Religious Beliefs and Practices toward HPV Vaccine Acceptance in Islamic Countries: A Scoping Review

"Islamic countries exhibit unique socio-cultural dynamics in which religious beliefs and practices play an important role in shaping social norms."

It is well established in the literature that religious beliefs have a profound impact on an individual's decision-making and health-related behaviours, including sexual health. Despite the availability of effective human papillomavirus (HPV) vaccines, their acceptance in Islamic countries is often influenced by religious beliefs, practices, and misconceptions. For example, since HPV is sexually transmitted, some parents may believe that vaccinating their daughters is unnecessary and immoral because it may encourage sexual activity at an early age. This review identifies current literature on religious beliefs and misconceptions toward HPV vaccine acceptance within Organisation of Islamic Cooperation (OIC) countries.

Using key terms, a systematic search in MEDLINE/PubMed, Embase, and CINAHL was conducted of all research articles published in English until October 31 2023. Of the 595 examined, 23 studies met the inclusion and exclusion criteria. The included studies represented a wide geographic range within OIC countries.Among the included articles, most were designed as cross-sectional studies and published in 2023 (six studies), followed by six studies in 2022 and three in 2021. The diverse sample populations provided a comprehensive overview of the issue across different demographics, enhancing the generalisability of the findings. The variety in settings, from urban centres to rural communities, helped foster understanding of how different environments influence religious beliefs and practices.

The results are summarised in Table 2 of the paper. They highlight the complexity of the relationship between religious beliefs and HPV vaccine uptake. The review showed that religious beliefs did not always affect overall vaccine uptake, but they did influence vaccine acceptability. The study identified a range of misconceptions and beliefs related to HPV vaccination. Some of these misconceptions included seeing the vaccine as a form of ethnic cleansing, a license for wanton sexual behaviour, a defiance of religious norms, a sneaky way to inject good Muslims with haram (forbidden by Islam) ingredients (e.g., claims that the vaccine was processed from pig's blood), and an abandonment of righteous principles in general.

The review also found that the degree of religious influence on health decisions varies not only between countries but also within different regions of the same country, reflecting the diversity in religious denominations and sects. The findings also underscore the complex interplay between cultural beliefs and public health interventions, highlighting the need for culturally sensitive education and communication strategies to address misconceptions about the HPV vaccine.

Some of the studies suggested public health strategies to increase HPV vaccine uptake in Islamic countries by increasing awareness among people refusing the HPV vaccine about religious beliefs and misconceptions about HPV vaccination. With any intevention, public health officials need to be sensitive to religious objections, addressing them respectfully and informally. Specific ideas include:
 

• Collaborate with religious leaders and institutions to influence community attitudes on health-related decisions. Leveraging the influence of religious leaders can shift community attitudes toward vaccine acceptance, especially when the messages are aligned with religious teachings and values.
• Adapt public health campaigns to regional variations in faith and practices to ensure the interventions are relevant to different cultural contexts.
• Develop culturally and religiously sensitive educational materials to bridge the gap between scientific knowledge and religious understanding.
• Utilise religious platforms for health education.
• Train health professionals in religious literacy and cultural competence, because it can equip them to better understand and address the concerns of the communities they serve.

The researchers also recommend further research to deepen understanding of the dynamic relationship between religious beliefs and health behaviours. Comparative studies across different contexts are essential, they argue, for understanding the different ways that religion influences health decisions. Qualitative studies can provide a deeper understanding of religious beliefs on vaccine acceptance and other religious-related health behaviours.

In conclusion: "Vaccine hesitancy is a result of doubts regarding the vaccine's safety, necessity, and compatibility with religious beliefs. It is recommended to encourage HPV vaccine uptake in Islamic countries by using public health strategies that adopt a holistic approach that incorporates religious, cultural, and social aspects."