Commentary: The uptake of human papillomavirus vaccination: the power of belief

International Journal of Epidemiology
Volume 42 Issue 3 June 2013

Commentary: The uptake of human papillomavirus vaccination: the power of belief
Heidi J Larson
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail:
Accepted April 29, 2013.

The systematic review and meta-analysis of ‘Inequalities in the uptake of human papillomavirus vaccination’ in this issue of IJE reveals the complexities of identifying the diverse factors which determine HPV vaccination uptake. The authors note ‘the factors affecting HPV vaccination in Black young women are not yet fully understood’.1

Although the review particularly focuses on socio-economic and ethnic disparities in HPV vaccine uptake among young women in the USA, it acknowledges additional underlying factors—beyond economic and ethnic determinants—which also affect the uptake of HPV vaccines confirmed in studies globally.1–4

The determinants of HPV acceptance are very different from those around childhood vaccines. Firstly, the vaccine prevents a sexually transmitted infection (STI)—evoking the moral judgements and religious and cultural taboos that come with discussing and addressing sexual behaviour. In some settings, the vaccine is being promoted largely as a vaccine for cancer prevention, making it more culturally acceptable than an STI vaccine, particularly for adolescents.1,3 Secondly, and linked to the issue …