Perceptions, knowledge, and access to the HPV vaccine among parents and healthcare providers in South Quito, Ecuador in 2025: A qualitative study.

Human papillomavirus (HPV) is estimated to cause 99.7% of all cervical cancers and is the main cause of anal cancer. Despite global progress, Ecuador has one of the highest cervical cancer mortality rates in Latin America, with fluctuating vaccine uptake since its introduction for girls in 2014 and expansion to boys in 2024. Semi-structured interviews were conducted with parents of vaccine-eligible children and healthcare providers (HCPs) in Quito. The interviews explored HPV knowledge, perceptions, and access to vaccination. The transcripts were analysed thematically. Forty-one participants (32 parents, 9 HCPs) were interviewed. Eight themes emerged: (1) parents desire more information about HPV, (2) neither parents nor HCPs associate HPV with cancer in men, (3) mothers have more knowledge than fathers, (4) fear of side effects contributes to vaccine hesitancy, (5) fear of sexual promiscuity does not influence vaccination, (6) HPV vaccine administration is conducted at schools, but parents and providers desire better support from these schools, (7) parents perceive a lack of information as their greatest barrier, while HCPs perceive carelessness among parents, and (8) age guidelines for vaccination can be confusing. HPV vaccine uptake is shaped by individual and system-level barriers. Aligning provider-parent perspectives and strengthening school- and community-based education may improve vaccination.