A national cross-sectional study on the influencing factors of low HPV vaccination coverage in mainland China

Abstract

BackgroundHPV vaccine can block the infection of high-risk human papillomavirus and is an important measure to effectively reduce the incidence of cervical cancer and precancerous lesions. However, the HPV vaccination rate is still low in China. There are many factors. Therefore, it is important to study the influencing factors to provide basis for promoting the formulation of vaccination strategies.MethodsThis study used a multi-stage sampling method to conduct a face-to-face questionnaire survey on women in different regions of China. The new general self-efficacy scale was used to measure the self-efficacy of the respondents. The short form of family health scale measured their family health. The t-test and binary Logistic regression analysis were used to screen the influencing factors of HPV vaccination. Restricted cubic spline model was used to analyze the influence trend of self-efficacy and family health on HPV vaccination rate.Results(1) The HPV vaccination rate was low, especially in the ≤18 group. The place of residence, capita household income/month, individual self-efficacy and family health had a significant impact on HPV vaccination. (2) The restricted cubic spline model showed that self-efficacy positively promoted HPV vaccination, the correlation strength was statistically significant (χ2 =27.64, P<0.001) and non-linear (χ2 = 12.49, P = 0.0004); The poor family health hindered HPV vaccination, and the association strength was statistically significant (χ2 = 47.81, P < 0.001) and non-linear (χ2 = 9.96, P = 0.0016).ConclusionIt is necessary to strengthen the health education of HPV vaccination knowledge in the population to eliminate the hesitancy of vaccination. Free HPV vaccination strategies should be developed and encourage people of appropriate age to receive as early as possible. Self-efficacy and family health should be enhanced to increase HPV vaccination rate, so as to achieve the goal of reducing the incidence of cervical cancer and protecting women's health.

Knowledge and Practices Regarding Human Papillomavirus and Cervical Cancer Screening Among Women in Low-Income Areas of China: A Cross-Sectional Study

“…In our study, although women who were not screened regularly exhibited lower socioeconomic status and awareness of HPV compared to those who underwent regular screenings, they still demonstrated a comparable willingness to accept HPV vaccination. This may be attributed to the high costs associated with HPV vaccination, difficulties in scheduling appointments, and a lack of supportive policies, which hindered their uptake [ 30 ]. The Lueyang County government recently devised a plan to implement a flat-rate subsidy for the cost of preventive HPV vaccination for girls aged 9-14 years within the county.…”

Knowledge and Practices Regarding Human Papillomavirus and Cervical Cancer Screening Among Women in low-income areas of China: A Cross-Sectional Study

“…However, in China, only a few cities with a high socioeconomic status have implemented free HPV vaccination programs 30 .Residents of other areas who wish to receive vaccination must bear the costs. Furthermore, owing to high expenses, challenges in making appointments, and a lack of policy support, the overall HPV vaccination coverage rate in China is generally low 31 .The Lueyang County government recently devised a plan to implement a at-rate subsidy for the cost of preventive HPV vaccination for girls aged 9-14 years within the county. This initiative aims to encourage HPV vaccination among girls of appropriate age and increase the local vaccination rate.…”

Cervical cancer prevention in China: where are we now, and what’s next?

“…A survey of approximately 13,000 parents of unvaccinated adolescents has found that worries regarding safety or adverse effects are the most common reasons for hesitant to vaccinate, and a lack of provider recommendation is the most common reason for unsure to vaccinate 13 . In China, beyond economic factors, undesirable self-efficacy and family health hinder HPV vaccination 14 . A lack of information, spread of misinformation, and cultural barriers can negatively affect related public service rollouts.…”