A descriptive study to assess the level of knowledge, attitudes, and

perception towards HPV infection, vaccination among adolescents

Introduction
Human Papillomavirus (HPV) is a highly prevalent virus transmitted primarily
through sexual contact. With over 200 identified types, HPV has a broad range of
clinical outcomes—from asymptomatic infections to conditions like genital warts
and various cancers. Because most sexually active individuals are exposed to HPV
at some point in their lives, vaccination, especially in adolescence, is a critical
public health intervention.
Prevalence: HPV is one of the most common sexually transmitted infections
(STIs).
Transmission: Mainly spread via skin-to-skin contact during sexual activity;
transmission can occur even without visible symptoms.
Disease Spectrum: Some HPV types cause benign conditions (e.g., genital warts),
while others are high-risk and can lead to cancers (e.g., cervical, anal,
oropharyngeal, vulvar, vaginal, and penile cancers).
2. HPV and Its Associated Risks
HPV-Related Diseases:
Cervical Cancer: Nearly all cases (approximately 99%) are linked to HPV,
particularly types 16 and 18.
Genital Warts: Typically caused by HPV types 6 and 11, these are non-cancerous
but can cause significant discomfort and psychosocial distress.
Why we need to focus on Adolescents?
Pre-Exposure Vaccination: The ideal time to vaccinate is before the initiation of
sexual activity, ensuring the immune system develops protective antibodies
without prior exposure to the virus.
Robust Immune Response: Adolescents tend to mount a stronger immune response
to the vaccine, offering long-term protection.
Types of HPV Vaccines:
Gardasil 9:
Covers nine HPV types, including those that cause both the majority of cervical
cancers (types 16, 18) and genital warts (types 6, 11), as well as additional high-
risk types (31, 33, 45, 52, 58).
Cervarix:
Protects mainly against HPV types 16 and 18 and is used in some regions as an
alternative.
Mechanism of Action:
Immune Response: The vaccine contains virus-like particles (VLPs) that mimic
the HPV outer shell. These VLPs are non-infectious but trigger the body to
produce antibodies against HPV.
Prevention: Once the immune system is primed, it can quickly respond to actual
HPV exposure, preventing the establishment of infection and subsequent
development of related diseases.
4. Recommended Vaccination Schedule
Age Groups and Dosage:
Ages 9–14 (Primary Target):
Dosage: A two-dose series is recommended.
Schedule: The first dose is given at an initial visit, and the second dose is
administered 6–12 months later.
Ages 15–26 (Catch-Up Vaccination):
Dosage: A three-dose series is recommended.
Schedule: Typically administered at 0, 1–2, and 6 months.
Adults (27–45 Years):
Considerations: Vaccination may be offered based on individual risk factors, but
the overall benefit declines as age increases and the likelihood of prior exposure to
HPV rises.

Rationale:
Early Vaccination: Ensures that adolescents are protected before they become
sexually active.
Dosage Schedule: Tailored to optimize the immune response. Younger individuals
respond more robustly, which is why a two-dose schedule is sufficient for them
compared to the three-dose schedule required for older adolescents and young
adults.
5. Safety and Efficacy
Safety Profile:
Extensive Research: The HPV vaccines have undergone rigorous clinical trials and
post-marketing surveillance.
Common Side Effects:
Mild pain or swelling at the injection site.
Low-grade fever, headache, or fatigue.
Rare Adverse Effects:Serious side effects are extremely rare. Multiple studies have
confirmed no causal link between HPV vaccination and serious conditions such as
autoimmune diseases or infertility.
Efficacy:
Prevention Rates:
The vaccine has proven highly effective in preventing infections with the HPV
types covered by the vaccine.
Significant reductions in HPV-related pre-cancerous lesions and genital warts have
been observed in populations with high vaccine uptake.
Long-Term Impact:
Modeling studies suggest that widespread vaccination could lead to the eventual
elimination of cervical cancer as a major public health problem.
6. Global Impact and Success Stories
Real-World Evidence:
Australia:
With one of the highest vaccination rates globally, Australia has witnessed a
dramatic decline in HPV infections and is on track to be the first country to
eliminate cervical cancer.
United Kingdom and Sweden:
Similar successes in reducing HPV prevalence and related diseases have been
reported.
Global Perspective:
Countries with robust vaccination programs show significant decreases in HPV-
related morbidity, indicating the success of these public health interventions.
Barriers to HPV Vaccination
Despite its proven benefits, several challenges hinder optimal vaccine uptake:
Awareness and Education:
Knowledge Gaps:
Many parents, adolescents, and even some healthcare providers may lack
comprehensive knowledge about HPV and the benefits of vaccination.
Misconceptions:
Myths such as the vaccine encouraging early sexual activity persist, despite
evidence to the contrary.
Vaccine Hesitancy:
Safety Concerns:
Misinformation spread via social media and other sources can create unfounded
fears about vaccine safety.
Cultural Beliefs:
In some communities, cultural or religious beliefs may influence attitudes toward
vaccination.
Access and Availability:
Healthcare Infrastructure:
In low-resource settings, limited access to healthcare facilities and vaccines can
restrict vaccination coverage.
Cost:
Even in developed countries, the cost of vaccines (if not subsidized) can be a
barrier for some families.
Strategies to Improve Vaccine Uptake
To overcome these barriers, several strategies can be implemented:
Education and Awareness Campaigns:
Targeted Communication:
Use evidence-based information to educate parents, adolescents, and healthcare
providers.
Public Health Messaging:
Campaigns should emphasize the vaccine’s safety, efficacy, and role in cancer
prevention.
School-Based Programs:
Accessibility:
Integrating HPV vaccination into school health programs makes it easier to reach
adolescents.
Peer Education:
Schools or college can serve as platforms for peer-led education, reducing stigma
and increasing acceptance.
Healthcare Provider Engagement:
Strong Recommendations:
Healthcare providers play a crucial role. When physicians strongly recommend the
vaccine, parents and adolescents are more likely to accept it.
Training and Resources:
Providing healthcare providers with up-to-date resources and training helps they
address concerns effectively.
Government Policies and Support:
Subsidized or Free Vaccination Programs:
Government initiatives to provide the vaccine at low or no cost can significantly
increase uptake.
Mandates and School Requirements:
Some regions have introduced mandates or school-entry requirements for HPV
vaccination, boosting coverage rates.
Conclusion
The HPV vaccine represents a significant advancement in public health,
particularly in the prevention of cervical and other HPV-related cancers. By
vaccinating adolescents before they become sexually active, we ensure they
develop strong, long-lasting immunity against the virus. The extensive research
supporting the vaccine’s safety and efficacy, combined with real-world evidence
from countries with high vaccination rates, makes a compelling case for its
widespread adoption.
However, challenges such as misinformation, cultural barriers, and access issues
must be addressed through comprehensive education, effective communication
strategies, and supportive public health policies. By overcoming these barriers, we
can move closer to eliminating HPV-related diseases, ultimately reducing the
global burden of cancer and improving overall community health.
Statement of the problem:
• A descriptive study to assess the level of knowledge, attitudes, and
perception towards HPV infection, vaccination among adolescents

OBJECTIVES:
 To assess the level of knowledge, attitudes, and perception towards
HPV infection, vaccination among adolescents
 To find out the correlation between the level of knowledge, attitudes,
and perception towards HPV Infection, vaccination among
adolescents
 To find out the significance different between the levelof knowledge,
attitudes, and perception towards HPV Infection, vaccination
among adolescents
 To find out the association between the levelof knowledge, attitudes, and
perception towards HPV infection, vaccination among adolescents
with selected demographic variables

HYPOTHESIS:
H1: There is a significance relationship between the levels of knowledge , and
attitudes
H2: There is significance difference between the levelsof knowledge , and
attitudes
H3: There is a significance association between the levelsknowledge , and
attitudes, perception
OPERATIONAL DEFINITION:
Assess: It refers to measure the level of knowledge, attitudes, and perception
among adolescents

Knowledge: It refers to measure the collecting information, understanding and

Perception: It refers to measure the ability to notice or understand something

Research methodology:
• Research approach: The research approach used for the study was
quantitative.
• Research design: The research design used for the study was descriptive
design.
• Setting of the study : The study was conducted in vidyarathna college of
nursing , Udupi
• Sampling technique: The sample were selected by using convenient
sampling technique
Research proposal