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Verification of Self-Reported HPV Vaccination in the Initial Cohorts of the Botswana National Immunization Programme, 2023-2024

Ramogola-Masire, D.; Mathoma, A.; Masono, M.; Masole, M.; Phiri, S.; Omolo, J.; Lewis, R.; Morroni, C.; Luckett, R.; Markowitz, L.; Gargano, J. W.

2026-07-01 public and global health
10.64898/2026.06.23.26355877 medRxiv
Show abstract

Botswana launched a national female-only school-based 2-dose HPV vaccination programme among 9-13-year-olds in 2015. During a 2023-2024 vaccine impact study among women aged 18-22 years recruited from the University of Botswana and Gaborone-area HIV clinics, we compared self-reported HPV vaccination to school and health facility records. Of 450 women, 446 self-reported HPV vaccination (301: 1-dose, 135: 2-dose, 10: 3-dose). Vaccination status was verified for 429/450 (95%); one was not vaccinated, 52 (12%) had 1 dose, 344 (80%) 2 doses, and 32 (7%) 3 doses. Agreement on [≥]1 dose was >99%; dose-specific agreement was 37% (159/429); 256 (60%) underreported and 14 (3%) overreported number of doses. While time- and resource-intensive, nationwide vaccination verification without a vaccination registry was feasible. Results suggest high vaccination coverage, including high at least 2-dose coverage. Self-report of at least 1 dose was highly accurate, but number of doses was often underreported.

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