Verification of Self-Reported HPV Vaccination in the Initial Cohorts of the Botswana’s National Immunization Programme, 2023–2024

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ABSTRACT Botswana launched a national female-only school-based 2-dose HPV vaccination programme among 9–13-year-olds in 2015. During a 2023–2024 vaccine impact study among women aged 18–22 years recruited from the University of Botswana and Gaborone-area HIV clinics, we compared self-reported HPV vaccination to school and health facility records. Of 450 women, 446 self-reported HPV vaccination (301: 1-dose, 135: 2-dose, 10: 3-dose). Vaccination status was verified for 429/450 (95%); one was not vaccinated, 52 (12%) had 1 dose, 344 (80%) 2 doses, and 32 (7%) 3 doses. Agreement on ≥1 dose was >99%; dose-specific agreement was 37% (159/429); 256 (60%) underreported and 14 (3%) overreported number of doses. While time- and resource-intensive, nationwide vaccination verification without a vaccination registry was feasible. Results suggest high vaccination coverage, including high ≥2-dose coverage. Self-report of ≥1 dose was highly accurate, but number of doses was often underreported.

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