Ethics and inclusion statement
Data for this study, including from Kenya, were collected via eCRFs in Kenya. Seven colleagues (M.A.O., E.A.B., B.N., I.W., C.B., S.K. and N.R.M.), including the senior author (N.R.M.) are from Kenya, a low-and-middle-income country and one other (R.V.B.) is South African and is now based in a high-income country. We fully endorse and are committed to the Nature Portfolio journals’ guidance on low-and-middle-income country authorship and inclusion.This research is locally relevant to Kenya and other countries that have not achieved the 90% HPV vaccine coverage goal.The KEMRI SERU (nos. 3745 and 3741) and the Massachusetts General Hospital Institutional Review Board (no. 2022P001178) approved the study. Study participation may have carried stigmatization associated with vaccination. The data collection and analysis techniques employed raised no risks pertaining to incrimination, discrimination, animal welfare, the environment, health, safety, security or other personal risks. All HPV and STI testing was conducted at local laboratories. Serum for specialized HPV antibody testing was shipped to Seattle for testing. No cultural artifacts or associated traditional knowledge has been transferred out of any country. In preparing the manuscript, the authors reviewed relevant studies from Kenya.