Awareness regarding and vaccines acceptability of human papillomavirus among parents of middle school students in Zunyi, Southwest China

HPV vaccination willingness among 3,081 secondary school parents in China's capital

Assessing knowledge of HPV and HPV vaccine and vaccine willingness among Beijing secondary school parents, and identifying decision-influencing factors. Selected via multi-stage stratified sampling, 3,081 Chaoyang secondary school students' parents participated in a June-August 2024 study. They completed a questionnaire assessing HPV knowledge, vaccine awareness, and vaccination willingness. Although 56.4% of parents showed a high awareness of HPV and its vaccine, only 13.7% had actually vaccinated their children, indicating a low vaccination rate. Moreover, 59.9% of parents indicated a willingness to vaccinate their children against HPV. Factors influencing this willingness included having daughters (OR: 2.873, 95% CI: 2.403-3.436), the school's street location (OR: 1.279, 95% CI: 1.056-1.550), personal HPV vaccination (OR: 2.153, 95% CI: 1.726-2.686), comprehensive knowledge about HPV and its vaccine (OR: 1.956, 95% CI: 1.595-2.398), awareness of vaccine price (OR: 1.500, 95% CI: 1.143-1.968), perceiving the price as reasonable (OR: 1.265, 95% CI: 1.029-1.533), and challenges in scheduling HPV vaccine appointments (OR: 3.909, 95% CI: 2.692-5.675). Notably, there was a negative correlation between parents' education levels and their willingness to vaccinate their children: junior college (OR: 0.690, 95% CI: 0.527-0.902), undergraduate (OR: 0.626, 95% CI: 0.482-0.813), postgraduate and above (OR: 0.686, 95% CI: 0.475-0.989). Therefore, relevant sectors must implement varied health campaigns, focusing on parental health needs, particularly HPV education for men, and advocate for HPV vaccines in immunization programs to boost secondary school students' vaccination rates.

Parental willingness of HPV vaccination in Mainland China: A meta-analysis

This meta-analysis aimed to systematically review and analyze parental awareness of human papillomavirus (HPV) and its vaccine, as well as parental willingness of the HPV vaccine in China. The literature search selected studies that met the following criteria: study published between 2009 and 2023, study design involving parents with at least one child aged ≤ 18 years, sample sizes exceeding 300, availability of data on parental willingness of the HPV vaccine or sufficient information to calculate effect sizes, and studies published in either English or Chinese. Studies that did not meet one of the above points were excluded. From an initial pool of 660 papers, 33 studies were included, encompassing a total sample size of 92,802. The analysis revealed that the pooled awareness rates of HPV and the HPV vaccine among Chinese parents were 45.0% (95% CI: 36.1-54.0%) and 41.4% (95%CI: 30.7-52.5%), respectively. The overall parental willingness for vaccinating children against HPV was 61.0% (95% CI: 53.5-68.3%). Both parental awareness and willingness of the HPV vaccine in China were found to remain low when compared to other countries.

Parental willingness to pay and preference for human papillomavirus vaccine for girls aged 9-14 in subsidy scenarios in Shanghai, China

Multiple studies have documented low human papillomavirus (HPV) vaccine uptake among Chinese girls. It remains crucial to determine the parental willingness to pay (WTP) HPV vaccine for girls. We conducted a cross-sectional study recruiting 3904 parents with girls aged 9-14 in Shanghai, China, employing an online questionnaire with a convenience sampling strategy. Parental WTP, both range of payment and estimated point value, were determined for themselves (or wives) and daughters. HPV vaccine uptake was 22.44% in mothers and 3.21% in daughters. Respondents favored WTP ≤ 1000 CNY/138 USD for themselves (or wives), whereas showed increasing WTP along with valency of HPV vaccine for daughters (2-valent: 68.62% ≤1000 CNY/138 USD; 4-valent: 56.27% 1001-2000 CNY/138-277 USD; 9-valent: 65.37% ≥2001 CNY/277 USD). Overall, respondents showed higher WTP for daughters (median 2000 CNY/277 USD; IQR 1000-3600 CNY/138-498 USD) than for themselves (2000 CNY/277 USD; 1000-3500 CNY/138-483 USD) or wives (2000 CNY/277 USD; 800-3000 CNY/110-414 USD) (each p < .05). Furthermore, parental WTP was higher for international vaccine and 9-valent vaccine (each p < 0.05). Between two assumed government subsidy scenarios, parental preference for 9-valent vaccine remained consistently high for daughters (approximately 24% in each scenario), whereas preference for themselves (or wives) was sensitive to payment change between the subsidy scenarios. Using a discrete choice experiment, we found domestic vaccine was commonly preferred; however, certain sociodemographic groups preferred multivalent HPV vaccines. In conclusion, the valency of HPV vaccine may influence parental decision-making for daughters, in addition to vaccine price. Our findings would facilitate tailoring the HPV immunization program in China.

Awareness regarding human papillomavirus and willingness for vaccination among college students with or without medical background in Guizhou Province

This cross-sectional epidemiological study aimed to investigate awareness regarding human papillomavirus (HPV) and willingness for vaccination among college students with or without medical background in Guizhou Province, China. A logistic regression model was used for univariate and multivariate analyses of cognition to determine factors influencing willingness for vaccination. In total, 2,540 questionnaires were collected, of which 2,360 were valid. The medical and nonmedical groups included 737 (31.2%) and 1,623 (68.8%) individuals, respectively. The medical group had heard of HPV and its vaccines more frequently than the nonmedical group, with the former also having greater awareness than the latter (P < .001). Females (1,325, 56.1%) had heard of HPV and its vaccines more frequently than males (1,035, 43.9%), with the former also having greater awareness than the latter. The cost, safety, and efficacy of the HPV vaccine and lack of knowledge regarding HPV and its vaccines were the main barriers for vaccination. The overall level of knowledge regarding HPV and its vaccines was lower in the nonmedical group and males than in the medical group and females. To help promote willingness for vaccination among the nonmedical group and males, strategies that deepen their knowledge regarding the HPV vaccine are needed.

Willingness of caregivers to have their daughters vaccinated against human papilloma virus and associated factors in Jimma Town, Southwest Ethiopia

Introduction

Human Papillomavirus (HPV) is a widespread sexually transmitted infection and a leading cause of cervical cancer. Although there is a significant HPV prevalence in Ethiopia, yet the uptake of the HPV vaccine remains low. This study aimed to assess the level of caregivers' willingness to vaccinate their daughters against the human papilloma virus and associated factors in Jimma town.

Methods

A community-based cross-sectional study was conducted from June 1-30, 2023. A total of 471 study participants were selected using multi-stage sampling techniques. Data was collected using an interviewer-administered questionnaire. Binary and multiple logistic regression analyses were done to identify associated factors, and the adjusted odds ratio and 95% confidence interval were computed. A value p of <0.05 was used to determine statistical significance.

Results

About 82.4% (95% CI: 79.0-86.0) of caregivers indicated a willingness to have their daughters vaccinated. Having college education or above (AOR:3.31, 95%CI:1.02-10.8), good knowledge of the HPV vaccine (AOR:2.25, 95%CI:1.05-4.85), good knowledge of sexually transmitted infections (STIs) (AOR:2.04, 95%CI: 1.09-3.82), good knowledge of cervical cancer (AOR:2.50, 95%CI:1.31-4.77) and a positive attitude towards the vaccine (AOR:4.03, 95%CI: 2.26-7.22), were associated with willingness.

Discussion

The majority of caregivers were willing to vaccinate their daughters against HPV. Caregivers who had higher education, good knowledge about the HPV vaccine, cervical cancer, and STIs, as well as positive attitudes towards the vaccine, were more likely to be willing to vaccinate. Efforts should be made to educate caregivers about the vaccine, cervical cancer, and STIs while promoting positive attitudes.

Parental Awareness, Attitude, and Acceptability of the Human Papillomavirus Vaccine in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study

Background Human papillomavirus (HPV) is a significant public health concern linked to various cancers and genital warts. Despite the availability of effective vaccines, vaccination rates remain suboptimal in many regions. Understanding parental awareness, attitudes, and acceptability of the HPV vaccine is critical for developing targeted interventions to increase vaccination uptake. Objective This study aims to assess parental awareness, attitudes, and acceptability of the HPV vaccine in Jeddah, Saudi Arabia, and identify factors influencing their decision-making regarding HPV vaccination for their children. Methods An analytical cross-sectional study was conducted in Jeddah, Saudi Arabia, in 2023. The calculated sample size was 420 parents. Eligible parents with at least one female child aged from nine to 18 years old were invited to participate in the study. A structured questionnaire was administered to parents, collecting data on demographics, knowledge of HPV and its vaccine, attitudes toward vaccination, and reasons for vaccine acceptability or hesitancy. Descriptive statistics were used to summarize the data, and inferential statistics were applied to identify associations between demographic factors and vaccine acceptability. Results The study included a diverse sample of parents. Approximately 153 (35.9%) of participants believed the HPV vaccine was effective, while 129 (30.3%) felt the benefits outweighed the risks. Common reasons for vaccinating included protection against sexually transmitted diseases (159, 37.3%) and genital cancers (178, 41.8%). Hesitancy was primarily due to fear of adverse effects (141, 33.1%) and insufficient information (84, 19.7%). Statistical analysis revealed significant correlations between vaccine acceptability and parental education level, employment status, and personal vaccination history. Conclusion The findings highlight a moderate level of awareness and acceptability of the HPV vaccine among parents in Jeddah. Educational interventions focusing on vaccine safety and efficacy are essential to address misconceptions and increase vaccination rates. Further research should explore tailored strategies to enhance parental acceptance of HPV vaccination in similar contexts.

Preference for human papillomavirus vaccine type and vaccination strategy among parents of school-age girls in Guangdong province, China

In China, the human papillomavirus (HPV) vaccination coverage among age-eligible girls is rather low, and parent's attitude often plays a determinant role in their girls' HPV vaccination. To accelerate HPV vaccination coverage, several cities and Guangdong province in China offered different HPV vaccine types with different reimbursement methods. In April 2022, we conducted a province-wide survey to investigate parents of children aged 9-15 in Guangdong province, and analyzed factors associated with their preference for HPV vaccine type and vaccination strategy. Of the 4,967 surveyed respondents, 2,610 (58.1%) have not yet vaccinated their children. Among these parents, 67.9% preferred to vaccinate their children with the nine-valent vaccine, while only 8.1% preferred the quadrivalent vaccine and 7.4% preferred the bivalent vaccine. More parents preferred fixed subsidies with free choices of HPV vaccine type over the domestic bivalent vaccine provided by the government (58.1% vs. 39.3%). The multinomial logistic regression showed that parents' relationship with children, educational level, household income, and vaccination status were significantly associated with parents' preference for HPV vaccine type. Parent's relationship with children, workplace, household income, vaccination status, and age of children, were significantly associated with parents' preference for HPV vaccination strategy. Our findings suggest that policymakers may consider adjusting the current vaccination strategy by offering more vaccination choices. More health education on HPV vaccine and vaccination should also be provided to parents of age-eligible girls. Future research should examine which HPV vaccination strategy is more effective in promoting HPV vaccine uptakes in China.

Awareness of HPV and HPV vaccines, acceptance to vaccination and its influence factors among parents of adolescents 9 to 18 years of age in China: A cross-sectional study

BACKGROUND

Vaccination uptake rates for adolescents are still low in China despite safe and effective human papillomavirus vaccines being available. The awareness and attitudes of parents to HPV vaccines play a decisive role in adolescents' HPV vaccination uptake.

METHODS

A cross-sectional study was conducted from March, 2022 to May, 2022 using an anonymous questionnaire among parents of 9 to 18 years of age from 73 cities in 23 provinces in mainland China. Demographic characteristics of parents, their knowledge and attitudes about HPV and HPV vaccination, as well as factors influencing HPV vaccination in adolescents were assessed.

RESULTS

More than two-thirds of parents heard of HPV (75.5%) and HPV vaccines (84.7%). Of these participants, mothers (83.8%) were in the majority. Parents willing to vaccinate themselves and their children against HPV were 84.9% and 87.6%, respectively. Parents were more likely to vaccinate their daughters against HPV than their sons (P < 0.001). Parents who had heard of the HPV vaccines (P = 0.028) or had vaccinated themselves (P < 0.001) were more likely to have HPV vaccination for their children. Parents who accepted the price of the HPV vaccines (P = 0.005) were more likely to have their children vaccinated against HPV.

CONCLUSIONS

Children's gender, awareness of the HPV vaccines, parental HPV vaccination, and the price of the HPV vaccines are likely to be the reason for parents' vaccine hesitancy for adolescents.

PRACTICE IMPLICATIONS

Nurses have a critical role in identifying parental hesitancy and providing individualized education to expand the parental awareness and knowledge and encourage on-time adolescents vaccination.

Immunogenicity and safety of two novel human papillomavirus 4- and 9-valent vaccines in Chinese women aged 20-45 years: A randomized, blinded, controlled with Gardasil (type 6/11/16/18), phase III non-inferiority clinical trial

BACKGROUND

Human papillomavirus (HPV) infections were the main cause of anogenital cancers and warts. HPV 6/11/16/18 vaccines provide protection against the high-risk types of HPV responsible for 70% of cervical cancers and 90% of genital warts. This randomized, blinded, non-inferiority phase III trial was to determine whether immunogenicity and tolerability would be non-inferior among women after receiving two novel 4- and 9-valent HPV vaccines (4vHPV, HPV 6/11/16/18; 9vHPV, HPV 6/11/16/18/31/33/45/52/58) compared with those receiving Gardasil 4 (4-valent).

METHODS

1680 females between 20 and 45 years were randomized in a 2:1:1 ratio to 20-26, 27-35, or 36-45 y groups. Subjects then equally assigned to receive 4vHPV, 9vHPV or Gardasil 4 (control) vaccine at months 0, 2, and 6. End points included non-inferiority of HPV-6/11/16/18 antibodies for 4vHPV versus control, and 9vHPV versus control and safety. The immunogenicity non-inferiority was pre-defined as the lower bound of 95% confidence interval (CI) of seroconversion rate (SCR) difference > -10% and the lower bound of 95% CI of geometric mean antibody titer (GMT) ratio > 0.5.

RESULTS

Among the three vaccine groups, more than 99% of the participants seroconverted to all 4 HPV types. The pre-specified statistical non-inferiority criterion for the immunogenicity hypothesis was met: all the lower bounds of 95% CIs on SCR differences exceeded -10% for each vaccine HPV type and the corresponding lower bounds of 95% CIs for GMT ratios > 0.5. Across vaccination groups, the most common vaccination reaction were injection-site adverse events (AEs), including pain, swelling, and redness. General and serious AEs were similar in the three groups. There were no deaths.

CONCLUSIONS

This study demonstrated that the novel 4- and 9-valent HPV vaccination was highly immunogenic and generally well tolerated, both of which were non-inferior to Gardasil 4 in immunogenicity and safety.