State of human papilloma virus vaccine uptake among girls (15-21 years) in Zambia: analysis of a 2024 national survey.
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BACKGROUND: The World Health Organisation recommends that countries will achieve at least a 90% human papilloma virus (HPV) vaccine uptake by the year 2030. Tracking the performance of Zambia is necessary to inform programme implementation and ensuring equitable coverage. This study estimates the prevalence of HPV vaccine uptake in Zambia, and examines its associated factors. METHODS: Data from the 2024 Zambia demographic and health survey was analysed (n = 3,942 girls aged 15–21). Analyses accounted for the complex survey design using sampling weights, clustering, and stratification. Multivariable logistic regression was computed in STATA 14. The adjusted odds ratio and 95% confidence intervals were reported. Statistical significance was set at p < 0.05. RESULTS: Overall, 61.8% (95%CI: 59.8–63.5) of the participants had ever received HPV vaccine. Among respondents who reported ever receiving the HPV vaccine, 46.3% and 53.2% had received one dose and two doses, respectively. HPV vaccine uptake was higher among girls with primary education (AOR = 4.45; 95%CI: 2.91–6.79), those with secondary/higher education (AOR = 9.08; 95%CI: 5.86–14.05) compared with those with no formal education. Exposure to family planning messages was positively associated with vaccineuptake (AOR = 1.32; 95%CI: 1.12–1.55). Initiation of sexual activity was inversely associated with vaccination, both for debut before age 15 (AOR = 0.79; 95%CI: 0.64–0.99) and at age 15 years or older (AOR = 0.77; 95%CI: 0.66–0.90). Higher odds of vaccination were found among girls from middle-wealth households (AOR = 1.27; 95%CI: 1.01–1.60). Rural dwelling girls had higher odds of HPV vaccination than their urban counterparts (AOR = 1.42; 95%CI: 1.15–1.75). There were lower odds of HPV vaccine uptake in Copperbelt (AOR = 0.72; 95%CI: 0.54–0.96), Lusaka (AOR = 0.70; 95%CI: 0.52–0.93), and Muchinga (AOR = 0.68; 95%CI: 0.50–0.94), while higher odds were observed in Southern Province (AOR = 1.40; 95%CI: 1.05–1.87) compared with Central Province. CONCLUSION: To ensure equitable coverage, the Zambian Ministry of Health must intensify vaccine availability and access, particularly among girls with no formal education, those residing in poorer households and girls in urban areas. Family planning education campaigns and mass media platforms can be leveraged to raise HPV vaccine awareness.