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Volume 13
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10.3390/vaccines13090948
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Article

Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia

by
Jacqueline Yap
1,*,
Fauzi Budi Satria
2,
Ivana Alona
2,
Indo Mora Siregar
2,
Shu Chen
3,4,
Chee Fu Yung
5,6,7,
Courtney Davis
5,6,7,
Inke Nadia Diniyanti Lubis
2 and
Shenglan Tang
4,7
1
Department of Biochemistry, Duke-NUS Medical School, Singapore 169857, Singapore
2
Faculty of Medicine, Universitas Sumatera Utara, Medan 20222, Indonesia
3
Australia National Centre for Immunisation Research and Surveillance, Westmead 2145, Australia
4
Department of Population Health Science, Duke Global Health Institute, Kunshan 215316, China
5
KK Women’s and Children’s Hospital, Singapore 229899, Singapore
6
SingHealth Duke-NUS Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
7
SingHealth Duke-NUS Global Health Institute, Duke-NUS Medical School, Singapore 169857, Singapore
*
Author to whom correspondence should be addressed.
Vaccines 2025, 13(9), 948; https://doi.org/10.3390/vaccines13090948
Submission received: 1 August 2025 / Revised: 25 August 2025 / Accepted: 28 August 2025 / Published: 4 September 2025
(This article belongs to the Special Issue Vaccination and Public Health Strategy)
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Abstract

Background: Indonesia launched a nationwide school-based HPV immunization program in August 2023. Despite this, regional disparities in vaccine uptake persist. Therefore, we undertook a study in North Sumatra Province to assess HPV vaccination coverage and analyze the main factors affecting the uptake of HPV vaccination. Methods: This study employed a mixed-methods approach and was carried out in Medan and Deli Serdang of North Sumatra Province. Quantitative data were used to examine HPV coverage rates among school-aged girls in 2024, while qualitative interviews with parents, teachers, and health officers explored administrative, social, and behavioral barriers and facilitators. Results: In 2024, HPV vaccine coverage in Deli Serdang reached 62.09%, while Kota Medan lagged behind at just 27.20%. High-coverage schools in the Galang subdistrict benefited from proactive engagement between Puskesmas (community health clinics) and parents. In contrast, lower-coverage areas experienced logistical and communication challenges. Parents expressed a preference for face-to-face communication over written consent forms and emphasized the importance of clear, empathetic messaging. Conclusions: The stark contrast in coverage—particularly the low uptake in urban Kota Medan—highlights the need for more responsive and localized implementation strategies. Strengthening direct communication, addressing administrative inefficiencies, and fostering trust through tailored community engagement are critical. These findings suggest a need for targeted improvements in urban settings and further research across diverse regions to inform policy development and strategies for improved coverage of HPV vaccinations.
Keywords: human papillomavirus vaccines; vaccine coverage; influencing factors human papillomavirus vaccines; vaccine coverage; influencing factors

Share and Cite

MDPI and ACS Style

Yap, J.; Satria, F.B.; Alona, I.; Siregar, I.M.; Chen, S.; Yung, C.F.; Davis, C.; Lubis, I.N.D.; Tang, S. Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia. Vaccines 2025, 13, 948. https://doi.org/10.3390/vaccines13090948

AMA Style

Yap J, Satria FB, Alona I, Siregar IM, Chen S, Yung CF, Davis C, Lubis IND, Tang S. Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia. Vaccines. 2025; 13(9):948. https://doi.org/10.3390/vaccines13090948

Chicago/Turabian Style

Yap, Jacqueline, Fauzi Budi Satria, Ivana Alona, Indo Mora Siregar, Shu Chen, Chee Fu Yung, Courtney Davis, Inke Nadia Diniyanti Lubis, and Shenglan Tang. 2025. "Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia" Vaccines 13, no. 9: 948. https://doi.org/10.3390/vaccines13090948

APA Style

Yap, J., Satria, F. B., Alona, I., Siregar, I. M., Chen, S., Yung, C. F., Davis, C., Lubis, I. N. D., & Tang, S. (2025). Challenges in Expanding Access to the HPV Vaccine Among Schooling Girls: A Mixed-Methods Study from Indonesia. Vaccines, 13(9), 948. https://doi.org/10.3390/vaccines13090948

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