Uptake of Human Papiloma Virus (HPV) Vaccine in Kenya: Barriers and Facilitators - A Scoping Review

Abstract

Cervical cancer is a leading cause of cancer-related deaths among women in Kenya, with human papillomavirus (HPV) as the primary causative agent. Despite the World Health Organisation (WHO) recommendations for HPV vaccination, uptake remains suboptimal. By 2020, only 33% of eligible adolescent girls had received the first dose, and just 16% had completed the second dose. Given the crucial role of HPV vaccination in cervical cancer prevention, understanding the factors influencing vaccine uptake is essential. This scoping review assessed HPV vaccine uptake among adolescent girls in Kenya, identified key barriers, and explored facilitators to improve coverage. A systematic search was conducted in MEDLINE (PubMed), CINAHL, and Google Scholar, focusing on studies published between 2006 and 2025. A total of 12 eligible studies were included, comprising six qualitative, five quantitative, and one mixed-method study. The findings indicate that the average first-dose uptake was 52%, but subsequent dose completion rates were significantly lower, highlighting challenges in ensuring full vaccine coverage. Barriers to uptake included widespread misinformation, vaccine hesitancy, financial constraints, long distances to healthcare facilities, negative provider attitudes, and socio-cultural opposition, including religious concerns and male guardian hesitancy. Additionally, the COVID-19 pandemic disrupted HPV vaccination programs, further reducing access. Facilitators of vaccine uptake included school-based vaccination programs, community engagement initiatives, targeted public education campaigns, and retraining of healthcare providers to improve vaccine advocacy. Integration of HPV vaccination with routine immunisation programs and youth-friendly reproductive health services was also identified as a strategy to enhance accessibility and adherence. Improving HPV vaccine uptake in Kenya requires a multi-pronged approach, including strengthening healthcare infrastructure, addressing vaccine safety concerns through transparent communication, and actively engaging key stakeholders, including parents, teachers, and community leaders. Policy adjustments, such as adopting a single-dose regimen where feasible, may further enhance vaccine accessibility and adherence. A comprehensive, collaborative strategy is essential to increasing HPV vaccine coverage and reducing the burden of cervical cancer in Kenya.