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Knowledge, Attitude, and Practice among school students and teachers about the Human Papillomavirus vaccine in Central Kerala- a cross-sectional study

John, A. S.; Pious, T.; Idicula, M. J.

2025-02-25 public and global health
10.1101/2025.02.24.25322810 medRxiv
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BackgroundHuman Papillomavirus (HPV) is the fourth most common cancer among women globally and a major public health concern. Uptake of HPV vaccine remains low despite its availability, in several countries, including India. India planned to introduce the HPV vaccine into the Universal Immunization Program (UIP), aiming to improve vaccine coverage. Knowledge, attitude, and practice (KAP) regarding the HPV vaccine among school-going adolescents, their parents, and teachers remain largely unexplored in Kerala, despite its high literacy. Understanding the awareness and perceptions of these stakeholders is critical for the successful implementation of vaccination programs. MethodsThis cross-sectional study will assess the KAP regarding HPV vaccination among school students (aged 11-15 years), their parents, and teachers in Thiruvalla Municipality, Kerala. A structured, validated questionnaire will be used to collect data from randomly selected government, private, and aided schools. Stratified random sampling will be used for student selection, while all teachers in the selected schools will be included through census sampling. Parents will be recruited using a convenience sampling approach. Descriptive and inferential statistical analyses will examine KAP levels, compare demographic groups, and identify predictors of vaccine acceptance. The study has received ethical approval and currently is in the process of obtaining necessary permissions from school authorities and fulfilling administrative requirements for implementation. Expected ResultsWe anticipate finding gaps in knowledge and varying levels of acceptance of the HPV vaccine among students, parents, and teachers. While some stakeholders may be aware of HPV and its link to cervical cancer, misconceptions and cultural barriers may hinder vaccine uptake. We expect that health education with access to reliable information will be associated with higher knowledge and a positive attitude toward vaccination. Expected ConclusionsThe study will provide insights into existing knowledge gaps and barriers to HPV vaccination in Kerala. Findings will inform the design of targeted educational interventions and policy recommendations to improve vaccine acceptance and coverage. Strengthening school-based awareness programs and involving teachers and parents as key advocates may significantly enhance HPV vaccine uptake and contribute to cervical cancer prevention efforts in India.

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