Barriers to HPV Vaccination in Brazil: A Systematic Review.
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INTRODUCTION: Cervical cancer is the third most common cancer worldwide. Expanding HPV (Human papillomavirus) vaccination coverage to 90% of all adolescent girls by 2030 is the World Health Organization's (WHO) primary vaccination strategy to eliminate cervical cancer by the end of the century. AIM: To identify the main challenges associated with HPV vaccination in Brazil. METHODS: A systematic review in accordance with the PRISMA reporting guidelines was conducted using PubMed, EMBASE Lilacs, Cochrane Library, SCOPUS, and Web of Science databases, which included prospective and cross-sectional studies. Different term combinations were used: ((("HPV vaccination"[TITLE]) OR ("HPV vaccine"[TITLE]) OR ("HPV immunization"[TITLE]))) AND (Brazil); HPV vaccination AND Brazil; Barriers AND vaccination AND HPV AND Brazil; Barriers AND HPV vaccination AND Brazil. This study included published articles with no language or date restrictions. RESULTS: A total of 179 articles were identified. After deleting 50 duplicates, 78 articles were excluded based on their title or abstract, while 28 were excluded after full reading, thus leaving only 23 articles. Seven studies were carried out in the southeast region, one in the southern region, one in the midwest region, and two in the north region. Knowledge was the biggest problem detected among parents and guardians, health caregivers, health students, and general users of the Brazilian Unified Health System (SUS). CONCLUSION: All studies indicated that knowledge is essential for adherence. For students and health professionals, a more comprehensive approach to the topic would be beneficial in advancing their knowledge.