Most Nigerian Doctors Back HPV Vaccines, but Knowledge Gaps Linger

Most licensed medical doctors in Nigeria know about the human papillomavirus vaccine, view it favourably and have actually recommended it to someone, according to a cross-sectional survey of 462 doctors published in Discover Health Systems. The study, conducted between October 2023 and January 2024, found that 72.3% of respondents scored as having good knowledge of HPV vaccination, 77.9% held a favourable attitude towards the vaccine, and 81.8% had previously advised someone to receive it. Nearly all of the doctors surveyed, 94.4%, said they would be willing to recommend the vaccine to a family member, and 94.8% said they would recommend it to other people.

The survey comes at a critical moment for Nigeria’s cervical cancer prevention efforts. The country introduced the HPV vaccine into its routine immunisation programme for nine-year-old girls with an official flag-off in October 2023, the same month data collection began. Because doctors are among the most trusted sources of vaccine information and their recommendations strongly influence whether parents accept vaccination for their children, the researchers set out to measure how prepared the medical workforce actually is to support the newly launched programme. According to the Medical and Dental Council of Nigeria, there were 44,052 doctors practising in the country in 2022, making even a snapshot of their knowledge and attitudes a meaningful indicator of the programme’s likely reception.

Participants were recruited through convenience sampling, with an online self-administered questionnaire disseminated via professional networks and doctors’ WhatsApp platforms across the country. The researchers note that no comprehensive national sampling frame of practising doctors was readily accessible for probability-based sampling, so they aimed instead to reach doctors from different regions, specialties and career stages, in both public and private facilities. The final sample of 462 exceeded the minimum sample size of 384 calculated using Fisher’s formula, though it fell short of the 500 the investigators had targeted for greater precision. Respondents answered questions on their sociodemographic characteristics, their knowledge of the HPV vaccine, their attitudes towards it, and their practices around recommending it.

The average respondent was 40.6 years old, with a standard deviation of 8.3 years. Most were male, 297 of 462 or 64.3%, and 242 doctors, or 52.4%, had more than eleven years of work experience. The sample skewed towards the public sector, with 89.0% working in government facilities and 73.2% in tertiary hospitals. Consultants made up 39.4% of respondents. By specialty, 27.3% worked in public health departments, 20.2% in family medicine, 18.0% in obstetrics and gynaecology, and 17.1% in surgery. Knowledge was scored using ten questions, attitude with seven, and recommendation practice with three, with correct or appropriate responses earning one point each. Scores were converted to percentages, and a 70% cut-off separated good from poor performance on each scale, a threshold the authors chose because doctors are expected to know more than the general population.

Some knowledge items revealed near-universal understanding. Every single respondent, 462 out of 462, correctly identified that cervical cancer is caused by HPV infection. Almost all, 97.0%, knew the vaccine is available in Nigeria, 77.9% knew the recommended age for vaccination, 78.8% knew the route of administration, and 80.5% knew the vaccine works best before HPV infection occurs. But deeper technical knowledge was thinner. Only 38.1% correctly identified the protection rate of the HPV vaccine against cervical cancer, and just 66.2% knew that a residual risk of cervical cancer remains even after vaccination. These gaps matter, the authors argue, because they may affect the quality of counselling doctors provide when patients and caregivers ask pointed questions about vaccine effectiveness and the continuing need for cervical cancer screening.

Attitude items painted a similarly encouraging picture. Most respondents agreed the vaccine is effective in preventing cervical cancer, 84.9%, and said they would accept the vaccine themselves if eligible, 86.1%. Large majorities correctly rejected common misconceptions: 85.7% disagreed that the HPV vaccine causes infertility, 82.3% disagreed that it is harmful to health, and 89.6% disagreed that it is unsafe. On the practice side, 81.8% had previously advised someone to receive the vaccine, and 79.2% overall demonstrated good recommendation practices. Among the minority who would not recommend the vaccine to others, the reported reasons included time constraints, the belief that recommendation is not their responsibility, concern that vaccination encourages early sexual initiation, and doubts about vaccine safety and efficacy.

The statistical analysis revealed clear patterns in who knew the most. Female doctors had higher odds of good knowledge than male doctors, with an adjusted odds ratio of 1.73 and a 95% confidence interval of 1.05 to 2.85. In raw proportions, 78.2% of female doctors had good knowledge compared with 69.0% of male doctors. Professional cadre mattered as well: compared with consultants, house officers had markedly lower odds of good knowledge, with an adjusted odds ratio of 0.18 and a confidence interval of 0.05 to 0.64, and resident doctors also had lower odds, at 0.51 with a confidence interval of 0.28 to 0.94. Consultants themselves had the highest proportion of good knowledge at 78.0%, while house officers had the lowest at 50.0%. Specialty made an even starker difference. Compared with surgeons, family physicians had an adjusted odds ratio of 2.18, internists 2.59, paediatricians 4.76, public health physicians 6.59, and obstetricians and gynaecologists 7.56, with confidence intervals ranging from 1.11 to 4.28 for family physicians up to 3.37 to 16.98 for obstetricians and gynaecologists. Surgeons had the lowest raw proportion of good knowledge, just 48.7%, while public health physicians had the highest at 85.7%.

Attitude and practice followed different demographic patterns than knowledge did. Only years of work experience was significantly associated with attitude at the bivariate level, and the relationship ran in an unexpected direction: doctors with five or fewer years of experience had the highest proportion with a favourable attitude, 89.7%, compared with 73.1% among those with six to ten years and 74.4% among those with eleven or more. Because only one variable reached significance, the authors did not run multivariable regression for attitude. For practice, department of practice was the sole significant factor, with good practice highest among obstetricians and gynaecologists at 87.8%, family medicine at 87.0%, public health at 85.7% and paediatrics at 81.3%, and lowest among surgeons at 59.0%. Multivariable analysis was likewise not performed for practice for the same reason. The authors suggest the specialty gradient in knowledge may reflect that gynaecologists manage cervical cancer directly, paediatricians focus on childhood and adolescent vaccines, and public health physicians concentrate on disease prevention, and they argue HPV vaccination should be treated as a shared responsibility across all specialties rather than confined to women’s and children’s health.

The study has limitations the authors acknowledge openly. Because the sampling was non-probabilistic and recruitment flowed through online professional networks and social media, selection bias is possible, and the sample may not fully represent all doctors in Nigeria, particularly those without internet access or outside the dissemination channels. The findings therefore may not be fully generalisable to the entire physician workforce. Still, the authors describe this as the first quantitative study of HPV vaccine knowledge, attitudes and recommendation practices among doctors in Nigeria, and it captures the workforce precisely as the national immunisation programme launched. Their conclusion points towards a practical remedy: continuous medical education, updated national HPV vaccination guidelines, evidence-based resources and clear risk communication to close the specific knowledge gaps around vaccine effectiveness and residual cervical cancer risk, allay lingering safety and efficacy concerns, and reinforce vaccine recommendation as a duty every physician shares, sustaining the momentum of the launch period as public attention naturally begins to fade.

Subject of Research: Knowledge, attitudes and recommendation practices regarding the HPV vaccine among licensed medical doctors in Nigeria

Article Title: HPV vaccine knowledge, attitude and practice among medical doctors in Nigeria

Article References: Adeniyi, M. A., Sherif Azees, A., Olubodun, T., & Kayode Ahmed, A. (2026). HPV vaccine knowledge, attitude and practice among medical doctors in Nigeria. Discover Health Systems, 5(1), Article 69. https://doi.org/10.1007/s44250-026-00407-x

Image Credits: AI Generated

DOI: 10.1007/s44250-026-00407-x

Keywords: HPV vaccine, Nigeria, medical doctors, cervical cancer, vaccine knowledge, vaccine hesitancy, cross-sectional study, routine immunisation, vaccine recommendation, continuing medical education, Discover Health Systems, public health