Knowledge on HPV Vaccine and Cervical Cancer Facilitates Vaccine Acceptability among School Teachers in Kitui County, Kenya.
BACKGROUND
Vaccines against human papillomavirus (HPV) infection have the potential to reduce the burden of cervical cancer. School-based delivery of HPV vaccines is cost-effective and successful uptake depends on school teachers' knowledge and acceptability of the vaccine. The aim of this study is to assess primary school teachers' knowledge and acceptability of HPV vaccine and to explore facilitators and barriers of an ongoing Gavi Alliance-supported vaccination program in Kitui County, Kenya.


METHODS
This was a cross-sectional, mixed methods study in Central Division of Kitui County where the Ministry of Health is offering the quadrivalent HPV vaccine to grade four girls. Data on primary school teachers' awareness, knowledge and acceptability of HPV vaccine as well as facilitators and barriers to the project was collected through self-administered questionnaires and two focus group discussions.


RESULTS
339 teachers (60% female) completed the survey (62% response rate) and 13 participated in 2 focus group discussions. Vaccine awareness among teachers was high (90%), the level of knowledge about HPV and cervical cancer among teachers was moderate (48%, SD = 10.9) and females scored higher than males (50% vs. 46%, p = 0.002). Most teachers (89%) would recommend the vaccine to their daughter or close relatives. Those who would recommend the vaccine had more knowledge than those who would not (p = <0.001). The main barriers were insufficient information about the vaccine, poor accessibility of schools, absenteeism of girls on vaccine days, and fear of side effects.


CONCLUSIONS
Despite low to moderate levels of knowledge about HPV vaccine among school teachers, vaccine acceptability is high. Teachers with little knowledge on HPV vaccine are less likely to accept the vaccine than those who know more; this may affect uptake if not addressed. Empowering teachers to be vaccine champions in their community may be a feasible way of disseminating information about HPV vaccine and cervical cancer.
Department of Medical Microbiology, School of Medicine, University of Nairobi, Nairobi, Kenya.
Moses Muia
MM
Masika
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
Javier Gordon
JG
Ogembo
Partners in Health Research and Development, Thika, Kenya.
Sophie Vusha
SV
Chabeda
Department of African-American Studies, Northeastern University, Boston, Massachusetts, United States of America.
Richard G
RG
Wamai
Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Nelly
N
Mugo
D000328:Adult; D003430:Cross-Sectional Studies; D005178:Faculty / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008297:Male; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control*
D053918:Papillomavirus Vaccines