# Human Papillomavirus vaccine knowledge and recommendation practice among primary care providers, Almaty, Kazakhstan – 2023

## TL;DR

This study assesses healthcare workers' knowledge and willingness to recommend the HPV vaccine in Kazakhstan, finding low levels of knowledge and highlighting the need for training.

## Contribution

The study provides new insights into HPV vaccine knowledge and recommendation practices among healthcare providers in Kazakhstan.

## Key findings

- Only 33% of healthcare workers had adequate HPV knowledge.
- Doctors were more likely to recommend the HPV vaccine than nurses.
- Training and communication could improve HPV vaccine acceptance.

## Abstract

Kazakhstan planned to reintroduce the human papillomavirus (HPV) vaccine into the national vaccination calendar in 2024 for girls aged 12–14. A 2013 pilot attempt failed due to low acceptance. To inform implementation, we evaluated HPV vaccine knowledge and recommendation practices among primary healthcare workers (HCWs). In April-May 2023, we conducted a cross-sectional survey using convenience sampling among HCWs responsible for vaccination at 5 private and 29 of the largest public polyclinics in Almaty. Participants self-completed anonymous questionnaires. Knowledge scores >70% were considered adequate. We used logistic regression to assess factors associated with intention to recommend HPV vaccines, reporting adjusted odds ratios (OR) and 95% confidence intervals (CI). Among 832 participants, 68% were nurses, and 18% had >20 y experience. One-third (33%) had adequate HPV knowledge, 22% knew HPV has no cure, and 71% understood it is not airborne. One-fifth (20%) could dispel common HPV vaccine myths, 39% dispelled common childhood immunization myths, 61% correctly identified childhood vaccine contraindications, and 58% believed in childhood vaccines’ safety and effectiveness. Overall, 28% would recommend the HPV vaccine to patients or their friends’ children. Doctors were more likely to recommend than nurses (OR = 1.52, 95% CI = 1.06–2.18). Higher recommendation odds were also associated with ability to dispel childhood vaccines myths (OR = 1.47, 95% CI = 1.03–2.07), adequate HPV knowledge (OR = 1.63, 95% CI = 1.14–2.32), belief in vaccine safety (OR = 1.65, 95% CI = 1.12–2.47), and support for vaccinating HCWs (OR = 3.07, 95% CI = 2.11–4.54). HPV-related knowledge and recommendation intent among HCWs were low. Targeted training and communication may improve HPV vaccine uptake in Kazakhstan.