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Children aged 9–14 years are the primary target demographic for human papilloma virus (HPV) vaccination, and the hesitancy of guardians in this age group regarding HPV vaccination is likely to significantly impact vaccination rates among children. Understanding the relationship between Levels of HPV Vaccine Knowledge, HPV Vaccine Health Beliefs, and HPV Vaccine Hesitancy is a crucial prerequisite for improving HPV vaccination rates among children aged 9–14. We recruited 5219 guardians of children aged 9–14 years in Shanxi Province, China, using a multistage random sampling method. Participants completed a questionnaire assessing Levels of HPV Vaccine Knowledge, HPV Vaccine Health Beliefs, HPV Vaccine Hesitancy, and demographic characteristics, including the current vaccination status of children aged 9–14. Employing the SPSS macro program PROCESS Model 7, we developed a moderated mediation model. The findings of the study reveal the following: 1) A significant direct effect of HPV vaccine knowledge on HPV vaccine hesitancy was observed; 2) The association between HPV vaccine knowledge and HPV vaccine hesitancy is partially mediated by HPV vaccine health beliefs; 3) The place of residence moderates the initial segment of the mediation effect, with HPV vaccine knowledge exerting a stronger positive predictive effect on health beliefs in rural areas. These results contribute novel insights to the existing literature by elucidating the underlying mechanisms between Levels of HPV Vaccine Knowledge and HPV Vaccine Hesitancy. These findings hold significant implications for enhancing HPV vaccination rates among children aged 9–14.

This qualitative study using in-depth interviews and focus group discussions is the first to investigate HPV vaccination in The Gambia; it provides an in-depth analysis of uptake, knowledge, and perceptions of HPV vaccination as well as trust in Ministry of Health vaccination advice. Despite high uptake rates, knowledge of HPV vaccination was low, and the most prominent concern was that the vaccine could cause infertility or is a form of population control. Holistic approaches to addressing HPV vaccine concerns relating to fertility that consider socio-political contexts, including colonial histories, could lead to more positive vaccine perceptions, empowered decisions and to increasing vaccine uptake rates in The Gambia and elsewhere.

There is relatively low awareness about Human papillomavirus (HPV) in Saudi Arabia. Increased awareness is required to gain better knowledge, particularly among the general population. This study aims to evaluate the awareness level of women about cervical smears, HPV, and HPV vaccine. Also, this study evaluates the effectiveness of the Saudi Ministry of Health’s campaign aimed to raise awareness of HPV and the HPV vaccine by comparing data collected before and after the campaign. This study employed a cross-sectional, online survey-based design conducted in Saudi Arabia. Data were collected during two periods: 2022 and 2024. The target participants were women aged 18 and older residing in Saudi Arabia. Exclusions included individuals with a history of HPV infection and those who did not provide consent. The questionnaire comprised 26 items, organized into three sections: sociodemographic information, awareness levels of HPV and the HPV vaccine, and cervical screening practices and vaccine acceptance. A total of 858 women participated in this study. Overall, 49.4% of women were aware of HPV, and 38% were aware of the HPV vaccine. Over two-thirds (67.6%) were willing to receive a free HPV vaccination. Social media was the most common source of information (HPV: 63.2%; HPV vaccine: 57.1%). From 2022 to 2024, there was a significant increase in HPV awareness, rising from 38.8% in 2022 to 71.1% in 2024 ( p  < 0.001), and awareness of the HPV vaccine significantly increased from 28.2% to 58.7% ( p  < 0.001). Despite these improvements in awareness, only 25.8% of participants reported having undergone cervical cancer screening (Pap smear). The main drivers for awareness are knowledge-based (knowing the vaccine exists for men/children, knowing where to get it). For acceptance of HPV vaccine, the strongest psychological driver is a parent’s willingness to vaccinate their children. This study highlights the success of the Saudi Ministry of Health’s campaign in raising awareness about HPV and its vaccine. Despite this progress, the low uptake of cervical cancer screening remains a critical public health issue. Greater emphasis on the importance of pap smear tests is needed to enhance early detection and prevention of cervical cancer.

Initially approved as a three-dose regimen, evolving evidence has supported the efficacy of reduced-dose schedules. Single-dose HPV vaccine data among males remain scarce. This study assesses the persistence of antibodies against HPV16/18 following a single HPV vaccine dose and the immune response to a subsequent delayed dose administered at least three years later in girls and boys. This single-group descriptive study involved youth from the Quebec City area, Canada, who received a single dose of 4vHPV (girls) or 9vHPV (boys) as part of the public school-based vaccination program. A blood sample was collected 3–10 years post-initial vaccination. Girls and boys then received one 9vHPV or 2vHPV booster dose, respectively, and had a second blood draw one month later. Serological assays were conducted using M9ELISA. Four years after the initial 9vHPV dose, among 141 boys aged 12 to 14 years 96.5 % and 97.9 % had detectable antibodies against HPV16 and HPV18, respectively. Among girls aged 13 to 24 years vaccinated 3–10 years prior with one 4vHPV dose, 95.0 % (HPV16) and 93.3 % (HPV18) had detectable antibodies. One-month post-second dose administration, all participants were seropositive for HPV16/18, with significant increases in geometric mean concentrations (GMCs). A single dose induces a strong and lasting immune response in girls (4vHPV) and boys (9vHPV), with a significant antibody anamnestic boost following a second dose administered several years later. These findings indicate the potential for a single-dose or a delayed booster strategy in both sexes, and support studies showing effectiveness of single-dose schedules. The study is registered with ClinicalTrials.gov (NCT 03431246). •Single-dose HPV vaccination induces long-lasting immunogenicity in boys and girls.•High antibody persistence for HPV16/18 observed up to 3–10 years after one dose.•Delayed bivalent or nonavalent HPV booster dose increases antibody concentrations.•The study shows the potential for a single-dose or a delayed booster strategy.

•Adolescent HPV vaccination in five Southern and Midwestern states remains low.•HPV vaccination hesitancy was associated with a lower likelihood of HPV vaccination initiation.•Having received other adolescent vaccines was associated with a higher odds of HPV vaccination.•Gaps remain in HPV vaccination uptake among younger adolescents and male children. In the United States (US), half of new human papillomavirus (HPV) infections occur among young people aged 15–24 years. Despite the effectiveness of HPV vaccination in protecting against HPV-associated cancers, its coverage among adolescents remains suboptimal. This study examined the association of sociodemographic characteristics and HPV vaccination hesitancy with HPV vaccination coverage in five US states with disproportionately low adolescent coverage rates compared to the national average. Responses to an online Qualtrics survey from 926 parents of children aged 9–17 years in Arkansas, Mississippi, Missouri, Tennessee, and Southern Illinois in July 2021 were analyzed using multivariate logistic regression to estimate the association of sociodemographic characteristics and HPV vaccination hesitancy with HPV vaccination coverage. Of the parents, 78 % were female, 76 % were non-Hispanic White, 61.9 % lived in rural areas, 22 % were classified as HPV vaccine hesitant, and 42 % had vaccinated their oldest child between the ages of 9–17 years against HPV. Children of vaccine hesitant parents were less likely to have received any doses of the HPV vaccine than children of non-vaccine hesitant parents (AOR: 0.17, 95 % CI:0.11–0.27). Male children were less likely to have initiated the HPV vaccine series than female children (AOR: 0.70, 95 % CI:0.50–0.97). Older children (13–17 vs 9–12 years), receiving the meningococcal conjugate or most recent seasonal influenza vaccine were all associated with higher likelihoods of receiving any doses of the HPV vaccine (AOR: 6.01, 95 % CI:3.98–9.08; AOR: 2.24, 95 % CI:1.27–3.95; AOR: 2.41, 95 % CI:1.73–3.36, respectively). Adolescent HPV vaccination coverage remains low in our targeted states. Children’s age, sex, and parental vaccine hesitancy were significantly associated with likelihood of HPV vaccination. These findings offer the opportunity for targeted interventions among parents in regions with low vaccine uptake and underscore the importance of developing and implementing strategies to address parental HPV vaccination hesitancy to improve uptake in the US.

Asian-Americans have been documented to have low human papillomavirus (HPV) vaccine initiation and completion. No research has attempted to examine underlying mechanisms of HPV vaccine uptake disparities among Asian-Americans. Using the P3 (practice, provider, and patient) model, this study aimed to identify practice-, provider-, and patient-level determinants of Asian-Americans’ HPV vaccine intention and uptake. We conducted a systematic review of published literature regarding practice-, provider- and patient-level determinants of vaccine intention (e.g., intention, willingness, or acceptability) and uptake (e.g., initiation or completion). Eligible studies were those presenting empirical/original data, focusing on Asian populations in the U.S., including outcomes related to HPV vaccine intention and uptake, and analyzing data on factors associated with these outcomes separately for Asian groups. Twenty-six studies (19 quantitative and 7 qualitative studies) were included in the review. Most commonly studied subgroups were Koreans (n = 9), Chinese (n = 6), and Cambodians (n = 5). Studies showed varied prevalence across subgroups (intention: 23.4%–72%; initiation: 14%–67%; completion: 9%–63%). Only 3 studies included measurements of practice-level determinants (language services, insurance policy). Twelve studies measured provider-level determinants (most commonly documented: HPV vaccine recommendation). All studies measured patient-level determinants (most commonly documented: HPV and HPV vaccine knowledge, perceived safety, perceived susceptibility, and perceived relationship between HPV vaccine and sexual activity). Existing research on determinants of HPV vaccine intention and uptake among Asian-Americans currently lacks measurements of practice-level constructs and perspectives of clinic staff and providers, which are needed to guide system-level interventions and provider training. Data regarding patient-level determinants suggest that interventions for Asian-American populations can focus on providing educational information in culturally-appropriate manners, leveraging familial influences, and attending to access-related or cultural beliefs about HPV vaccine. Interventions should take into account varied vaccine intention and uptake prevalence in different Asian subgroups.

Background. The high prevalence of HPV infection among Kazakhstani women and the absence of an HPV vaccination program are directly reflected in increasing rates of cervical cancer incidence and mortality. Kazakhstan made its first attempt at introducing the HPV vaccine in 2013, but was unsuccessful due to complications and low public acceptance. The attitudes of Kazakhstani women towards the vaccine were never measured. Therefore, this study aims to investigate the attitudes of women towards the HPV vaccine and determine factors associated with positive, negative, or neutral attitudes. Methods. A 29-item survey consisting of 21 demographic and contextual questions and 8 Likert-scale questions was distributed among women attending gynecological offices in four major cities of Kazakhstan from December 2021 until February 2022. Attitudes of women were measured based on their answers to the eight Likert-scale questions. Ordinal logistic regression was built to find associations between demographic characteristics and attitudes of women. Results. Two hundred thirty-three women were included in the final analysis. A total of 54% of women had positive attitudes towards the vaccine. The majority of women did not trust or had a neutral attitude towards the government, pharmaceutical industry, and traditional and alternative media. However, the trust of women was high in medical workers and scientific researchers. Women’s age, education, number of children, effect of the 2013 HPV program, and trust in alternative medicine were included in the ordinal logistic model. Women with a low level of education, a high number of children, who believe in alternative medicine, and who were affected by the failed 2013 vaccination program were less likely to have a positive attitude towards the vaccine. Conclusions. Contrary attitudes towards HPV vaccination exist among Kazakhstani women, with approximately half having positive and almost half having negative or neutral attitudes towards the vaccine. An informational campaign that takes into consideration women’s levels of trust in different agencies, as well as targets those who are the most uninformed, might help in a successful relaunch of the HPV vaccination program. However, more studies that cover a higher number of women are required.

Purpose Compared to US urban populations, rural residents have a higher incidence of HPV-related cancer and lower HPV vaccine coverage. This study determined what is known about barriers and facilitators to vaccine uptake in US rural settings. Methods A scoping review was conducted to describe individual, interpersonal, organizational, and community/societal barriers and facilitators to HPV vaccine initiation and completion among US rural populations and to identify gaps in the current research. A systematic search was conducted using PubMed/MEDLINE and CINAHL databases. Results A total of 1,083 abstracts were reviewed and 13 articles met the inclusion criteria. Major themes at the individual-level included caregiver and vaccine-recipient demographics, other immunizations received, pap test history, awareness/knowledge of cervical cancer, HPV vaccine, or HPV infection, attitudes and motivation to vaccinate, STD diagnosis, sexual behavior, cervical cancer history, contraceptive use, and cancer fatalism. Interpersonal themes focused on provider influence and communication, caregiver and peer influence, and social support for the caregiver. At the organizational-level, themes included health insurance, provider characteristics, school-based interventions, and provider/practice-based interventions. The only community/societal factor examined related to a social marketing campaign. Conclusion Additional research is needed on interpersonal, organizational, and community/societal factors, as well as an expanded focus on rural males. Future studies should account for rural heterogeneity by expanding the geographic areas studied. Our findings detailing factors found to be associated with HPV vaccine uptake will help inform future clinical, health services, and community research, as well as interventions and policy efforts.

Background Human papillomavirus (HPV) is the most common sexually transmitted infection and is associated with many types of cancers that disproportionately impact Hispanics. An HPV vaccine is available for individuals ages 9—45 that can prevent up to 90% of HPV-associated cancers. The current study investigates factors associated with accepting the HPV vaccine in a predominately Hispanic community. Methods A cross-sectional study design with an online questionnaire was used to collect data from a community sample of adults between the ages 18–65 residing in a U.S./Mexico border city, El Paso, Texas. Theory-based factors (e.g., the Health Belief Model), culture-based factors (e.g., familism), and trusted sources of information were examined as predictors of HPV-vaccine acceptance (HPV-VA) and HPV-vaccine uptake (HPV-VU). Results Community members ( N  = 602, M age  = 34.65, SD  = 9.79) who were predominately Hispanic (89.4%) and female (79.6%) participated in the study. Linear regression models revealed that HPV-VA was associated with household size , primary language , engagement in organizational activities , health-related community stigma, government trust, and the HBM theory-based factors: perceived benefits, perceived harm, and perceived severity. Logistic regression analyses revealed that HPV-VU was associated with household size , engagement in non-organizational activities , HPV trusted sources of information , and perceived safety . Conclusions Adequate HPV vaccination uptake among all vaccine-eligible Hispanics is an important step to lessen the HPV-attributed cancer burden. Our hypothesis that theory-based factors would be associated with HPV-VA and HPV-VU was supported. Our findings have implications for designing trusted, theory-based, and culturally sensitive health communications and interventions to promote vaccines in minority underrepresented communities.

Many countries in the world are facing challenges to reach the WHO proposed target of HPV vaccination of 90 % of girls by the age of 15. A population-based cross-sectional survey was conducted in Manizales, Colombia to identify sociodemographic factors and components of the health belief model related to HPV vaccination in the 2003, 2004, and 2005 birth cohorts of girls and their parents targeted by the national HPV vaccination program in 2012, 2013, and 2014. Complementary log-log generalized linear models were used to obtain adjusted Prevalence Ratios (aPR) and 95 % confidence intervals (CI). A lower prevalence of HPV vaccination was observed in girls of the 2004 (aPR 0.82; 95 % CI 0.71–0.92) and 2005 (aPR 0.61; 95 % CI 0.52–0.71) cohorts compared to the 2003 cohort. The higher scores of perceived benefits by girls (aPR 1.06; 95 % CI 1.05–1.08) or their parents (aPR 1.05; 95 % CI 1.03–1.06) were associated to a higher prevalence of HPV vaccination of the girls. Conversely, this prevalence decreased with perceived barriers by girls (aPR 0.94; 95 % CI 0.91–0.96) and parents (aPR 0.91; 95 % CI 0.88–0.94). Parent's education lower attainment, lower socioeconomic stratum, and subsidized (public) health insurance were related to decreased likelihood of HPV vaccination. The results suggest that campaigns for HPV vaccination require effective education strategies to improve public perception of the vaccine's safety and benefits. Decision-makers and implementers must address also other social determinants such as disparities in access to education by parents, the SES, and the type of health insurance to improve HPV vaccination coverage. •HPV vaccine uptake in Colombia is below the WHO target.•Sociodemographic factors and health beliefs influencing HPV vaccine uptake were assessed in girls and their parents.•Parental education, socioeconomic status, and health insurance correlated with lower vaccination rates.•Lower perceived benefits and higher perceived barriers in Girls and parents were also related to vaccine uptake.•Improved HPV vaccination in Colombia requires targeted education and addressing social determinants.