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Background Human papillomavirus (HPV) vaccination has been perceived in diverse ways some of which encourage its uptake while others could potentially deter its acceptability. This study explored community member’s perceptions about HPV vaccination in Ibanda district and the implications of the perceptions for acceptability of HPV vaccination. The study was conducted following initial vaccination of adolescent schoolgirls in the district between 2008 and 2011. Methods This qualitative study employed focus group discussions (FGDs) and key informant interviews (KIIs). FGDs were conducted with schoolgirls and parents/guardians and KIIs were conducted with school teachers, health workers and community leaders. Transcripts from the FGDs and KIIs were coded and analyzed thematically using ATLAS.ti (v. 6). Results The HPV vaccination was understood to safely prevent cervical cancer, which was perceived to be a severe incurable disease. Vaccinations were perceived as protection against diseases like measles and polio that were known to kill children. These were major motivations for girls’ and parents’ acceptance of HPV vaccination. Parents’ increased awareness that HPV is sexually transmitted encouraged their support for vaccination of their adolescent daughters against HPV. There were reports however of some initial fears and misconceptions about HPV vaccination especially during its introduction. These initially discouraged some parents and girls but over the years with no major side effects reported, girls reported that they were willing to recommend the vaccination to others and parents also reported their willingness to get their daughters vaccinated without fear. Health workers and teachers interviewed however explained that, some concerns stilled lingered in the communities. Conclusions The perceived benefits and safety of HPV vaccination enhanced girls’ and parents’ acceptability of HPV vaccination. The initial rumors, fears and concerns about HPV vaccination that reportedly discouraged some girls and parents, seemed to have waned with time giving way to more favourable perceptions regarding HPV vaccination although the study still found that a few concerns still lingered on and these have implications for HPV vaccination acceptability.

While many clinicians encounter parents or adolescents who refuse HPV vaccine, little is known about the prevalence of hesitancy for HPV vaccine nationally or its association with vaccination. In April 2019, we surveyed families with adolescents 11–17 years using a national online panel (Knowledge Panel®) as the sampling frame. We assessed the prevalence of HPV vaccine hesitancy with the validated 9-item Vaccine Hesitancy Scale (VHS). We used multivariate analyses to assess demographic factors associated with HPV vaccine hesitancy. We also assessed practical barriers to receipt of HPV vaccine and the relationship between barriers and hesitancy. Finally, we evaluated the association between both HPV vaccine hesitancy and practical barriers on HPV vaccine receipt or refusal. 2,177 parents out of 4,185 sampled (52%) completed the survey, 2,020 qualified (lived with adolescent). Using a VHS cut-off score > 3 out of 5 points, 23% of US parents were hesitant about HPV vaccine. Hesitancy was lower among those with Hispanic ethnicity. At least one out of five parents disagreed that the HPV vaccine is beneficial for their adolescent, that the vaccine is effective, protects against HPV-related cancers, or that they followed their adolescent’s health-care provider’s recommendation about the vaccine. Many were concerned about vaccine side effects and the novelty of the vaccine. Adolescents living with vaccine-hesitant parents were less than one-third as likely to have received the vaccine (RR = 0.29, 95% CI 0.24, 0.35) or completed the vaccine series (RR = 0.29, 95% CI 0.23, 0.36), and were 6-fold more likely to have refused the vaccine because of parental vaccine-related concerns (RR = 6.09, 95% CI = 5.26, 7.04). Most practical barriers were independently associated with vaccine receipt but not with vaccine refusal. HPV vaccine hesitancy is common nationally and strongly related to both under-vaccination and vaccine refusal.

Background Human Papilloma Virus (HPV) infection is a significant public health concern in the Gulf Cooperation Council countries, being widely prevalent and the main risk factor for cervical cancer. We aimed to assess knowledge and perception towards HPV, acceptability of the HPV vaccine, and HPV vaccination rates among university students in Education City, Doha, Qatar. Methods This cross-sectional survey utilized proportional quota-sampling, with quotas based on university, sex, and nationality, to recruit students from seven universities between February and September 2022. The English language questionnaire requested socio-demographic information, knowledge, and attitudes about HPV infection and the vaccine. The chi-square test, Student t-test, Mann-Whitney-Wilcoxon tests and multivariable ordinal logistic regression were used to assess differences in proportion, mean, and median according to broad HPV knowledge categories. Results Three hundred and ninety-eight students were recruited (response rate = 82.3%), of whom 251 (63.1%) were female. Mean age was 21.7 years. Eighty-nine (22.4%, 95% CI 18.4–26.8%) students had poor knowledge about HPV, 220 (55.3%, 95% CI 50.2–60.2%) students had some awareness, and 89 (22.4%, 95% CI 18.4–26.8%) students were knowledgeable. Age, nationality, and field of study influenced the students’ knowledge about HPV. Only 25 (6.3%) students had previously been vaccinated against HPV. However, 71% of the unvaccinated students reported being willing to get vaccinated if recommended by their healthcare provider. Conclusions Overall, 77.7% of the student population had some-to-good levels of knowledge about HPV-related infection, cancer, and vaccination. There are gaps in the student population’s understanding and knowledge about HPV. Increasing knowledge can be key toward shared decision-making for HPV vaccination among eligible populations. Targeted public health campaigns and integration into childhood vaccination programs should be critical first steps, especially as most of the surveyed students had a positive outlook on getting vaccinated. Healthcare professionals should be incentivized to increase their HPV knowledge and communication skills, while policymakers can work toward easing barriers in integrating HPV vaccinations in the immunization schedule and encouraging overall HPV vaccination uptake.

HPV vaccination is effective in preventing cancer and is recommended for children as early as age 9. However, the HPV vaccination rate remains well below the target goal of 80 % for adolescents in the United States. Receiving recommendations from parents who have already vaccinated children can prompt vaccination norms among those who have not. Yet factors associated with recommendation behavior remain underexplored. Our paper identifies behavioral and social determinants associated with intention to recommend HPV vaccination to others among parents who had their children vaccinated. Participants were a national sample of 1019 American adults recruited from a Qualtrics Panel from August to October 2023. The survey assessed key constructs related to vaccination communication and behavior, demographic characteristics, and attitudes to HPV vaccination. We used the path model of Structural Equation Modeling to examine relationships among the constructs. We found that HPV-related risk appraisal, HPV vaccine effectiveness and safety, vaccination norms, recommendations received, and ability of information seeking are primarily correlated with attitudes towards HPV vaccination and intention to recommend HPV vaccination to others. The study makes unique contributions in several ways, as it is among the first to examine relationships among parents who have already vaccinated their children.

Background The human papillomavirus (HPV) vaccine reduces the burden of cervical and other cancers. In numerous countries, a slow uptakeof this vaccine persists, calling for a better understanding of the structural factors leading to vaccine acceptation. We aimed to assess the attitudes toward HPV vaccination among its intended public to explore its specific characteristics. Methods A random cross-sectional telephone survey of the French general population provided data from a sample of 2426 respondents of the target public: the parents of young women and the young women aged 15-25 themselves. We applied cluster analysis to identify contrasting attitudinal profiles, and logistic regressions with a model averaging method to investigate and rank the factors associated with these profiles. Results A third of the respondents had never heard of HPV. However, most of the respondents who had heard of it agreed that it is a severe (93.8%) and frequent (65.1%) infection. Overall, 72.3% of them considered the HPV vaccine to be effective, but 54% had concerns about its side effects. We identified four contrasting profiles based on their perceptions of this vaccine: informed supporters, objectors, uninformed supporters, and those who were uncertain. In multivariate analysis, these attitudinal clusters were the strongest predictors of HPV vaccine uptake, followed by attitudes toward vaccination in general. Conclusions Tailored information campaigns and programs should address the specific and contrasted concerns about HPV vaccination of both young women and of their parents.

The vaccination uptake rates of the human papillomavirus (HPV) vaccine remain low despite the fact that the effectiveness of HPV vaccines has been established for more than a decade. Vaccine hesitancy is in part due to false information about HPV vaccines on social media. Combating false HPV vaccine information is a reasonable step to addressing vaccine hesitancy. Given the substantial harm of false HPV vaccine information, there is an urgent need to identify false social media messages before it goes viral. The goal of the study is to develop a systematic and generalizable approach to identifying false HPV vaccine information on social media. This study used machine learning and natural language processing to develop a series of classification models and causality mining methods to identify and examine true and false HPV vaccine-related information on Twitter. We found that the convolutional neural network model outperformed all other models in identifying tweets containing false HPV vaccine-related information (F score=91.95). We also developed completely unsupervised causality mining models to identify HPV vaccine candidate effects for capturing risk perceptions of HPV vaccines. Furthermore, we found that false information contained mostly loss-framed messages focusing on the potential risk of vaccines covering a variety of topics using more diverse vocabulary, while true information contained both gain- and loss-framed messages focusing on the effectiveness of vaccines covering fewer topics using relatively limited vocabulary. Our research demonstrated the feasibility and effectiveness of using predictive models to identify false HPV vaccine information and its risk perceptions on social media.

Background Regardless of the disease burden of human papillomavirus (HPV), the vaccine has not been included in the Indonesia National Immunization Program. Since 2017 there was a demonstration program of the HPV vaccination in Yogyakarta Province. This vaccine was given free to female primary school students in the 5th and 6th grades (11–13 years old). This study aimed to assess whether a structured-educational intervention focus on HPV increases the parental awareness, knowledge, and perceptions toward HPV and the vaccine acceptability. Methods We conducted a pre-post structured-educational intervention study from July to August 2017 before the implementation of the HPV vaccination demonstration program, in Kulon Progo District, Yogyakarta Province, Indonesia. Parents of female primary school students grades 5th and 6th were selected using a school-based proportional random sampling. A pediatric resident provided a structured-educational intervention, which consists of the burden and risk of HPV disease, as well as the benefit and safety of the vaccine. Parents were required to complete validated self-administered questionnaires before and after the structured-educational intervention. Results A total of 506 parents participated. Before receiving the structured-educational intervention, parents’ awareness of HPV infection and the vaccines were low. Only 49.2% of parents had heard HPV infection, and 48.8% had heard about the vaccine. After the structured-educational intervention, there were significant improvements in parent’s awareness, knowledge, and perceptions of HPV infection, cervical cancer, and HPV vaccination (all p  < 0.001). HPV vaccine’s acceptability increased from 74.3 to 87.4% ( p  < 0.001). There was a significant correlation between increasing HPV vaccine acceptability with the improvement of awareness, knowledge, and perception toward HPV infection, cervical cancer and HPV vaccination (r = 0.32 to 0.53, p  < 0.001). After the structured-educational intervention, better knowledge and positive perceptions of HPV vaccination were predictive of HPV vaccine’s acceptability with OR 1.90 (95%CI:1.40–2.57) and OR 1.31(95%CI,1.05–1.63), respectively. Conclusions A structured-educational intervention may improve parental awareness, knowledge, and perceptions toward HPV and the acceptability of the vaccine. Further study, a randomized control trial with longer follow-up are needed to evaluate the long-term and actual effectiveness of improving parents’ knowledge, perceptions and HPV vaccine acceptability .

The Chinese government has not yet included male population for HPV vaccination but there are increasingly more discussions about including them. Primary care providers' (PCPs) recommendation is an important driver for increasing vaccine uptake but understanding of PCPs' recommendation of HPV vaccine for adolescent males in China is limited. This study examined multidimensional factors associated with PCPs' recommendation of HPV vaccine for male adolescents, aiming to inform future HPV vaccination programs targeting adolescent males in China. A sequential explanatory mixed-methods was used. In the quantitative phase, we conducted an online survey with PCPs in Eastern China. Multivariable logistic regression analysis identified individual, interpersonal, community, organizational, and policy factors associated with their recommendation of HPV vaccines for adolescent males. Specialty, job title, and income were adjusted as potential confounding factors. The qualitative phase involved thematic analysis to explore these findings further. Among the 605 PCPs recruited, only 16.4 % recommended HPV vaccines to adolescent males in the past 12 months. Multivariable logistic regression analysis showed that institutional support for HPV vaccination policies for adolescent males (AOR = 3.05, 95 % CI: 1.65–5.64), frequent institutional vaccine promotion activities (AOR = 1.82, 95 % CI: 1.12–2.96), and institutional incentives for vaccine promotion (AOR = 2.12, 95 % CI: 1.18–3.83) were associated with their recommendation behaviors. Additionally, those who perceived a community norm that HPV vaccines are only for females were less likely to recommend HPV vaccines to adolescent males (AOR = 0.54, 95 % CI: 0.33–0.87). Qualitative research further explained these findings, highlighting the role of organizational factors in PCPs' recommendation of HPV vaccination for adolescent males. A low proportion of PCPs recently recommended HPV vaccines to adolescent males. Organizational-level factors were found to be significantly associated with their recommendation behaviors, and these may help inform future vaccination programs targeting adolescent males. •First study on Chinese PCPs' recommendation of HPV vaccines to adolescent males.•Only 16.4 % of PCPs recommended HPV vaccines to adolescent males in the past 12 months.•Institutional support for HPV policies increases PCPs' recommendations to adolescent males.•Vaccine promotion activities and incentives increased recommendation likelihood.•Perceived community norm that HPV vaccines are only for females reduces recommendations.

•Parents were concerned about HPV vaccine safety and the child's age.•Most parents were unaware of the benefits of the HPV vaccine for boys.•COVID-19 may have disrupted the passive acceptance of vaccines. HPV vaccination has been offered in school programs for over a decade in Quebec, Canada, but the vaccine coverages are not reaching the target coverage in several regions. This qualitative study aimed to describe barriers and enabling conditions of HPV vaccination as perceived by parents and school nurses and identify potential solutions to improve HPV vaccine uptake rates and acceptance in school-based programs. Three focus group discussions were conducted with parents of children in Grades 2 or 3 who were unsure or unwilling to vaccinate. Individual interviews were conducted with 24 school nurses. A thematic content analysis was performed using N'Vivo. The main parental questions and concerns regarding the HPV vaccination were the children’s young age, the possible side effects, the rationale behind boys’ vaccination and the possible interaction with COVID-19 vaccination. Except for interaction with COVID-19 vaccination, these concerns remain similar to those identified before the pandemic. Interviews highlighted that the information on HPV vaccination provided by the public was not well understood by parents. Parents suggested different tools to access information tailored to their concerns and situation. From the nurses’ perspective, HPV vaccination promotion tools such as decision-aids and social media communication campaigns were needed and could reduce their work. COVID-19 may have disrupted the acceptance of the vaccines. While strategies to catch up on missed doses and reduce access barriers to vaccines are urgently needed, our findings highlight that a shift in attitudes toward routine vaccines may pose further challenges even if HPV vaccine coverage appears to have returned to pre-pandemic levels.

Little research has been conducted on the intention to obtain HPV vaccine now that the vaccine is approved for use in China. Acceptance of the three HPV vaccines, which differ in valency and price, has never been investigated. An online cross-sectional survey assessing female undergraduate students’ intention to obtain the HPV vaccine and their acceptability of 2-, 4- and 9-valent HPV vaccines (2vHPV, 4vHPV, and 9vHPV, respectively). Of a total of 997 complete responses, 55.2% reported intent to obtain the HPV vaccine. Some of the significant factors exerting influence on intent to obtain HPV vaccination were high knowledge score (OR = 1.469, 95% CI:1.087–1.987), perceived high risk of HPV infection (OR = 1.466, 95%CI:1.017–2.114), perception of no serious side effects (OR = 1.562, 95%CI:1.150–2.121), and mass media exposure to HPV vaccination information (OR = 2.196, 95%CI: 1.625–2.966). Socioeconomic status indicators did not significantly influence intent to obtain the HPV vaccine. A higher proportion of respondents were willing to pay for 2vHPV (78.6%) and 4vHPV (68.0%) compared with 9vHPV (49.3%). Socioeconomic status indicators were the strongest correlates of acceptability for all the three vaccines. Exposure to mass media reporting about HPV vaccination is the factor which exerts the most influence on acceptance of 9vHPV after socioeconomic status indicators. It is important to improve knowledge and health beliefs, and to establish a mass media marketing strategy to promote HPV vaccination in order to enhance HPV vaccine uptake. Undergraduate female students should be provided with detailed information about the different valency vaccine choices to help them make informed decisions about immunization.