A Qualitative Study of Awareness, Perceptions and Acceptance of Human PapillomavirusVBaccination among Female Healthcare Students in Pakistan

Abstract

Human Papillomavirus (HPV) vaccination coverage remains critically low in Pakistan despite a high burden of cervical cancer. Understanding attitudes and barriers among female healthcare students is essential for designing effective interventions. This qualitative study explored knowledge, attitudes, hesitancy drivers, and recommended strategies for HPV vaccination among female healthcare students in Pakistan. This qualitative study used face-to-face semi-structured interviews with 20 female medical students from public and private institutions in Islamabad and Rawalpindi, Pakistan. Data were collected from December 2025 to February 2026. Inductive thematic analysis was performed following Braun and Clarke’s framework. Participants were generally aware that HPV vaccination prevents cervical cancer; however, in-depth scientific understanding was limited. While most trusted the vaccine’s effectiveness, many remained skeptical of government-led vaccination programs, reflecting lingering distrust following the COVID-19 pandemic. Healthcare practitioners, particularly gynecologists, were regarded as the most reliable sources of vaccination recommendations. Misconceptions linking HPV vaccination to infertility were identified as the primary cultural obstacle, impacting perceptions even among participants who rejected the notion. Protecting adolescent girls from cervical cancer was one of the strongest motivators for vaccination acceptance. Participants favored informed choices over compulsory vaccination and advocated for culturally tailored, multi-channel awareness campaigns, involvement of religious scholars, large-scale public education, and healthcare practitioners’ visible endorsement, such as vaccinating their own children. Among this sample of female medical students in Pakistan, awareness of HPV vaccination was often superficial and accompanied by institutional distrust and perpetual infertility-related misconceptions. Enhancing HPV vaccination acceptance requires multifaceted strategies that extend beyond awareness alone, emphasizing trusted healthcare practitioners, open communication, and culturally sensitive, research-based messaging to promote public confidence in immunization programs. Additional qualitative and quantitative studies including more diverse populations are warranted to validate and extend the generalizability of these findings.