Stages of HPV Vaccine Hesitancy Among Guardians of Female Secondary School Students in China

Zheng, Wei; Liu, Yang; Zhang, Liuren; Sun, Xiaonan; Jiang, Qijing; Li, Zhenwei; Wu, Yue; Fu, Chuanxi

doi:10.1016/j.jadohealth.2022.08.027

Cited by 14 publications

(16 citation statements)

References 40 publications

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“…Our data suggest a Chinese caregiver preference for 9vHPV vaccines. This is consistent with data from China (20,45). This was related to the perception that higher coverage of HPV viruses offered much greater effectiveness (46).…”

Section: Discussionsupporting

confidence: 90%

“…For Chinese adolescents awaiting HPV vaccination, primary caregivers, usually parents, have a strong in uence over the decision (18-21). In 2020, Zheng et al found that more than half of guardians of secondary school girls in China were vaccinehesitant; among them 21.1% reported they were undecided about vaccination (22). Studies found that Chinese caregivers were primarily in uenced by concerns about vaccine safety and effectiveness (6, 16, 23), inadequate access to health information and professional advice (16, 23) and low risk perception of cervical cancer (6).…”

Section: Introductionmentioning

confidence: 99%

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Between Now and Later: A Mixed Methods Study of HPV Vaccination Delay Among Chinese Caregivers in Urban Chengdu, China

Yim,

Wang,

et al. 2023

Preprint

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Background: Adolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls. Methods: Quantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14–18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen’s Behavioural Model for Health Services Use. Results: A total of 100 caregivers – 85 were mothers and 15 were fathers – participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage, inadequate health communication, and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, and the belief that adolescents were unlikely to be sexually active. Conclusion: In urban areas, Chinese caregivers’ intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Between Now and Later: A Mixed Methods Study of HPV Vaccination Delay Among Chinese Caregivers in Urban Chengdu, China

Yim,

Wang,

et al. 2023

Preprint

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“…The HBM has been applied in several regions of the world, allowing comparisons [ 22 , 23 , 27 , 37 , 38 , 39 , 40 ]. It provides information on behaviors allowing to list interventions that focus on individuals’ attitudes and beliefs to overcome low vaccination coverage.…”

Section: Discussionmentioning

confidence: 99%

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

2023

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Vaccination coverage against Human Papillomavirus (HPV) is low compared with uptake of other vaccines in many countries, including Brazil. The aim of this study was to examine the main reasons provided by parents or guardians of a target population that did not have the first dose of HPV vaccine in a small rural Brazilian municipality, and to verify the factors associated with the reasons for non-vaccination. This is a cross-sectional study with interviews based on the Health Belief Model (HBM), conducted with parents and guardians of 177 unvaccinated children or adolescents. The outcome of interest was the main reason for not vaccinating the child/adolescent. The exposure factors of interest were knowledge about HPV and its prevention as well as sociodemographic characteristics. The main justifications for not vaccinating were lack of information (62.2%), fear or refusal (29.9%), and logistical issues (7.9%). The justifications associated with adolescents’ sex, fear, or refusal were mentioned by 39.3% (95% CI: 28.8–50.6%) of parents or guardians of girls and by 21.5% (95% CI: 13.7–31.2%) of parents or guardians of boys. The main barrier to HPV vaccination is lack of information. Further training of health professionals in clarifying the benefits of vaccination and differentiating the risks between boys and girls could encourage uptake.

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“…Vaccine hesitancy, a recurring challenge with multiple vaccines [ 18 ], also plays a pivotal role. As indicated by Wei et al, 53.9% of parents of female secondary school students in China exhibited hesitancy towards HPV vaccines [ 19 ]. Furthermore, the school-based nature of many vaccination programmes pose potential barriers, including perceptions of HPV vaccine being unsuitable for school-aged girls, conflicts to cultural norms, disagreement from schools, as well as the overshadowing of other health education priorities [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Willingness and hesitancy towards the governmental free human papillomavirus vaccination among parents of eligible adolescent girls in Shenzhen, Southern China

Wu,

Liu,

Wang

et al. 2024

BMC Women's Health

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Background Since 2020, China has actively promoted HPV vaccination for eligible adolescent girls through various pilot programmes. This study investigated parental willingness and hesitancy towards the government-sponsored, free human papillomavirus (HPV) vaccination for eligible adolescent girls in Shenzhen, Southern China. Methods From June to August 2022, a cross-sectional survey was conducted with parents of girls entering Grade 7, employing an adapted Vaccine Hesitancy Scale to assess vaccine hesitancy and logistic regression to identify factors influencing willingness to accept the free domestic vaccines. Results Although only 3.4% of the 2856 respondents had their daughters vaccinated against HPV prior to the survey, 91.7% were willing to utilise the governmental vaccination services. Parents with children in public schools (χ2 = 20.08, p < 0.001), those with more secure medical insurance (χ2 = 4.97, p = 0.026), and parents who had received an HPV vaccine themselves (χ2 = 28.829, p < 0.001) showed more reluctance towards the free vaccines. Vaccine hesitancy was presented in a mere 2.1% but was a significant predictor of vaccine refusal, even after adjusting for multiple factors (adjusted OR = 15.98, 95% CI: 9.06, 28.20). Notably, about four-fifths of parents of unvaccinated daughters harboured concerns about the safety and efficacy of the domestic vaccine. Conclusions Although parents show a strong inclination to utilise the government vaccination services, their vaccine hesitancy, driven by safety concerns and a preference for imported vaccines, remains a significant barrier for rolling out vaccination coverage. This study highlights the need for multifaceted intervention strategies that address these issues to enhance HPV vaccine uptake effectively.

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Stages of HPV Vaccine Hesitancy Among Guardians of Female Secondary School Students in China

Cited by 14 publications

References 40 publications

Between Now and Later: A Mixed Methods Study of HPV Vaccination Delay Among Chinese Caregivers in Urban Chengdu, China

Between Now and Later: A Mixed Methods Study of HPV Vaccination Delay Among Chinese Caregivers in Urban Chengdu, China

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

Willingness and hesitancy towards the governmental free human papillomavirus vaccination among parents of eligible adolescent girls in Shenzhen, Southern China

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