Integrating Human Papillomavirus Vaccination into Postpartum Care: A Feasible Strategy to Improve Cervical Cancer Prevention

Objective: The objective of this study was to assess the effect of structured counseling on awareness of human papillomavirus (HPV), cervical cancer, and HPV vaccination among postpartum women and to evaluate HPV vaccine uptake when offered during the postpartum period. Materials and Methods: A prospective interventional study was conducted at a tertiary care hospital in South India from January 2017 to October 2018. Pregnant women in the third trimester who had not previously received HPV vaccination were enrolled. Baseline awareness regarding cervical cancer, HPV infection, and HPV vaccination was assessed using a pretested questionnaire. Participants then received structured counseling. Postintervention assessment was performed in the postpartum period. Women consenting to vaccination received the first dose of quadrivalent HPV vaccine (Gardasil; Merck and Co., Inc., Whitehouse Station, NJ, USA) prior to discharge. Data were analyzed using SPSS software (IBM Corp., Armonk, NY, USA). Results: A total of 150 women completed pre- and postintervention assessments. Awareness of cervical cancer increased from 38.7% to 93.3% following counseling ( P < 0.001). Awareness of HPV vaccination improved from 5.3% to 97.3% ( P < 0.001). Seventy percent of participants accepted HPV vaccination postpartum. Among those who initiated vaccination, 86.6% completed the three-dose schedule. Cost, family refusal, and safety concerns were the most common barriers to vaccination. Conclusions: Structured counseling delivered during routine antenatal care, with HPV vaccination offered in the postpartum period, significantly improves awareness and vaccine uptake. The postpartum period represents an underutilized opportunity for catch-up HPV vaccination with potential to reduce future cervical disease burden and colposcopy referrals.