entry requirement in Puerto Rico during the COVID-19 pandemic. We conducted 26 semi-structured interviews with stakeholders and community-based organizations from August 2021 to March 2022. The interview guide was developed using the 2009 Consolidated Framework for Implementation Research (CFIR). The interviews were recorded and transcribed in Spanish. Data were analyzed using applied thematic techniques. These themes included the following: (i) Intervention characteristics: Participants noted that the school-entry requirement was effective in increasing vaccination uptake prior to the pandemic. Issues with the immunization registry were noted; (ii) Outer setting: External influences, access barriers, and an increase in HPV vaccine exemptions since the implementation of the COVID-19 vaccine were discussed; (iii) Inner setting: Communication within organizations and HPV vaccination efforts improved as the pandemic progressed; (iv) Characteristics of individuals: Most agreed with the school-entry requirement, including exemptions; and (v) Process: Results showed the need to reinforce the population’s education about HPV and the vaccine. Implementation of the policy was challenging during the early stages of the pandemic due to measures enacted to stop the spread of COVID-19 and focus on the COVID-19 vaccine. Efforts to increase HPV vaccine should focus on increasing HPV vaccine education and creating collaborations. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
24 pages, 680 KiB  
Article
Healthcare Professionals’ Perspectives on HPV Recommendations: Themes of Interest to Different Population Groups and Strategies for Approaching Them
by Carlos Murciano-Gamborino, Javier Diez-Domingo and Jaime Fons-Martinez
Vaccines 2024, 12(7), 748; https://doi.org/10.3390/vaccines12070748 - 6 Jul 2024
Cited by 1 | Viewed by 2012
Abstract
As a flagship of the Europe’s Beating Cancer Plan, the European Commission supports EU member states’ efforts to strengthen and expand the routine vaccination of girls and boys against human papillomavirus (HPV). Populations across Europe have grown in diversity, and health systems must [...] Read more.
As a flagship of the Europe’s Beating Cancer Plan, the European Commission supports EU member states’ efforts to strengthen and expand the routine vaccination of girls and boys against human papillomavirus (HPV). Populations across Europe have grown in diversity, and health systems must adapt to meet the specific needs of increasing diversity. Healthcare professionals (HCPs) must strive to communicate HPV vaccine information in a culturally sensitive manner and address specific concerns related to cultural beliefs, trust in health systems and perceived risks. The objectives of this exploratory study are to identify which themes are most frequently raised during the recommendation of vaccination to minors based on the characteristics of the population (religion, region of origin, gender, level of education and language proficiency) and to collect strategies to improve communication with a diverse population. A survey was distributed through various European public health institutions to HCPs in the region and their networks. The survey included multi-response questions (themes addressed during vaccination recommendation based on population characteristics) and open-ended questions (own qualitative comments and strategies). The most common issues that arise during vaccine recommendation are a lack of knowledge, followed by misinformation. Differences were detected according to the population characteristics. Suggested strategies to improve HPV vaccine recommendation focused on the following aspects: affordability; sexuality and gender; communication platforms; multilingualism; quality of care; school collaboration. HCPs report differences according to the characteristics of the population receiving the recommendation. Personalisation of the recommendations would help to optimise the decision-making process for some groups. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
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15 pages, 271 KiB  
Article
Promoting Rural-Residing Parents’ Receptivity to HPV Vaccination: Targeting Messages and Mobile Clinic Implementation
by Carla L. Fisher, M. Devyn Mullis, Antionette McFarlane, Marta D. Hansen, Melissa J. Vilaro, Carma L. Bylund, Lori Wiggins, Halie Corbitt and Stephanie A. S. Staras
Vaccines 2024, 12(7), 712; https://doi.org/10.3390/vaccines12070712 - 26 Jun 2024
Viewed by 1534
Abstract
Interventions are needed to increase low HPV vaccination rates within rural areas in the United States, particularly in the state of Florida, which has the seventh highest number of HPV-related cancers. Florida also ranks low compared to other states in terms of HPV [...] Read more.
Interventions are needed to increase low HPV vaccination rates within rural areas in the United States, particularly in the state of Florida, which has the seventh highest number of HPV-related cancers. Florida also ranks low compared to other states in terms of HPV vaccination. Rural-residing parents may benefit from two evidence-based strategies to increase vaccination rates: reminder messages informing and prompting vaccination appointments and mobile clinics to reduce transportation barriers. We sought to identify parental attitudes towards (1) message features that promote rural-residing parents’ receptivity to HPV vaccination; (2) parents’ acceptability of three reminder message modalities (text, postcard, phone); and (3) implementation factors that promote parents’ acceptability of using a mobile clinic for vaccination. We recruited 28 rural-residing parents of 9- to 12-year-old children (unvaccinated for HPV) for focus group and individual interviews and thematically analyzed transcripts. Three features promoted parents’ receptivity to HPV vaccination messages: source credibility, specific information coverage, and personalization (name and birthday wishes). Parents most preferred text messages and identified three factors promoting parents’ mobile clinic use: convenience and feasibility, trustworthiness, and detailed information. The findings indicate rural-residing parents’ acceptability of reminder messages and mobile clinics as well as the importance of trust and feasibility when implementing these evidence-based strategies for rural-residing parents. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)

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9 pages, 191 KiB  
Opinion
Position Statement about Gender-Neutral HPV Vaccination in Korea
by Kyung-Jin Min, Yung-Taek Ouh, Sangrak Bae, Yong-Bae Ji, Jae-Kwan Lee, Jae-Weon Kim, Kwang-Jae Cho and Dong-Hun Im
Vaccines 2024, 12(10), 1110; https://doi.org/10.3390/vaccines12101110 - 27 Sep 2024
Viewed by 1236
Abstract
Given the rising incidence of human papillomavirus (HPV)-related diseases, including cervical, penile, and oropharyngeal cancers, particularly among men, the implementation of comprehensive HPV vaccination strategies is necessary in South Korea. This position statement advocates the introduction of gender-neutral vaccination (GNV) in the country. [...] Read more.
Given the rising incidence of human papillomavirus (HPV)-related diseases, including cervical, penile, and oropharyngeal cancers, particularly among men, the implementation of comprehensive HPV vaccination strategies is necessary in South Korea. This position statement advocates the introduction of gender-neutral vaccination (GNV) in the country. It recommends the administration of the HPV vaccine to both men and women aged 9–26 years to prevent a broad spectrum of HPV-related conditions. Specifically, individuals aged 9–14 years are advised to receive two doses of the vaccine, whereas those aged 15–26 years are advised to receive three doses. The optimal age for vaccination is identified as 11–12 years old. Additionally, this statement recommends that women aged 27 years and older be vaccinated based on the discretion of healthcare providers. The introduction of GNV is essential to curb the spread of HPV and reduce the overall burden of HPV-related cancers, making it a critical public health initiative in Korea. Full article
(This article belongs to the Special Issue Promoting HPV Vaccination in Diverse Populations)
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