Education and social determinants shaping HPV vaccine uptake: Insights from a nationwide cross-sectional study

HPV is a common sexually transmitted infection (STI), often affecting young women. Although most infections are asymptomatic, high-risk types of HPV can cause multiple types of cancer, especially cervical cancer. Brazil's 2014 national HPV vaccination campaign, targeting girls aged 11 to 13, improved awareness and vaccine coverage. However, challenges such as vaccine hesitancy and the ongoing need for educational interventions persist, highlighting the need for additional studies to better understand factors influencing vaccine uptake among adolescents. This study analyzed data from the 2019 PeNSE survey, focusing on HPV vaccination information in the dataset. It also examined factors like socioeconomic conditions, family context, and access to education and healthcare. The study found that access to information through cellphones increased HPV vaccine uptake, particularly among females. Indigenous adolescents had higher vaccination odds compared to White adolescents, likely due to campaigns that aimed at vulnerable individuals. Overall, any degree of maternal schooling, compared to no formal education, was related to higher odds of being vaccinated. Sexual health education, particularly on pregnancy prevention and STIs, also boosted vaccine uptake, likely due to overlapping content that includes HPV-related information. The student population presents an opportunity for improving HPV vaccination coverage through parental and school education, healthcare information, and targeted optimization strategies for both genders. Future studies should be designed to leverage these opportunities to achieve the WHO goal of 90% vaccination coverage among girls by age 15 by 2030.