Published in PLOS One on 2026-07-09, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Sohail Agha, Khadija Hassan, T. O. Olusanya, Hauwa Abbas, Drew Bernard, Ifeanyi Nsofor
Source: PLOS One • DOI 10.1371/journal.pone.0352986
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Market priming strategies use communication to prepare target audiences for service uptake when services become available. In 2025, a health worker strike in Abuja, Nigeria resulted in the suspension of HPV vaccination services for approximately four months. Services were temporarily restored for five days (July 16–20, 2025) during a Maternal, Newborn, and Child Health (MNCH) week. This study assessed whether caregiver recall of a digital market priming campaign was associated with HPV vaccine uptake during this brief service resumption.
We conducted a cross-sectional exit survey of 271 caregivers of adolescent girls aged 9–17 years attending vaccination sites during MNCH week. The survey collected data on socio-demographic characteristics, Facebook use, recall of HPV vaccine advertising on Facebook or Instagram, and caregiver-reported adolescent vaccination status. Survey findings were triangulated with administrative data on the number of HPV vaccinations delivered during the MNCH week. Analyses included descriptive statistics and multivariable logistic regression. A two-stage residual inclusion (2SRI) model was used as a sensitivity analysis to assess potential bias from unobserved confounding related to social media use. Ward-level regression analyses using administrative data compared vaccinations delivered in wards targeted by the digital campaign with those in non-targeted wards.
Overall, 33.6% of caregivers recalled HPV vaccine advertising on Facebook or Instagram, and 64.2% reported that their adolescent had received the HPV vaccine. Message recall was associated with higher odds of caregiver-reported vaccination (adjusted odds ratio = 3.36; 95% CI: 2.75–4.11). Model-predicted marginal effects indicated a 23.3 percentage-point difference in reported vaccination probability between caregivers who did and did not recall messages, corresponding to an estimated 7.9 percentage-point difference in vaccination prevalence when applied to the caregiver population attending vaccination services. The 2SRI analysis found no evidence of endogeneity (p = 0.736). Administrative data were consistent with survey findings, suggesting an approximately 3 percentage-point higher vaccination coverage in wards targeted by the digital campaign compared with control wards during MNCH week.
Caregiver recall of a digital market priming campaign was associated with higher HPV vaccination uptake during a short-term resumption of services following a prolonged disruption. These findings suggest that insights-informed, subnational digital priming strategies—when combined with complementary offline approaches to ensure equitable reach—may help maintain caregiver readiness and support HPV vaccine delivery during periods of service instability.
Introduction
Human papillomavirus (HPV) is a leading cause of cervical cancer, which disproportionately affects women in low- and middle-income countries (LMICs). Despite the high efficacy of HPV vaccines and the World Health Organization’s global elimination targets [1,2], vaccination coverage in many LMICs remains well below the 90% goal. Vaccine rollouts in these settings frequently face challenges related to supply constraints, service delivery disruptions, and caregiver hesitancy. Together, these challenges highlight the importance of communication strategies that shape demand and help ensure that caregivers are prepared to accept HPV vaccination when services become available.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Sohail Agha, Khadija Hassan, T. O. Olusanya, Hauwa Abbas, Drew Bernard, Ifeanyi Nsofor. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Strengthened HPV vaccination among adolescents living with HIV, – Findings of a Pilot QI project in Kampala Metropolitan, Uganda
- Evidence brief: Understanding factors influencing HPV vaccine uptake among caregivers in Kwara State, Nigeria: A qualitative study
- Evidence brief: Prevalence, spatial patterns and determinants of zero-dose vaccination among children aged 12–23 months in Sub-Saharan Africa: A multilevel spatial analysis
