Perceptions and Practices Among Students, Parents, and Teachers of the Human Papilloma Virus( HPV) vaccine : A Pilot Feasibility Study from Rural Kerala

BackgroundIndia bears the worlds highest cervical cancer burden, yet awareness and uptake of the effective HPV vaccine remain low. Although Kerala has initiated pilot HPV vaccination programmes, stakeholder knowledge, attitudes, and practices (KAP) are not well documented. This pilot study aimed to assess the feasibility of a KAP study and to identify gaps in the questionnaire, for future analytical modelling. MethodsA cross-sectional pilot study was conducted in a school in Pulinkunnu, Kerala, among students aged 11-15 years, their parents, and teachers. A structured, validated questionnaire, developed in English, translated into Malayalam, was administered during school hours. Responses were entered into secure electronic spreadsheets. Descriptive statistics summarised KAP outcomes. As key demographic and behavioural predictors--such as gender, socioeconomic status, prior health education, and exposure to HPV information--were not captured, multivariable analysis was not undertaken. ResultsThe pilot included 75 students and 20 teachers, predominantly female. HPV-related knowledge was low across groups, with widespread misconceptions and limited awareness of vaccine availability and cervical cancer screening. Attitudes toward vaccination were mixed, marked by safety concerns and modest willingness to receive or recommend the vaccine. Practices reflected low prior awareness and uptake, with few respondents having heard of or received the HPV vaccine. ConclusionsThis pilot revealed major gaps in HPV-related knowledge, attitudes, and practices, among stakeholders and highlighted the need for an improved questionnaire in item clarity, response patterns, and missing variables and a larger study to identify predictors and inform targeted school-based HPV education efforts. Ethics and DisseminationEthical approval for this pilot study was obtained from the Institutional Ethics Committee of Pushpagiri Institute of Medical Sciences and Research Centre. Written informed consent was obtained from participating teachers, and parental consent was sought for students; however, parents were unavailable on the day of data collection, resulting in their non-participation. Verbal assent was obtained from all student participants prior to survey administration. Patient and Public InvolvementStudents, teachers, and parents were not involved in the development of the research protocol or the pilot questionnaire. As this was a preliminary feasibility study, no direct involvement in interpreting or disseminating the results is planned at this stage. Insights from the pilot will instead be used internally by the research team to refine the study tools and procedures for the full-scale investigation.