PONE-D-24-59459Public Health Implications of Introducing Human Papillomavirus (HPV) Vaccination in Pakistan: A protocol for mixed method study to explore community perceptions and health system preparednessPLOS ONE

Dear Dr. Noreen,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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ACADEMIC EDITOR:

Edit the content of the manuscript to correct the numerous grammatical errors.

The proposed sampling is not clear.

Specify the age of adolescents of interest, if it is 9 to 16 years or 9 to 17 years.

Merge the analysis for belief, hesitancy and knowledge to avoid the current repetitions in the manuscript.

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Please submit your revised manuscript by Apr 07 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Folusho Mubowale Balogun

Academic Editor

PLOS ONE

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Additional Editor Comments:

The manuscript needs to be edited as it presently has many grammatical errors.

The sampling is not clear.

Specify if the age of interest for the adolescent s is 9 to 16 years or 9 to 17 years.

Merge the data analysis for belief, hesitancy and knowledge instead of the current repetitions.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Partly

Reviewer #2: Partly

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: No

Reviewer #2: No

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: No

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: * The Aim of the paper is not aligned to the objectives.

* Obj1 does not refer to girls yet in the body 2.3 the girls are in the inclusion criteria. Correct and be consistent.

*Rephrase 2.3 to Only those who give consent after recruitment will form part of the sample.

* 2.4 The sampling strategy is not clear how will random sampling occur on social media platforms, or in schools.

* It confusing how will sample frame be from a university? are there girls aged 6-16 years. Please be consistent with the age group ; elsewhere it is 9-16 and some places 9-17 years.

* A reference is mentioned in the sample size calculation without mention of this reference.

* What do you mean by 'Cast" in 2.5 paragraph, elaborate.

* How will data collection on social media platforms be controlled? there are concerns of duplication or same people answering more than once.

QUALITATIVE PHASE

* Will data collection use IDIs or FGDs or both? it is not clear which one, please delineate and explain where each will be used.

Please correct the methodological errors to make the method replicable for use in other settings.

The protocol and the study will provide valuable contribution to the scientific community.

Reviewer #2: State Data Sharing plan

Revise Methodology to elucidate data gathering process for each stakeholder group (i.e one for parents, one for potential vaccinees, and so on)

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Reviewer #1: Yes:  Prof Yolanda Malele-Kolisa

Reviewer #2: No

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PONE-D-24-59459R1Public Health Implications of Introducing Human Papillomavirus (HPV) Vaccination in Pakistan: A protocol for mixed method study to explore community perceptions and health system preparedness

PLOS ONE

Dear Dr.Khola Noreen,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

ACADEMIC EDITOR:

Thank you for addressing almost all the issues raised in the earlier submission. However, there are few important aspects that still need attention and they are as follows:

1. The English needs further editing. Many definite and indefinite articles are missing in the text.Avoid mixing both American and British English. Stick to one.

2. The Aim is to look at factors influencing the uptake of HPV vaccine, not HPV. Correct this.

3. Objective 2: be specific about the country (Pakistan in this case)

4. Objective 3: be specific about the community.

5. Under HPV Vaccination belief subheading, HBM should be written in full at first use.

6. Qualitative data: This data was to be collected till data saturation is achieved. However, the authors stated that only 4 FGDs will be conducted with the KIIs. Please, reconcile these to clearly show how sample size will be determined.

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Please submit your revised manuscript by April 12, 2025. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Folusho Mubowale Balogun

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

Public Health Implications of Introducing Human Papillomavirus (HPV) Vaccination in Pakistan: A protocol for mixed method study to explore community perceptions and health system preparedness

PONE-D-24-59459R2

Dear Dr. Khola Noreen,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Folusho Mubowale Balogun

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: