Exploring Indonesian Primary Schoolgirls’ Experiences of School-based HPV Vaccination, Knowledge of HPV Risks and Prevention, and Preferences for Cervical Cancer Education

Sep 21, 2026

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Objective: In 2016, Indonesia launched an HPV vaccination demonstration program for primary school girls in grades 5 and 6 to reduce cervical cancer burden and test feasibility nationwide. Methods: An online survey recruited girls vaccinated between 2019 and 2021 through the program in Jakarta and Yogyakarta. Purposive sampling used partnerships with primary public health centres and schools. Results: 140 girls completed the survey; mothers and schools were key information sources, and knowledge needed improvement. Conclusion: Culturally appropriate, evidence-based strategies for parents and school educators are needed.

LanguageEnglish

CategoryHealthcare

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Pages8

Reading Time20 min

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Abstract

Introduction

RESEARCH ARTICLE Editorial Process: Submission:10/18/2023 Acceptance:04/07/2024 Exploring Indonesian Primary Schoolgirls’ Experiences of School-based HPV Vaccination, Knowledge of HPV Risks and Prevention, and Preferences for Cervical Cancer Education Setiyani Marta Dewi*, Linda Rae Bennett, Anna Barrett Abstract Objective: In 2016, Indonesia introduced its Human Papillomavirus (HPV) vaccination demonstration program for girls in grades 5 and 6 of primary school, to reduce cervical cancer (CC) burden in selected provinces and test the viability of nationwide vaccination. This study explored schoolgirls’ experience of school-based HPV vaccination, their knowledge of HPV and HPV vaccination, and their preferences for cervical cancer (CC) education. Methods: An online survey was conducted with schoolgirls who experienced HPV vaccination between 2019 and 2021 through the demonstration program. Using purposive sampling, respondents were recruited through partnerships with primary public health centres and primary schools in Jakarta and Yogyakarta. Data analysis was conducted using Chi-square test, Independent-samples t-test, and one-way ANOVA. Results: One hundred and forty primary schoolgirls with a mean age of 12.2 years (SD = 0.70) completed the survey. Schools and mothers were identified as key actors in socialising children about important health information and as girls’preferred sources of information. The average summed score for girls’knowledge of HPV, the HPV vaccine, and CC after being vaccinated was 5.07 out of 10 (SD 0.23) . Significant differences in the mean knowledge scores among participants with different preferences regarding CC education in school were observed. Conclusion: While schoolgirls’ experiences of HPV vaccination were largely positive, their knowledge of critical health information regarding HPV vaccination and CC prevention needs improving. Thus, it is necessary to provide parents, and school-based educators with culturally appropriate strategies and comprehensive evidence-based information about HPV vaccination and CC prevention more effectively to children. Keywords: Adolescent girls-cervical cancer education-school-based-human papillomavirus vaccination-Indonesia Asian Pac J Cancer Prev, 25 (4), 1285-1292 Introduction Annually, around 36,600 Indonesian women are diagnosed with CC, however, it is estimated that 103 million females aged 15 and older are at risk of acquiring it [1] . The Quadrivalent HPV (Human Papillomavirus) vaccine is known to be efficacious in preventing CC anda subset of other cancers [2] and is recommended by The Centre for Disease Control and Prevention (CDC) for all children for routine vaccination starting at age 9 [3] . In 2016, Indonesia introduced HPV vaccination using a quadrivalent HPV vaccine through a demonstration program targeting primary schoolgirls in grades 5 and 6 in the provinces of Jakarta, Yogyakarta, East Java, Bali, South Sulawesi, and North Sulawesi. The program is part of Indonesia’s prevention strategy to reduce CC burden by providing primary prevention via school-based HPV vaccination and secondary prevention via screening for pre-cancer with visual inspection with acetic acid (VIA) or pap-smears. In 2022, Indonesia announced the intention to upscale HPV vaccination for girls in grades 5 and 6, by adding HPV vaccination to the National Childhood Immunisation Program that is implemented through primary schools, with a goal of vaccinating around 2 million adolescent girls by 2024. The success of the demonstration program was affirmed by more than 90% of eligible girls participating and high vaccination completion rate (>90%), yet the program’s evaluation report also highlighted challenges for future implementation [4] . The absence of a policy for vaccinating out-of-school girls indicates possible inequality in access to the vaccine. Misinformation and myths regarding the HPV vaccine also remain among some community members and health

FAQs

What was the purpose of Indonesia’s 2016 HPV vaccination demonstration program?

The program aimed to reduce the cervical cancer burden by providing school-based HPV vaccination for primary school girls and to test feasibility for nationwide vaccination.

How was the study conducted and who were the participants?

An online survey recruited schoolgirls who experienced the school-based HPV vaccination between 2019 and 2021 through the demonstration program in Jakarta and Yogyakarta using purposive sampling.

Which sources were identified as key for sharing health information about HPV?

Schools and mothers were identified as key actors in socialising children about important health information and as girls’ preferred sources of information.

Sep 21, 2026

Upload by Hazel