Knowledge, Attitudes, and Perceptions of HPV Vaccination for Adolescents with Intellectual Disabilities: A Systematic Review.

BACKGROUND/OBJECTIVES: Adolescents with intellectual disabilities may experience inequities in preventive healthcare, including HPV vaccination. This review aimed to synthesize evidence on HPV vaccination-related knowledge, attitudes and perceptions among adolescents with intellectual disabilities, parents/caregivers, educators, healthcare professionals and other stakeholders. METHODS: A systematic search was conducted in PubMed, Embase and Scopus on 29 October 2025. Eligible studies reported original data on knowledge, attitudes or perceptions regarding HPV vaccination for adolescents with intellectual disabilities or relevant stakeholders. The protocol was registered on PROSPERO (CRD420251015183). Quantitative, qualitative and mixed-methods studies were considered. RESULTS: Seven studies were included. They were conducted in the USA, Australia and the UK and involved parents/caregivers, healthcare providers, school staff, immunization staff and adolescents or young people with disabilities. Direct evidence from adolescents was limited. HPV-related knowledge was often limited or uneven, and standard information materials were perceived as insufficiently accessible. Parents/caregivers were often broadly supportive of vaccination, but HPV-specific acceptance was affected by perceived low susceptibility, assumptions about sexual inactivity, safety concerns, procedure-related distress and lack of provider recommendation. Healthcare providers generally supported HPV vaccination; however, recommendations were sometimes influenced by perceived sexual activity, age or consent. School-based vaccination was considered useful but required tailored information, preparation, individual adjustments and follow-up. CONCLUSIONS: Evidence on HPV vaccination-related knowledge, attitudes and perceptions among adolescents with intellectual disabilities and their stakeholders remains limited and geographically restricted. Improving equitable access may require interventions that should be further investigated, such as accessible communication, systematic provider recommendation, flexible vaccination pathways and greater involvement of adolescents in decision-making.