Factors Associated with Low Uptake of Human Papilloma Virus (HPV) Vaccination Series in Adolescent Girls in Rukiga District, Uganda

Background This study investigated the low completion rates of the HPV vaccine series in Rukiga District, Uganda, a critical step for cervical cancer prevention. Methods A mixed-methods, cross-sectional study was conducted which included a final sample of 292 parents or caregivers of adolescent girls. Researchers used multivariate logistic regression to identify determinants of completing the two-dose regimen and conducted in-depth interviews with 11 health workers involved in immunisationand 10 Village Health Team members to explore barriers. Results Only 27.49% of eligible girls completed the two-dose series. Girls with mothers as caregivers had greater odds of completion (AOR = 1.70, 95% CI: 1.05-2.74, p = 0.030). Caregivers without formal education were less likely to vaccinate their daughters (AOR = 0.19, 95% CI: 0.05-0.74, p = 0.033). Awareness of HPV infection was a powerful predictor of uptake (AOR = 4.65, 95% CI: 2.03-10.66, p < 0.001). Qualitative data highlighted barriers including vaccine safety misinformation, insufficient health worker training, stockouts, long wait times, and community distrust. Conclusion The low HPV vaccine completion rate is attributed to a combination of caregiver knowledge gaps, socioeconomic obstacles, and systemic health service limitations. Community mistrust and misinformation further exacerbate the issue. Interventions should be integrated to address both supply and demand-side barriers, increase health worker capacity, and rebuild community trust.