{
  "abstract": "Introduction The development of effective vaccines targeting human papillomavirus (HPV) has significantly contributed to disease prevention, highly relevant in immunosuppressed patients who have higher incidence of HPV-related cancers than their non-immunosuppressed counterparts. However, the acceptance and uptake of the HPV vaccine among immunosuppressed individuals pose unique challenges. Immunocompromised patients’ acceptance of the HPV vaccine is influenced by multifaceted factors, including concerns about safety and effectiveness, interactions with immunosuppressive medications and uncertainties due to their compromised immunity. This systematic review aims to identify the main factors influencing HPV vaccine acceptance among immunosuppressed patients.Methods and analysis A comprehensive search strategy will be executed across databases such as MEDLINE/PubMed, Embase, Scopus, Web of Science, ScienceDirect, Latin American and Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature and Cochrane Database. The review will encompass the three WHO-endorsed HPV vaccines (quadrivalent, bivalent and nonavalent) and will consider studies related to HPV vaccines and their administration. The scope includes study focusing on immunosuppressed patients who received organ transplants, cancer treatments or are HIV-positive. No temporal restrictions will be applied, and searches will be conducted until December 2025. Observational studies, including retrospective/prospective cohorts, case–control and cross-sectional studies, reporting factors influencing HPV vaccination in immunosuppressed populations will be included. Studies with overlapping patient populations will be excluded. Data extraction will include study details, demographics, vaccine type, risk/protective factors, outcomes and medical history. Validation and cross-verification will ensure data accuracy. Risk of bias will be assessed using ROBINS-I (Risk Of Bias In Non-randomised Studies of Interventions), and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will rate evidence certainty. Meta-analysis, guided by Cochrane and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, will employ fixed/random-effects models, assessing heterogeneity using I² statistics.Ethics and dissemination This research will analyse previously published data, so ethical approval is not required. The results of the systematic review will be submitted for publication in a peer-reviewed journal.PROSPERO registration number CRD42023452537.",
  "authors": [
    {
      "affiliations": [
        "Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil",
        "Department of Surgery, Federal University of Rio Grande do Norte, Natal, Brazil",
        "EVA - Grupo Brasileiro de Tumores Ginecológicos, São Paulo, Brazil",
        "Latin American Cooperative Oncology Group, Porto Alegre, Brazil"
      ],
      "name": "Lygia Maria Costa Soares"
    },
    {
      "affiliations": [
        "Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil"
      ],
      "name": "Ariane Vieira Carvalho"
    },
    {
      "affiliations": [
        "Department of Medicine, Federal University of Rio Grande do Norte, Natal, RN, Brazil"
      ],
      "name": "Caroliny Hellen Azevedo da Silva"
    },
    {
      "affiliations": [
        "Department of Medicine, Federal University of Rio Grande do Norte, Natal, RN, Brazil"
      ],
      "name": "Gabriela Moura Maximo"
    },
    {
      "affiliations": [
        "Institute of Teaching, Research, and Innovation, League Against Cancer, Natal, RN, Brazil"
      ],
      "name": "Kleyton Santos de Medeiros"
    },
    {
      "affiliations": [
        "Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil"
      ],
      "name": "Dyego Leandro Bezerra de Souza"
    },
    {
      "affiliations": [
        "EVA - Grupo Brasileiro de Tumores Ginecológicos, São Paulo, Brazil",
        "Latin American Cooperative Oncology Group, Porto Alegre, Brazil",
        "Department of Clinical Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil"
      ],
      "name": "Angelica Nogueira-Rodrigues"
    },
    {
      "affiliations": [
        "Department of Nursing, Federal University of Rio Grande do Norte, Natal, Brazil"
      ],
      "name": "Ana Elza Oliveira de Mendonça"
    }
  ],
  "title": "Factors influencing HPV vaccine acceptance in immunosuppressed patient populations: a protocol for a systematic review",
  "uid": "7d9f4830-c9a6-5dd5-ac14-b346e6627344"
}