Factors Associated with College Students’ Human Papillomavirus (HPV) Vaccination and Preferred Strategies for Catch-Up Vaccine Promotion: A Mixed-Methods Study

Abstract

Human papillomavirus (HPV) vaccination protects against six types of cancer—cervical, anal, oropharyngeal, penile, vulvar, and vaginal. In the United States (U.S.), HPV vaccination coverage in college students remains low, especially in the Mid-South region, despite the highest risk of HPV infections and disease burden. However, few studies have assessed HPV vaccination among college students here. This study examined factors associated with HPV vaccination among college students in the Mid-South and explored preferred strategies for promoting vaccination. A mixed-methods design comprising a cross-sectional, self-report online survey and dyadic virtual interviews was conducted. Simple random sampling was performed to recruit a total of 417 undergraduate students aged 18–26 from March to May 2021; convenience sampling was performed to recruit three sex-matched dyads of a total of six (four female and two male) undergraduates from survey respondents who had not completed the HPV vaccine series in May 2021. Binary logistic regression analyses showed HPV vaccine knowledge and perceived barriers to vaccination were factors contributing to coverage for both female and male students, while perceived risks of HPV and vaccine hesitancy were factors only among female students. Findings from the qualitative content analysis identified college students’ perceived barriers to the vaccination at multiple levels and preferred strategies for vaccination promotion, corroborating the findings from the survey study. The findings provide implications that benefit the development of tailored interventions aimed at facilitating catch-up vaccination among college students in the Mid-South region. There is an urgent need for further research and the implementation of effective strategies that address the identified barriers and improve HPV vaccine uptake in this population.

Human Papillomavirus Perceptions, Vaccine Uptake, and Sexual Risk Factors in Students Attending a Large Public Midwestern University

“…In a 2022 study of HPV vaccination rates in states, Iowa had the fourth highest uptake among states, with 74.9% of adolescents aged 13–17 years having received the HPV vaccine [ 19 ]. In a 2023 study of 417 Mid-South college students aged 18–26 years, 48.7% of students had been vaccinated for HPV, and 53% of females had received at least one dose of the vaccine [ 13 ]. The increased rate of vaccination of students surveyed in this study may be explained by Iowa having a higher uptake of the vaccine than many other states; however, the surveyed students had a higher vaccination rate than the Iowa average as well.…”

“…To our knowledge, there have been no studies on HPV vaccine uptake and perceptions in large Midwest universities. Similar studies in the US in the South and Mid-Atlantic have found HPV vaccine uptake and HPV knowledge to be low in university students [13,14]. The objective of this study was to determine the uptake and perceptions of the HPV vaccine in students enrolled at the University of Iowa.…”

Predictors of seasonal influenza and COVID-19 vaccination coverage among adults in Tennessee during the COVID-19 pandemic

“…Each of the surveys consisted of items and instruments developed by the research team based on prior research ( 27 , 28 ) and experience and also based on published available items and surveys. In some instances, items were adapted for the study to focus on selected vaccinations and the population being studied.…”

“…This warrants concern as people who are classified as vaccine-hesitant may have different or similar motivations and informational needs across vaccines ( 23 ) which could be overlooked in intervention development, limiting effectiveness. Furthermore, vaccine concerns change over time and should be monitored for changes in vaccination attitudes and behaviors for different vaccines ( 27 ).…”

A transversal cross-sectional study of factors related to HPV vaccination status and cancer screening participation among French women aged 25–40

“…In Italy in 2022, HPV vaccination coverage was clearly inadequate, as was adherence to screening, both far from WHO targets [ 7 ]. Studies have identified perceived barriers to vaccination among the student population[ 8 ] as well as among health care workers and teachers[ 9 ], including mistrust of the vaccine due to its perceived novelty, low knowledge, and misinformation about the vaccine. A Chinese study found in 2015 that educational intervention on HPV increased awareness regarding HPV and women’s intention to vaccinate themselves[ 10 ].…”