Sibylle Herzig van Wees

The human papillomavirus (HPV) is responsible for most cervical and anogenital cancers. The HPV vaccine can effectively reduce invasive cervical cancer

however, HPV vaccine uptake is low in certain groups due to hesitancy and refusal, which undermines the success of the vaccine. In Sweden, HPV vaccine hesitancy has mainly been observed among parents and adolescents in socioeconomically disadvantaged communities with large immigrant populations.The purpose of this project is therefore to co-design and assess the feasibility and preliminary effects of digital health intervention tools to reduce HPV vaccine hesitancy and increase uptake of this vaccine in socioeconomically disadvantaged communities in Stockholm, Sweden. Several research questions shall assess whether a co-designed digital health intervention has the potential to improve HPV uptake, awareness and confidence.The project involves three sub-studies implemented by an interdisciplinary team.  Study 1 will involve a formative stage whereby adolescents, parents/guardians and school nurses situated in socially disadvantaged areas in Stockholm will be interviewed to understand their perspectives and concerns related to the HPV vaccine. Thereafter, study 2 will use knowledge gained from study 1 to inform the co-design phase where adolescent boys/girls and their parents/guardians are invited to develop and provide feedback on content and prototypes for digital health interventions. Finally, study 3 will involve pilot-testing of the intervention for feasibility, acceptability and preliminary effect, using a cluster-randomized design.This project is highly feasible as it builds on the study team’s previous research, which show that immigrant communities in Sweden experience poorer health outcomes as well as vaccine hesitancy. Because 1 in 5 Swedes have a migrant background this study is relevant to Swedish society. An appropriate and accessible digital health intervention has the potential to prevent cervical cancer, saving lives and reducing future burdens on an overstretched Swedish healthcare system. The results from this project will be generalizable to similar contexts in Sweden and possibily beyond.

The introduction of the COVID-19 vaccine has highlighted the problem of vaccine hesitancy in Africa. This trend is in part driven by the spread of anti-vaccine information on social media. As this gains further traction, it could lead to a sharp increase in vaccine hesitancy rates and weaken confidence in other essential vaccines. Several studies have established widespread vaccine hesitancy among health workers in Africa. The aim of this project is to develop and evaluate an innovative peer-led social media intervention that addresses vaccine concerns among health workers in  Ethiopia and Nigeria. These countries were selected because of observed vaccine hesitancy among health workers and because social media use is very common. The intervention will be co-designed by health workers

thereafter peers will promote the messages on social media. The impact of the intervention on the vaccination status of health workers will be assessed through a cluster-randomised trial. Targeting health workers can have positive ripple effects

vaccines can protect health workers as well as the patients they care for, thereby preserving the health system. Increasing trust among health workers can also have the positive effect of building confidence in essential childhood vaccines among the wider population as they are influential role models. Addressing vaccine hesitancy and the underlying misinformation can help build higher acceptance of future vaccines.