EXPLORING THE FACTORS OF UNWILLINGNESS OF CERVICAL CANCER VACCINATION IN PAKISTAN

Abstract

Despite international recommendations, the uptake of the human papillomavirus (HPV) vaccine is still low in low- and middle-income countries like Pakistan, where cervical cancer is still a significant preventable public health concern. This study aimed to determine the reasons Pakistani parents are unwilling to vaccinate their daughters against HPV, with a focus on informational, psychological, and attitudinal issues. A standardised questionnaire was used to assess awareness, social influence, safety perceptions, and beliefs about the cervical cancer vaccine in a cross-sectional study. Utilising Cronbach's alpha (α = 0.87), the instrument's internal consistency was confirmed. Three underlying factors—trust in medical advice, social and familial influence with uncertainty, and health attitudes and safety concerns—accounted for 47.5% of the total variation, according to the exploratory factor analysis. The perception that immunisation is unnecessary and doubt about immunisations were the strongest predictors of vaccine unwillingness, according to ordinal logistic regression analysis. The chance of vaccine aversion was intensely enhanced by demographic factors such age, wealth, occupation, education, and marital status, but these characteristics had little effect. Reduced hesitation was associated with accurate safety perceptions, although this impact was not statistically significant. These results show that psychological and informational barriers, rather than structural or demographic problems, are the main reasons why Pakistanis refuse the HPV vaccine. Targeted public health initiatives aimed at scattering doubt, removing uncertainty, and boosting confidence in vaccination programs are necessary to increase vaccination uptake and lower the incidence of cervical cancer.