Leveraging social media to mitigate HPV vaccine service disruptions in Abuja, Nigeria

Abstract

Introduction Market priming strategies use communication to prepare target audiences for service uptake when services become available. In 2025, a health worker strike in Abuja, Nigeria resulted in the suspension of HPV vaccination services for approximately four months. Services were temporarily restored for five days (July 16–20, 2025) during a Maternal, Newborn, and Child Health (MNCH) week. This study assessed whether caregiver recall of a digital market priming campaign was associated with HPV vaccine uptake during this brief service resumption. Methods We conducted a cross-sectional exit survey of 271 caregivers of adolescent girls aged 9–17 years attending vaccination sites during MNCH week. The survey collected data on socio-demographic characteristics, Facebook use, recall of HPV vaccine advertising on Facebook or Instagram, and caregiver-reported adolescent vaccination status. Survey findings were triangulated with administrative data on the number of HPV vaccinations delivered during the MNCH week. Analyses included descriptive statistics and multivariable logistic regression. A two-stage residual inclusion (2SRI) model was used as a sensitivity analysis to assess potential bias from unobserved confounding related to social media use. Ward-level regression analyses using administrative data compared vaccinations delivered in wards targeted by the digital campaign with those in non-targeted wards. Results Overall, 33.6% of caregivers recalled HPV vaccine advertising on Facebook or Instagram, and 64.2% reported that their adolescent had received the HPV vaccine. Message recall was associated with higher odds of caregiver-reported vaccination (adjusted odds ratio = 3.36; 95% CI: 2.75–4.11). Model-predicted marginal effects indicated a 23.3 percentage-point difference in reported vaccination probability between caregivers who did and did not recall messages, corresponding to an estimated 7.9 percentage-point difference in vaccination prevalence when applied to the caregiver population attending vaccination services. The 2SRI analysis found no evidence of endogeneity (p = 0.736). Administrative data were consistent with survey findings, suggesting an approximately 3 percentage-point higher vaccination coverage in wards targeted by the digital campaign compared with control wards during MNCH week. Conclusions Caregiver recall of a digital market priming campaign was associated with higher HPV vaccination uptake during a short-term resumption of services following a prolonged disruption. These findings suggest that insights-informed, subnational digital priming strategies—when combined with complementary offline approaches to ensure equitable reach—may help maintain caregiver readiness and support HPV vaccine delivery during periods of service instability.