{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T04:54:56Z","timestamp":1786769696122,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council (SAMRC)","doi-asserted-by":"publisher","award":["43500"],"award-info":[{"award-number":["43500"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"South African National Department of Health","award":["43500"],"award-info":[{"award-number":["43500"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: South Africa launched a school-based human papillomavirus (HPV) vaccination programme in 2014 and has achieved a national coverage of more than 80%. However, there is subnational variation in coverage, with eThekwini District in the province of KwaZulu-Natal having the lowest coverage at 40%. Knowledge of the factors associated with vaccine acceptance in this district would inform tailored strategies to improve coverage, which could be extrapolated to similar settings. We conducted this cross-sectional study to assess the factors associated with HPV vaccine acceptance in eThekwini District. Methods: We used stratified random sampling to select caregivers of children aged 9\u201314 years in the district. We interviewed participants in April\u2013May 2023 and employed bivariate and multivariate logistic regression models to assess the factors associated with HPV vaccine acceptance. Results: Of 793 individuals contacted, 713 (89.9%) participated. Most were women (86.1%) and had a mean age of 42.6 \u00b1 11.6 years and secondary or lower education (83.8%). Most participants knew about the HPV vaccination programme (86.0%) and accepted HPV vaccination (93.5%). The latter includes 42.9% who had already vaccinated their daughters and 50.6% who were willing to allow their daughters to be vaccinated. A negligible proportion was either undecided (2.1%) or unwilling (4.4%) to accept HPV vaccination. Awareness of the programme (adjusted odds ratio [aOR] 5.22; 95% confidence interval [95%CI] 2.01\u201313.56), confidence in vaccine safety (aOR 19.69; 95%CI 5.86\u201366.15), and endorsement by religious leaders (aOR 5.06; 95%CI 1.56\u201316.45) were independent predictors of vaccine acceptance. Conclusions: Our findings highlight the critical role of the provision of information and education about the benefits and safety of HPV vaccination.<\/jats:p>","DOI":"10.3390\/vaccines13070732","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T10:03:27Z","timestamp":1751882607000},"page":"732","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated with Acceptance of Vaccination Against Human Papillomavirus in eThekwini District of South Africa"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7915-0068","authenticated-orcid":false,"given":"Phelele","family":"Bhengu","sequence":"first","affiliation":[{"name":"Department of Medicine & CIDRI-Africa, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa"},{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1273-4779","authenticated-orcid":false,"given":"Charles S.","family":"Wiysonge","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"},{"name":"Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa"},{"name":"Vaccine Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville P.O. Box 06, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0553-201X","authenticated-orcid":false,"given":"Patrick D. M. C.","family":"Katoto","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"},{"name":"Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town 7505, South Africa"},{"name":"Centre for Tropical Diseases and Global Health, Catholic University of Bukavu, Bukavu P.O. Box 285, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duduzile","family":"Ndwandwe","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9894-236X","authenticated-orcid":false,"given":"Sara","family":"Cooper","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebenzile","family":"Bhengu","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4946-6736","authenticated-orcid":false,"given":"Akhona V.","family":"Mazingisa","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"},{"name":"Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Saber","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandisi","family":"Sithole","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9332-0138","authenticated-orcid":false,"given":"Darian","family":"Smith","sequence":"additional","affiliation":[{"name":"Research, Development, Science and Innovation, Human Science Research Council, Durban 3209, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindiwe G.","family":"Tembe","sequence":"additional","affiliation":[{"name":"Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2483-3499","authenticated-orcid":false,"given":"Paul","family":"Kuodi","sequence":"additional","affiliation":[{"name":"Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity (UGHE), Kigali P.O. Box 6955, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8776-4737","authenticated-orcid":false,"given":"Muki S.","family":"Shey","sequence":"additional","affiliation":[{"name":"Department of Medicine & CIDRI-Africa, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106399","DOI":"10.1016\/j.ypmed.2020.106399","article-title":"HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010\u20132019","volume":"144","author":"Bruni","year":"2021","journal-title":"Prev. Med."},{"key":"ref_2","unstructured":"World Health Organization (2022). Human papillomavirus vaccines: WHO position paper (2022 update). Wkly. Epidemiol. 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