Alessandra Herbst de Cortina, MD Student


GHES U.S. Fellow 2019-2020

FELLOWSHIP SITE: Public Health Research Institute of India (PHRII)

Project Title: Demonstration of School-Based Human Papillomavirus Vaccination in Mysore, India

Human Papillomavirus (HPV) is a common sexually transmitted infection and largest risk factor for cervical cancer. Currently, HPV vaccination is optional in India’s Universal Immunization Programme and is available through private physicians for self-paying patients. There is poor data for the uptake of HPV vaccination in India, but previous PHRII surveys in Mysore demonstrated an acceptance rate ranging from 71-7.9% among parents of adolescent girls. Barriers to uptake included lack of awareness of HPV and cervical cancer, underestimation of the severity of HPV infection, doubt regarding vaccine effectiveness and safety, and belief that vaccination would increase promiscuity. We plan to re-evaluate attitudes and capture actual uptake among parents when vaccination is offered.

Parents of girls aged 9-14 will be recruited at private pediatric clinic appointments. They will be surveyed regarding sociodemographic information, knowledge about HPV infection and cervical cancer, perceived benefits and risks of vaccination, perceptions about whether their children are at-risk for HPV infection, and vaccination history of their children. Parents will be consented for their daughters to undergo vaccination. Their daughters will receive one dose at that visit, and be reminded by postcard to return in 6 months for a second and final dose. The proportion of parents who initiate vaccination and the proportion of parents who complete vaccination will be calculated. We will examine parents’ surveys for associations between question responses, uptake of the vaccination, and completion of two doses.