Changes in attitudes toward the HPV vaccine in Kenya

Globally, attitudes about vaccines and vaccination are changing rapidly, but few studies have examined within-person shifts over time. We use a longitudinal survey in Kenya to assess how respondents' attitudes about the human papillomavirus (HPV) vaccine changed between 2022 and 2024. In 2022, we conducted a random digit-dialed phone survey of 1405 Kenyan parents/caregivers of girls age-eligible for the HPV vaccine; respondents were re-contacted in 2024, and 1093 people (78%) were successfully re-surveyed. Each survey included identical questions about HPV vaccine and vaccination attitudes (adapted from the Vaccine Hesitancy Scale-HPV). We estimate direction and degree of each person's change in attitude, overall and by construct/question, and explore associations between these changes and respondent demographics, and baseline knowledge about HPV and HPV vaccination. Attitudes about the HPV vaccine changed substantially from 2022 to 2024. Although perceptions of the vaccine's importance and effectiveness were relatively stable (only 25% of respondents reported any attitude change), there were significantly more changes among respondents with lower educational attainment and who were unemployed. Safety perceptions changed substantially over this period: two-thirds of respondents changed their beliefs around the vaccine's side effects and riskiness. Approximately one-quarter of respondents developed a worse safety attitudes, while 18.9% of respondents improved their safety attitude. Among individuals with lower socioeconomic status, attitudes about following a clinician's HPV vaccination recommendation and riskiness of the HPV vaccine significantly worsened over this period. We found that, in this population of Kenyan adults and over a two-year period, attitudes about the HPV vaccine have changed both positively and negatively. Targeted interventions may be needed, particularly with less socioeconomically-advantaged groups, to reinforce messages about the vaccine's importance, effectiveness, and safety. Further research is needed about reasons for the large changes in safety perceptions, both toward more and less favorable views.