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Table 2 Reported rumours, institutional refusals, and management approaches

From: Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries

Reported rumours Management approaches (preventative and reactionary)
 HPV vaccine is experimental/untested
 (Countries 3, 12, 24)
• Rumours resulted from opt-in consent, which was changed to opt-out;
• Government and experts immediately addressed rumours.
 HPV vaccination causes fertility problems
 (Countries 8, 17, 21, 24, 31, 16, 28)
• Mobilisation was started very early and messages built into parent-teacher meetings;
• High-level advocacy using parliamentarians from the beginning of the programme;
• Intense mobilisation targeted anti-vaccination lobbyists;
• A reactive crisis response was organised, including meeting with communities.
 Vaccine causes long-term adverse events, e.g., death, cancer
 (Countries 28, 33, 35, 26)
• Adverse events were investigated and guardians reassured that it was not due to vaccination.
 There is another cure for cervical cancer other than vaccination
 (Country 35)
• Rumours were tackled immediately with email newsletter and/or parent meetings.
Institutional refusals related to the vaccine Management approaches
 Private/faith-based schools
 (Countries 23, 24, 31, 35, 37)
• Sensitization through the community and targeted mobilisation using influencers;
• Media access to correct information so communities could obtain HPV vaccine information from an independent source.
 Churches/religious groups
 (Countries 3, 28, 37)
• Increased face-to-face, community, and religious leaders’ meetings.
 Community/parent groups
 (Countries 1, 5, 6, 10, 14, 18, 23)
• Identified groups opposing vaccination were provided with more information;
• Frequent repetition of messages;
• Involved leaders and managed vaccination through government system;
• Provided additional training and information to health-workers and teachers.
 Anti-vaccination lobbyists, human rights groups, academics
 (Countries 12, 30)
• Provided additional media information and internet-based information campaigns.
 Teacher and health-worker reluctance to vaccinate girls
 (Countries 6, 23)
• Provided additional training to healthworkers and used peers to trace missing and out-of-school girls.