Primary Cervical Cancer Prevention in Morocco: HPV Vaccine Awareness and Acceptability among Parents

Cervical cancer is a major public health concern in Morocco where it represents the second most common and lethal cancer in women. Human papillomavirus (HPV) vaccines have been licensed in Morocco since 2008 but there is no available data on their acceptability. This study aimed to assess awareness of HPV and the vaccine, and to identify factors associated with acceptability of the vaccine among parents in Morocco. A questionnaire-based survey using face-to-face interviews was conducted in a sample of 852 parents (670 mothers and 182 fathers) with at least one unmarried daughter ≤26 years. The study took place within public and private health centres and clinics in four regions in Morocco between July and August 2012. The main outcome measure was willingness to consider vaccinating a daughter against HPV. Responses revealed very low awareness of HPV infection (5%) and the HPV vaccine (14%). None of the participants had vaccinated their daughters against HPV and only 35% (32% of mothers and 45% of fathers) were willing to consider doing so in the future. Higher education and income, previous awareness of the HPV vaccine and endorsement of the belief that a recommendation from the ministry of health or a doctor to have the vaccine would be encouraging, were associated with mothers’ HPV vaccine acceptance. Non-acceptance among mothers was associated with having more than two daughters, believing the vaccine was expensive and lack of information. The only factor associated with the fathers’ acceptance of the vaccine was the cost. Increasing HPV and HPV vaccine awareness through educational campaigns, along with active recommendation by physicians and a publically funded vaccination programme could increase parental acceptance of the vaccine in Morocco.