# Religion, Politics, and Vaccines: Elaborating the Integrative Public Policy Acceptance (IPAC) Framework Through HPV Vaccine Program Acceptance Among Religious Leaders in Bangladesh

## TL;DR

This study explores how religious leaders in Bangladesh accept or reject the HPV vaccine, showing how politics and religion influence public health policy acceptance.

## Contribution

The study extends the IPAC framework by highlighting the role of political consensus in public policy acceptance.

## Key findings

- Religious leaders' support for the HPV vaccine was influenced by limited awareness of cervical cancer and concerns about ingredients and side effects.
- Political ideologies significantly impacted leaders' support, especially when they perceived government opposition to their religious beliefs.
- The study emphasizes the need for health policies in Muslim-majority countries to align with religious and cultural values.

## Abstract

In October 2023, Bangladesh introduced a free, single-dose human papillomavirus (HPV) vaccine for girls aged 9–14 through its national vaccination program to prevent cervical cancer, the second most common cancer among Bangladeshi females, caused by the HPV. Although vaccine hesitancy was not a significant issue before the COVID-19 pandemic, experiences from that pandemic and global literature suggest that the population’s uptake of this vaccine may face barriers due to concerns related to reproductive health, fertility, and cultural and religious beliefs. This is particularly relevant in a country where Islam is the state religion, 91% of the population is Muslim, and religious leaders hold significant influence over public opinion.

Building upon the recently developed Integrative Public Policy Acceptance (IPAC) framework, this qualitative study explores the factors shaping religious leaders’ support for the HPV vaccine informing their potential role in promoting it. Semi-structured interviews with leaders from Bangladesh’s five main Islamic traditions were thematically analysed using NVivo 14 with inductive and deductive coding.

Islamic religious leaders’ varying support for HPV vaccinations in Bangladesh was influenced by their limited awareness of cervical cancer, as well as their religious and social concerns about ingredients, side effects and a fear of promoting promiscuity. Political ideologies also played a significant role, as leaders were less supportive of the program when they perceived the government as ideologically opposed to the beliefs or practices of their specific religious tradition.

The study’s contribution to the IPAC framework highlights the importance of political consensus in policy acceptance, explaining how partisanship and ideological differences impact public policy compliance. The findings underscore the need for health systems in Muslim majority countries to engage with religious authorities, build political inclusivity and consensus, and align health policies with religious and cultural values.