Vaccination against the human papillomavirus (HPV) is an effective primary prevention measure for HPV-related diseases. For children and young adolescents, the uptake of the vaccine is contingent on parental consent. This study sought to identify key differences between parents who obtain (acceptors) and parents who refuse (non-acceptors) the HPV vaccine for their daughters. In the context of a free, universal, school-based HPV vaccination program in Qu ebec, 774 parents of 9-10 year-old girls completed and returned a questionnaire by mail. The questionnaire was based on the theoretical constructs of the Health Belief Model (HBM), along with constructs from other theoretical frameworks. Of the 774 parents, 88.2% reported their daughter having received the HPV vaccine. Perceived susceptibility of daughters to HPV infection, perceived benefits of the vaccine, perceived barriers (including safety of the vaccine), and cues to action significantly distinguished between parents whose daughters had received the HPV vaccine and those whose daughters had not. Other significant factors associated with daughter vaccine uptake were parents' general vaccination attitudes, anticipated regret, adherence to other routinely recommended vaccines, social norms, and positive media influence. The results of this study identify a number of important correlates related to parents' decisions to accept or refuse the HPV vaccine uptake for their daughters. Future work may benefit from targeting such factors and incorporating other health behavior theories in the design of effective HPV vaccine uptake interventions.

The success of large-scale COVID-19 vaccination campaigns is contingent upon people being willing to receive the vaccine. Our study explored COVID-19 vaccine hesitancy and its correlates in eight different countries around the globe. We analyzed convenience sample data collected between March 2020 and January 2021 as part of the iCARE cross-sectional study. Univariate and multivariate statistical analyses were conducted to explore the correlates of vaccine hesitancy. We included 32,028 participants from eight countries, and observed that 27% of the participants exhibited vaccine hesitancy, with increases over time. France reported the highest level of hesitancy (47.3%) and Brazil reported the lowest (9.6%). Women, younger individuals (≤29 years), people living in rural areas, and those with a lower perceived income were more likely to be hesitant. People who previously received an influenza vaccine were 70% less likely to report COVID-19 vaccine hesitancy. We observed that people reporting greater COVID-19 health concerns were less likely to be hesitant, whereas people with higher personal financial concerns were more likely to be hesitant. Our findings indicate that there is substantial vaccine hesitancy in several countries, with cross-national differences in the magnitude and direction of the trend. Vaccination communication initiatives should target hesitant individuals (women, younger adults, people with lower incomes and those living in rural areas), and should highlight the immediate health, social and economic benefits of vaccination across these settings. Country-level analyses are warranted to understand the complex psychological, socio-environmental, and cultural factors associated with vaccine hesitancy.

ObjectiveTo examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021.DesignFive sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys.SettingCanada.ParticipantsA total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18–95 years) and predominantly white (80.8%).Primary and secondary outcome measuresRates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates.ResultsA total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy.ConclusionsResults highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors.