Prof. Chunxia Yang
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, China
Title: Willingness to HPV vaccination for girls and its influencing factors in western Sichuan, China
Abstract:
Background The Human papillomavirus（HPV）infection rate in Sichuan, China, is higher than the national average. In response, the Sichuan provincial government is set to promote HPV vaccination programs across the province, with a particular focus on impoverished areas such as the Ganzi, Aba, and Liangshan (GAL) prefectures. The uptake of HPV vaccination among adolescents is significantly influenced by the willingness of their caregivers to vaccinate. This study seeks to investigate the current status of HPV vaccination among adolescent females in the GAL prefectures, explore existing policies, and assess the knowledge and attitudes of caregivers of primary and secondary school girls regarding HPV vaccines. Additionally, it aims to analyze the factors that affect caregivers' willingness to vaccinate their daughters against HPV.
Methods The research, conducted from September 2023 to May 2024 in GAL prefectures of Sichuan Province, China, utilized a cross-sectional design that integrated both quantitative and qualitative methods. The quantitative study involved administering questionnaires to caregivers of primary and secondary school girls under the age of 15. The primary focus was to assess caregivers' willingness to vaccinate their daughters against HPV. Chi-square tests, Mann-Whitney U tests, and binary logistic regression analyses were used to identify the factors influencing their willingness. Additionally, a qualitative study was carried out through focus group discussions (FGDs) and face-to-face interviews to assess the local HPV vaccination coverage rate and explore the various factors affecting vaccination uptake. Interviews were conducted with vaccination-related personnel and caregivers of girls aged 9 to14.
Results In this quantitative study, a total of 2,584 caregivers participated in the survey, with 2,397 (92.76%) completing valid questionnaires. Among them, 1,421 (59.28%) caregivers had heard of HPV, while 1,669 (69.63%) knew about the HPV vaccine. An impressive 92.12% of caregivers expressed their willingness to vaccinate their children against HPV. Those in favor of vaccinating their daughters cited reasons such as the belief that the HPV vaccine effectively prevents cervical cancer (56.39%) and it is safe (34.74%). Conversely, the main reasons for reluctance included a lack of knowledge about the vaccine (30.69%) and concern about potential side effects (28.04%). The relationship between caregivers and the girl, their marital status, awareness of HPV and the HPV vaccine, knowledge level and scores, willingness to cover vaccination cost, personal willingness to receive the HPV vaccine, willingness to get all scheduled and recommended vaccines for themselves and their children, as well as any history of vaccine refusal for themselves or their children, all showed statistically significant differences in their willingness to vaccinate their daughters against HPV (all p<0.05). Binary logistic regression analyses showed that caregivers who were mothers, willing to pay for HPV vaccination, personally willing to receive the HPV vaccine, and had never refused a vaccine were more likely to vaccinate their children against HPV (all p<0.05). The findings from the qualitative study showed that although the governments of GAL prefectures were making active efforts in cervical cancer prevention and the promotion of HPV vaccination, the HPV vaccination coverage rate among girls remained disappointingly low. The main obstacles were insufficient vaccine supply, unfavorable economic conditions, and limited public knowledge of the HPV vaccine. To boost vaccination rates, it is critical to enhance awareness campaigns, secure a reliable vaccine supply, and explore subsidy policies.
Conclusion In this study, the HPV vaccination coverage rate among primary and secondary school girls in GAL prefectures remained notably low, and caregivers lack sufficient knowledge about HPV. However, caregivers generally hold positive attitudes towards HPV vaccination. It is critical to ensure a reliable vaccine supply, lower the cost of HPV vaccination, improve caregivers' knowledge, alleviate concerns about the safety and efficacy of vaccines could significantly enhance vaccination rates in regions with limited healthcare resources in western China.
Keywords HPV vaccination, Caregivers of primary and secondary school girls, Vaccination willingness, Mixed methods
Biography: