Press release
New research led by the MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine (MRCG at LSHTM) has found that while acceptance of human papillomavirus (HPV) vaccination is high among primary caregivers in The Gambia, knowledge of HPV, HPV vaccine, and cervical cancer remains limited.
The qualitative study involved 23 in-depth interviews and 10 focus group discussions with 83 primary caregivers across all five regions of The Gambia(West Coast, North Bank, Lower River, Central River and Upper River Regions).Although caregivers widely expressed willingness to vaccinate their daughters, the findings published shows that this acceptance is not supported by adequate understanding, leaving families vulnerable to misinformation and uncertainty.
Dr Penda Johm, Lead-Author and Postdoctoral Researcher at MRCG at LSHTM explained that acceptance alone is not enough, and that caregivers need accurate and accessible information to make confident and informed decisions about HPV vaccination.
“We found that acceptance of HPV vaccination does not actually stem from well informed primary caregivers, as they had limited knowledge about HPV, cervical cancer and the HPV vaccine Primary caregivers in The Gambia need accurate and accessible information to make well informed decisions about HPV vaccinations for their daughters.”
The research shows that trust in health workers and community leaders play a key role in encouraging acceptance. However, misinformation particularly rumours linking the HPV vaccine to infertility or population control and often circulated through social media continue to pose significant challenges.
The study also highlights how gender norms influence vaccination decisions. While mothers are typically responsible for the care of their children, they often require approval from fathers or elders before providing consent. Additionally, gaps in communication persist, with caregivers reporting limited engagement from healthcare workers, unclear consent processes in schools and confusion about HPV symptoms and its link to cervical cancer.
These challenges come at a critical time, as cervical cancer remains one of the most pressing health threats for women in The Gambia, where over 770,000 women are at risk, and an estimated 286 new cases occur each year. In addition, despite the introduction of the HPV vaccine in 2019, national coverage has remained low, with only 34% receiving the first dose and 30% completing the final dose in 2021.
Commenting on the importance of the study, Professor Ed Clarke, Co-Author and Vaccines and Immunity Lead at MRCG at LSHTM stated; “These findings show that acceptance alone is not enough. To improve HPV vaccine uptake, we must bridge the knowledge gaps, tackle misinformation and ensure that families especially mothers have the support and accurate information they need to confidently protect their daughters from cervical cancer.”
Given that sub-Saharan Africa accounts for 20% of cervical cancer cases and 25% of related deaths globally, the implications of the study extend beyond The Gambia. The findings point to a need for stronger community-based sensitisation, clearer informed consent procedures, gender-inclusive vaccination approaches, and improved engagement with trusted community figures to build confidence and increase vaccine uptake.
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