Health Literacy Correlates to HPV Vaccination Among US Adults Ages 27–45

Abstract

Human papillomavirus (HPV) vaccination is now available for adults aged 27–45 as a shared clinical decision. Health literacy skills (i.e., accessing, understanding, appraising, applying information) may facilitate vaccine decision-making for adults with a provider recommendation. This study assessed associations between health literacy skills and willingness to get a provider-recommended HPV vaccine among newly eligible US adults. In 2020, US participants (51% women), aged 27–45 years, were surveyed online ( n = 691). The outcome was willingness (willing/not willing) to get the HPV vaccine with provider recommendation. Measures were adapted from Sørensen’s multidimensional European Health Literacy Scale, which assesses health literacy among four domains (i.e., access, understanding, appraisal, application). Adjusted odds ratios were calculated for the outcome and each health literacy domain, adjusting for personal health determinants (e.g., age, sex). The sample consisted of primarily non-Hispanic (91.2%), White (74.4%), and married (60.7%) adults. Approximately 65% of participants were willing to get a provider-recommended HPV vaccine. Higher willingness to vaccinate with provider recommendation was significantly associated with increased HPV knowledge (understanding; aOR = 1.13, 95% CI 1.04, 1.24), ability to understand HPV information (understanding; aOR = 1.96, 95% CI 1.09, 3.52), increased perceived vulnerability to HPV-related cancer (appraising; aOR = 3.22, 95% CI 1.83, 5.69), and the need for more information on vaccine safety to seek vaccination (applying; aOR = 3.25; 95% CI 2.05, 5.16). Utilizing a multidimensional health literacy framework to evaluate facilitators to HPV vaccination uptake among adults aged 27–45 can help guide future interventions by targeting accurate, easy-to-understand HPV information that connects vaccination efficacy to reduction in HPV cancer risk.

Human Papillomavirus Vaccine Administration Trends Among Commercially Insured US Adults Aged 27-45 Years Before and After Advisory Committee on Immunization Practices Recommendation Change, 2007-2020

“…Previous studies that surveyed adults aged 27 to 45 years after the ACIP recommendation update found that the majority of these adults were likely to ask health care professionals about HPV vaccination and willing to get a vaccine if recommended by their clinician . The likelihood of receiving the HPV vaccine was highly associated with the perceived likelihood of benefiting from the vaccine .…”

“…Previous studies that surveyed adults aged 27 to 45 years after the ACIP recommendation update found that the majority of these adults were likely to ask health care professionals about HPV vaccination and willing to get a vaccine if recommended by their clinician. 29,30 The likelihood of receiving the HPV vaccine was highly associated with the perceived likelihood of benefiting from the vaccine. 29 Similarly, according to a study that surveyed primary care physicians, the majority of physicians reported that they would be more likely to recommend HPV vaccination to adults aged 27 to 45 years due to the new ACIP recommendation.…”

“If People Were Told About the Cancer, They’d Want to Get Vaccinated”: Knowledge, Attitudes, and Beliefs About HPV Vaccination Among Mid-Adult Men

“…This research has identified low awareness of eligibility for HPV vaccination ( Alber et al, 2021 ), low knowledge of HPV-related cancers that directly affect men ( Thompson et al, 2020 ), concerns about HPV vaccine safety, and beliefs that the HPV vaccine is unnecessary ( Muthukrishnan et al, 2022 ) among mid-adults, which may pose barriers to uptake. Mid-adults’ willingness to be vaccinated has been identified as being positively associated with level of knowledge about HPV vaccination, perceived ease of understanding HPV vaccine information, and perceived vulnerability to HPV-related cancers ( Galvin et al, 2023 ). Positive attitudes toward HPV vaccination, perceived effectiveness of vaccines against HPV infection, and perceived likelihood of benefiting from HPV vaccination have been reported to increase mid-adults’ perceived likelihood of getting vaccinated ( Thompson et al., 2021 ).…”

Establishment of an Evaluation System for Cervical Cancer Health Literacy Among Chinese Women

“…Improving cervical cancer health literacy levels is one of the keys to preventing cervical cancer [12]. Several studies have shown that an increased level of cervical cancer health literacy is associated with improved HPV vaccination, cervical cancer screening, and treatment [13][14][15]. In China, the HPV vaccine is not included in the national immunization program, but a cervical cancer screening program was instituted in 2009 as part of primary health care inviting rural women aged 35-64 years to undergo regular screenings.…”