Acceptability of HPV vaccine implementation among parents in India
Open accessAbstract
Due to high cervical cancer rates and limited research on human papillomavirus (HPV) vaccine acceptability in India, the research team examined parental attitudes toward HPV vaccines. Thirty-six interviews with parents were conducted to assess sexually transmitted infection (STI)-related knowledge and HPV-specific vaccine awareness and acceptability. Despite limited knowledge, parents had positive views toward HPV vaccines. Common barriers included concerns about side effects, vaccine cost, and missing work to receive the vaccine. Parents were strongly influenced by health care providers' recommendations. Our findings suggest that addressing parental concerns, health worker training and polices, and efforts to minimize cost will be central to successful HPV vaccine implementation.
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Much of the research to date about HPV vaccine acceptability in India has been limited to urban areas, with very limited information available from rural India where 60% of the Indian population resides.
“Much of the research to date about HPV vaccine acceptability in India has been limited to urban areas with very limited information being available from rural India where 60% of the Indian population resides.”
From Human Papillomavirus Vaccine Acceptability among Parents of Adolescent Girls in a Rural Area, Mysore, India (2018) · cites this paper as [12]
The paper's introductory passage (labeled Abstract in our copy; page unavailable) says relatively little HPV vaccine acceptability research had been done in India and describes this study as taking place in a peri-rural area. It does not establish that most prior Indian research was urban or state that 60% of India's population resides in rural areas. Its separate reference to nearly 60% concerns HPV-related high-grade lesions, not population residence. (LLM, conf=0.84)
Experimental — accuracy not yet measuredUptake of HPV vaccination in general has been low in India due to misperceptions about HPV infection, cervical cancer and HPV vaccine, and due to cultural reasons.
“However, uptake of HPV vaccination in general has been low due to misperceptions about HPV infection, cervical cancer and HPV vaccine, and due to cultural reasons in India.”
From Human Papillomavirus Vaccine Acceptability among Parents of Adolescent Girls in a Rural Area, Mysore, India (2018) · cites this paper as [12]
The Discussion (page unavailable) reports limited knowledge of HPV and cervical cancer and says concerns about vaccine side effects may foster misinformation and negative attitudes. But the study examined parental attitudes before the vaccine was available in its study area; it does not establish that vaccination uptake was generally low in India or that misperceptions and cultural reasons caused low uptake. (LLM, conf=0.86)
Experimental — accuracy not yet measuredInstitutional settings, particularly schools and health centres, proved effective for vaccine delivery when adequately supported, yet out-of-school girls remained underserved.
“Institutional settings, particularly schools and health centres, proved effective for vaccine delivery when adequately supported, yet out-of-school girls remained underserved33,35,40.”
From Barriers to HPV vaccination among adolescent girls in India: A scoping review (2026) · cites this paper as [40]
The Discussion (page unavailable) says adolescents have fewer formal interactions with the healthcare system and that reaching them for vaccination will be a challenge. It mentions opportunistic boosters at primary health centres, but does not show that schools or health centres proved effective for HPV vaccine delivery, or specifically identify out-of-school girls as underserved. (LLM, conf=0.85)
Experimental — accuracy not yet measuredReligion was another factor, with some communities expressing stronger resistance due to their religious norms or misinformation within their social circles.
“Religion was also found to be another factor, with some communities expressing stronger resistance due to their religious norms or misinformation within their social circles36,42.”
From Barriers to HPV vaccination among adolescent girls in India: A scoping review (2026) · cites this paper as [42]
The Discussion (page unavailable) says potential religious differences in vaccine acceptance need further study; it does not report that particular communities showed stronger resistance because of religious norms. It also suggests that concerns about side effects could become misinformation and lead to negative attitudes, but does not locate that misinformation within social circles. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSchool-based HPV vaccination programs demonstrated high efficiency and coverage.
“Programs implemented through schools demonstrated high efficiency and coverage35,40.”
From Barriers to HPV vaccination among adolescent girls in India: A scoping review (2026) · cites this paper as [40]
The Results describe parents’ access to village-based childhood immunization, and the Discussion reports coverage of existing vaccines among children under two. Our copy does not report the efficiency or coverage of a school-based HPV vaccination program (searched for school-based programs, efficiency, coverage, and school). (LLM, conf=0.75)
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Cited by
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Degarege, A., Krupp, K., Fennie, K., Srinivas, V., Li, T., Stephens, D. P., Marlow, L. A. V., Arun, A., & Madhivanan, P. (2018) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2018.07.008 · Cited by 34 · see citing works
Barriers to HPV vaccination among adolescent girls in India: A scoping review
Josten, K., Rose Dhar, R., Reshmi, B., Natti Krishna, V., & Vennila, J. (2026) · The Indian Journal of Medical Research · doi:10.25259/ijmr_1834_2025 · Cited by 6 · see citing works
“Religion was also found to be another factor, with some communities expressing stronger resistance due to their religious norms or misinformation within their social circles 36,42 .”
- Authors
- Paul, P., Tanner, A. E., Gravitt, P. E., Vijayaraghavan, K., Shah, K. V., Zimet, G. D., & Study Group, C.
- Affiliations
- Johns Hopkins University (US)
- University of North Carolina at Greensboro (US)
- Mediciti Institute of Medical Sciences (IN)
- Indiana University School of Medicine (US)
- Corresponding author
- Paul, Proma
- Venue
- Health Care for Women International
- Publisher
- Informa UK Limited
- Published
- 2013-04-23
- Volume
- 35
- Issue
- 10
- Pages
- 1148-1161
- ISSN
- 0739-9332 (ISSN-L)
- 1096-4665
- PMC
- PMC4503242
- OpenAlex
- W2044925032
- Cited by
- 34
- References
- 1
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 5 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 3
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Care For Women International (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- NC Digital Online Collection of Knowledge and Scholarship (The University of North Carolina at Greensboro) (submittedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Cancer Institute (P50 CA98252, P50CA098252)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- HPV vaccine, vaccine acceptance, parental attitudes, cervical cancer prevention, vaccine side effect concerns, vaccine cost barriers, provider recommendation, vaccine implementation, India
- MeSH terms
- Adult, Uterine Cervical Neoplasms, Female, Humans, Interviews as Topic, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Parents, Patient Acceptance of Health Care, Surveys and Questionnaires, Sexually Transmitted Diseases, Socioeconomic Factors, Vaccination, Papillomavirus Infections, Qualitative Research, Papillomavirus Vaccines, Young Adult
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