The behavioral and social drivers of HPV vaccination among parents and young people in Indonesia: a scoping review.

Abstract

Purpose: The Indonesian Government launched the national human papillomavirus (HPV) vaccination program in August 2023, reaching 90% coverage for both doses. This scoping review explored the behavioral and social drivers of HPV vaccination among parents and young people in Indonesia.

Methods: We searched four databases for primary quantitative, qualitative, and mixed-method studies in English or Bahasa Indonesia assessing behavioral and social drivers of HPV vaccination in Indonesia. Participants were parents and young people under 24. The quality was appraised with the Mixed Methods Appraisal Tool. Narrative synthesis was conducted to summarize findings according to the World Health Organization's Behavioral and Social Drivers (BeSD) of vaccination framework.

Results: Eighteen studies were included. Drivers were mapped across the BeSD domains: thinking and feeling, social process, motivation, and practical issues. The majority were related to what people think and feel including low knowledge and awareness of HPV disease and vaccines despite high motivation to vaccinate. This review identifies the importance of HPV vaccines' halal-haram status. Spouses and teachers were the most cited influencers in vaccine decision-making not healthcare providers. Puskesmas was the preferred vaccination location and concerns about vaccine costs were frequently mentioned.

Conclusion: This review identifies the main drivers of HPV vaccination among parents and young people in Indonesia to optimize HPV vaccine uptake as the national rollout is expanded. Clear communication about the halal-haram status of HPV vaccines, involvement of parents, family, teachers, and trusted community members to communicate about HPV vaccines and ensuring HPV vaccine accessibility outside schools are needed.