Perception and Uptake of HPV Vaccination Among Female Secondary School Students in Enugu State

Cervical cancer is the leading gynaecological cancer in Nigeria, and human papillomavirus (HPV) vaccination of adolescent girls represents the most effective primary prevention strategy, yet vaccine uptake remains limited across many states. This study assesses perception and uptake of HPV vaccination among female secondary school students in Enugu State, South East Nigeria. A descriptive cross-sectional study enrolled 300 female students aged 10 to 19 years from five secondary schools across Enugu North and Enugu South LGAs. Structured self-administered questionnaires measured awareness of HPV and cervical cancer, perception of vaccine safety and benefit, and self-reported vaccination status, with parental consent documentation reviewed. HPV awareness was 44 percent overall and higher in senior secondary students. Vaccine uptake was 21 percent, with the majority citing unawareness of vaccine availability and parental non-consent as primary barriers. Positive perception of vaccine safety was associated with prior health education exposure (OR 3.1) and positive teacher attitude (OR 2.4). Fear of injection and cultural concerns about a vaccine targeting sexual behaviour were documented in qualitative probing. The study identifies awareness and attitudinal gaps as the primary modifiable determinants of HPV vaccination uptake in Enugu secondary schools. Recommendations include school-based HPV vaccination programmes integrated into the National Primary Immunisation Schedule and teacher-led reproductive health education. Keywords: HPV vaccination, cervical cancer prevention, secondary school, Enugu State, adolescent health