Acceptability Of Human Papillomavirus Vaccine For 9-14-Year-old Girls Among Parents In Four Provinces Of China

Objective:This study aims to investigate the cognition and acceptance on human papillomavirus vaccine among parents whose daughter was 9-14-year-old,and to explore the factors that affect the willingness of parents to vaccinate their daughters against HPV.Methods:By using convenient sampling method,48 primary schools and junior high schools were selected from four provinces of Zhejiang,Henan,Sichuan and Heilongjiang respectively in the east,middle,west and northeast area of China.The parents whose daughters were in grade 4-9 and 9-14 years old were investigated to complete self-administered questionnaire.Descriptive analysis was used to describe the awareness rate of HPV and HPV vaccine,knowledge level,the willingness of parents to vaccinate their daughter against HPV and the health education methods they were preferred.Univariate analysis and logistic regression were used to analyze the factors associated with HPV related knowledge level and the acceptance of HPV vaccination.Results:1.This survey included 4947 guardians.The awareness rates of HPV and HPV vaccine of female parents were 60.76%and 54.90%respectively,of which 76.08%and 72.86%were respectively unfamiliar with HPV and HPV vaccine.The mean score of HPV vaccine-related questions for female parents was 2,and 16.27%of parents were in a high awareness level.Influencing factors of the high level of HPV knowledge included school type(suburban school vs urban school,OR=0.82,95%CI:0.68-0.97),parents(mother vs father,OR=1.40,95%CI:1.09-1.79),education level(university degree or above vs elementary school or below,OR=7.46,95%CI:4.64-12.00),occupation(medical workers vs other,OR=3.88,95%CI:2.55-5.90),monthly per capita household income(3000-4999 yuan vs<3000 yuan,OR=1.52,95%CI:1.24-1.87),daughter’s self-paid vaccination history(yes no,OR=1.40,95%CI:1.15-1.70).2.The HPV vaccination rates of 9-14 year-old girls and mothers were 1.37%and 2.57%,respectively.The proportions of parents willing to vaccinate HPV vaccines for daughters and mothers were 45.62%and 50.07%,respectively(χ2=19.04,P<0.01).After controlling for other variables,the influencing factors of parents’willingness to vaccinate their daughters with HPV vaccine included school type(urban school vs suburban school,OR=1.24,95%CI:1.08-1.41),education(junior high school vs elementary school and below,OR=1.60,95%CI:1.26-2.02;university degree or above vs elementary school and below,OR=2.24,95%CI:1.60-3.14),monthly per capita household income(7000-8999 yuan vs<3000 yuan,OR=1.36,95%CI:1.02-1.81),daughter ’s self-paid vaccination history(yes vs no,OR=1.35,95%CI:1.16-1.56),HPV vaccine awareness(heard but unfamiliar vs familiar,OR=0.56,95%CI:0.44-0.70;not heard vs familiar,OR=0.36,95%CI:0.28-0.45),knowledge score level(high vs low,OR=1.64,95%CI:1.36-1.97),HPV vaccination promoters,recognition of cervical cancer severity,recognition of HPV vaccine effect,recognition of HPV susceptibility and etc.3.The main reasons for parents’ unwillingness or uncertainty in getting HPV vaccine for daughters were ’unfamiliar with HPV vaccine’(73.73%),’worrying about the safety of HPV vaccine’(44.89%),’ HPV vaccine is expensive’(33.09%),‘doubting the efficacy of HPV vaccine’(31.40%),’HPV vaccine is not widely used’(24.50%).13.21%of parents were only willing to vaccinate mothers against HPV The main reasons were that ’mothers are more likely to be infected with HPV and more susceptible to cervical cancer’(47.61%)and ’worried about daughter’s abnormal reaction after vaccination’(45.57%).41.53%of parents who were unwilling or uncertain to vaccinate daughter only accepted vaccinating their daughter for free,and 23,83%chose‘500 yuan at most’ and 12.20%chose‘1000 yuan at most’.4.The main sources of HPV vaccine information trusted by parents are ’Center for disease control and prevention,hospital,vaccination clinic’(87.18%),and’government departments,health committee’(62.40%).Parents pay attention to the following contents,’ways to prevent HPV infection’(65.41%),’safety of HPV vaccine’(62.54%),’ways of HPV infection’(58.78%),’effect of HPV vaccination’(53.81%),’Who should acquire HPV vaccination’(45.02%).Video explanation was the favorite carrier parents preferred(32.03%)Conclusion:1.The HPV vaccination rate of girls aged 9-14 is low,and parents’ acceptability for daughters’ HPV vaccination was lower than that for mothers’ HPV vaccination.2.Lower level of education and income,daughters attending suburban schools,low awareness level of HPV vaccine,distrust of vaccine effects were important factors that influence the acceptance of HPV vaccine.3.Parents have misunderstandings about HPV and HPV vaccines,and their cognitive level needs to be improved.