HPV vaccination coverage and determinants in adolescent girls with disability: a scoping review

Human papillomavirus (HPV) vaccination has been scaled up in many countries in response to global calls for cervical cancer elimination. Adolescent females with disability face significant inequities when accessing healthcare and may be overlooked in vaccination programs and campaigns. We undertook a scoping review to examine HPV vaccination coverage and key enablers and barriers for this population. Our secondary aim was to describe the methodologies used to study this population to guide future research.

A scoping review was conducted using the Joanna Briggs Institute guidelines. Four databases were searched for English-language peer-reviewed literature examining HPV vaccination amongst adolescent girls with disability in low-, middle- and high-income countries, with no restrictions on timeline or context. HPV vaccination coverage rates and study methodologies were extracted into tables, and key enablers and barriers were mapped to the socio-ecological framework.

Twenty-four studies were included. Studies reported a wide range in HPV vaccination coverage from 22.9 % to 87.4 % and a variety of research methods were used to derive these estimates. Slightly more than half of studies (n = 6/11) which included a comparison cohort reported lower HPV vaccination coverage rates in adolescent females with disability compared to those without disability. Included studies found individual and interpersonal level enablers and barriers at a greater frequency compared to organisational, environmental and policy level determinants.

The current literature shows disparities in HPV vaccination coverage and identifies a diverse range of enablers and barriers for adolescent girls with disability, using multiple research methodologies. Efforts are needed to incorporate theoretical frameworks to guide research, extend research to low-resource countries and implement population level registry data sets.