This study synthesizes experiences and lessons learnt around social mobilization, consent and acceptability from 55 HPV vaccine demonstration projects and 8 national programmes in 37 low and middle-income countries (LMIC) between January 2007 and January 2015.
The qualitative study design included: (i) a systematic review, in which 1,301 abstracts from five databases were screened and 41 publications included; (ii) soliciting 124 unpublished documents from governments and partner institutions; and (iii) conducting 27 key informant interviews. Data were extracted and analysed thematically.
Almost all experiences framed mobilization messages around vaccine-induced protection from cervical cancer, rather than prevention of a sexually transmitted infection. Rumours were consistent across world regions and largely focused on the effect of the vaccine on girls’ fertility. Experiences emphasized that it was critical to address rumours as soon as they emerged. Interactive communication with parents was more likely to achieve high uptake than non-interactive messaging. Political and/or celebrity champions proved useful in mobilizing both girls and their parents. Acceptability was generally determined by personal knowledge of the vaccine’s benefits, acceptance within the surrounding community, limited exposure to rumours and knowing where and when to go for vaccination.
Social mobilization strategies and factors influencing HPV vaccine acceptance are consistent across world regions and projects/programmes. Thus, further formative research may not be required. Countries introducing HPV vaccination or increasing coverage can learn from the available experiences, regardless of their economic status.