1
|
Tan S, Wang S, Zou X, Jia X, Tong C, Yin J, Lian X, Qiao Y. Parental willingness of HPV vaccination in Mainland China: A meta-analysis. Hum Vaccin Immunother 2024; 20:2314381. [PMID: 38385893 PMCID: PMC10885179 DOI: 10.1080/21645515.2024.2314381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
This meta-analysis aimed to systematically review and analyze parental awareness of human papillomavirus (HPV) and its vaccine, as well as parental willingness of the HPV vaccine in China. The literature search selected studies that met the following criteria: study published between 2009 and 2023, study design involving parents with at least one child aged ≤ 18 years, sample sizes exceeding 300, availability of data on parental willingness of the HPV vaccine or sufficient information to calculate effect sizes, and studies published in either English or Chinese. Studies that did not meet one of the above points were excluded. From an initial pool of 660 papers, 33 studies were included, encompassing a total sample size of 92,802. The analysis revealed that the pooled awareness rates of HPV and the HPV vaccine among Chinese parents were 45.0% (95% CI: 36.1-54.0%) and 41.4% (95%CI: 30.7-52.5%), respectively. The overall parental willingness for vaccinating children against HPV was 61.0% (95% CI: 53.5-68.3%). Both parental awareness and willingness of the HPV vaccine in China were found to remain low when compared to other countries.
Collapse
Affiliation(s)
- Sensen Tan
- School of Public Health, Chongqing Medical University, Chongqing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumeng Wang
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xunwen Zou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Xinhua Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chenyunhao Tong
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Yin
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuemei Lian
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
2
|
Zhao C, Zhao Y, Li J, Li M, Shi Y, Wei L. Opportunities and challenges for human papillomavirus vaccination in China. Hum Vaccin Immunother 2024; 20:2329450. [PMID: 38575524 PMCID: PMC10996835 DOI: 10.1080/21645515.2024.2329450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
Current estimates of the HPV infection rate in China vary by geographic region (9.6-23.6%), with two age peaks in prevalence in women ≤20-25 years of age and 50-60 years of age. HPV-16, 52 and 58 are the most commonly-detected HPV genotypes in the Chinese population. In China, five HPV vaccines are licensed and several others are undergoing clinical trials. Multiple RCTs have shown the efficacy and safety of the bvHPV (Cervarix), Escherichia coli-produced bvHPV (Cecolin), Pichia pastoris-produced bvHPV (Walrinvax), qvHPV (Gardasil) and 9vHPV (Gardasil-9) vaccines in Chinese populations, including two studies showing long-term efficacy (≥8 years) for the bvHPV and qvHPV vaccines. Real-world data from China are scarce. Although modeling studies in China show HPV vaccination is cost-effective, uptake and population coverage are relatively low. Various policies have been implemented to raise awareness and increase vaccine coverage, with the long-term aim of eliminating cervical cancer in China.
Collapse
Affiliation(s)
- Chao Zhao
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Yun Zhao
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Jingran Li
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Mingzhu Li
- Gynaecology, Peking University People’s Hospital, Beijing, China
| | - Yujing Shi
- MRL Global Medical Affairs, MSD China, Shanghai, China
| | - Lihui Wei
- Department of Gynecology and Obstetrics, Peking University People’s Hospital
| |
Collapse
|
3
|
Lin Z, Chen S, Su L, Cao H, Chen H, Fang Y, Liang X, Chen J, Luo B, Wu C, Wang Z. Associations of mothers' decisional conflicts and satisfaction with governmental health promotion materials with their daughters' HPV vaccination uptake in China: A cross-sectional survey. Vaccine X 2024; 19:100529. [PMID: 39161948 PMCID: PMC11331965 DOI: 10.1016/j.jvacx.2024.100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/25/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024] Open
Abstract
Background China started to implement the HPV vaccination program for females in 2016. This study investigated associations between mothers' decisional conflicts, satisfaction with governmental health promotion materials, and their daughters' HPV vaccination uptake. Methods A cross-sectional online survey was conducted between July and October 2023 among mothers of girls aged 9-17 years in Shenzhen, China. Participants were mothers having a daughter aged 9-17 years at the survey date and a smartphone with internet access. About 3 % of all primary and secondary schools in Shenzhen were randomly selected by the research team (11 primary schools and 13 secondary schools). Teachers at the selected schools invited mothers of female students aged 9-17 years to complete an anonymous online questionnaire. Multivariate logistic regression was fitted. Results Among 11,728 mothers who completed the survey, 18.9% of their index daughters received at least one dose of HPV vaccination. In multivariate analysis, less decisional conflict about the choice of HPV vaccines for their daughters (AOR: 1.07, 95%CI: 1.05, 1.10), more satisfaction with the government's health promotional materials related to HPV vaccines (AOR: 1.15, 95%CI: 1.12, 1.19), receiving more cue to action from significant others (AOR: 1.23, 95%CI: 1.19, 1.27), and perceived higher self-efficacy related to HPV vaccines (AOR: 1.79, 95%CI: 1.67, 1.92) were associated with a higher uptake of HPV vaccines. Perceived susceptibility to HPV (AOR: 0.79, 95%CI: 0.74, 0.85), perceived barriers to having the index daughter receive HPV vaccines (AOR: 0.82, 95%CI: 0.80, 0.84), and mothers who were hesitant to receive HPV vaccination (AOR: 0.75, 95%CI: 0.68, 0.84) were associated with a lower uptake. Conclusion HPV vaccination uptake was low among girls in China. Future health promotion should address mothers' decisional conflicts about the choice of HPV vaccines for their daughters and improve the health promotional materials. School-based HPV vaccination programs might be useful.
Collapse
Affiliation(s)
- Zian Lin
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
4
|
Bittew SM, Masresha SA, Mulaw GF, Yimam MA, Zimamu AA, Abriham AA, Kidie AA. Parental willingness to vaccinate their daughters against human papilloma virus and its associated factors in Woldia town, Northeast Ethiopia. Front Glob Womens Health 2024; 5:1243280. [PMID: 39049935 PMCID: PMC11266047 DOI: 10.3389/fgwh.2024.1243280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
Background The cells of the cervical epithelial wall are the source of the malignant tumor caused by the human papilloma virus (HPV) known as cervical cancer. In 2018, Ethiopia implemented the HPV vaccine specifically targeting girls aged 9-14 years. This vaccination initiative serves as an effective preventive measure against cervical cancer, provided that parents express a positive inclination to have their daughters vaccinated as part of the program. Objective The aim of the study was to assess parental willingness to vaccinate their daughters against human papillomavirus and its associated factors in Woldia town, Northeast Ethiopia. Methods A community-based cross-sectional study was conducted among 414 parents of daughters aged 9-14 years between 10 and 25 January 2023. Respondents were selected by a systematic sampling method and a face-to-face interview was conducted to collect data. Data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Multivariable analyses were used to examine the association between dependent and independent variables. The adjusted odds ratio (AOR), 95% confidence interval (CI), and p-value <0.05 were used to determine statistical significance. Results A total of 410 study participants with a response rate of 99% were included in the study, and approximately 72.9% (95% CI: 68.3-77.2) of them were willing to vaccinate their daughters. This study found that parents with a family history of cervical cancer screening (AOR = 3.27, 95%; CI = 1.38-7.74), secondary and above educational status (AOR = 2.72, 95% CI = 1.29-5.73), good knowledge of the human papilloma virus vaccination (AOR = 3.00, 95% CI = 1.70-5.28), and favorable attitude toward the human papilloma virus vaccine (AOR = 4.40, 95% CI = 2.45-7.88) were significantly associated with parental willingness to vaccinate their daughters against human papilloma virus. Recommendation In this study, most parents were willing to vaccinate their daughters against human papilloma virus. The significant determinants of parental willingness to their daughter's human papilloma virus vaccination were family history of cervical cancer screening, level of education, and knowledge and attitude toward the human papilloma virus vaccine. Therefore, health information regarding the human papillomavirus vaccination with an emphasis on raising community awareness should be designed.
Collapse
Affiliation(s)
| | | | - Getahun Fentaw Mulaw
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Mohammed Ahmed Yimam
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | | | | | - Atitegeb Abera Kidie
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| |
Collapse
|
5
|
Wang X, Pan J, Yan B, Zhang R, Yang T, Zhou X. Inequities in human papillomavirus vaccination among children aged 9-14 years old under constrained vaccine supply in China. Int J Equity Health 2024; 23:112. [PMID: 38822383 PMCID: PMC11141026 DOI: 10.1186/s12939-024-02199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Inequities in access to human papillomavirus (HPV) vaccine are becoming a growing critical issue globally. Few studies investigate the factors determining HPV vaccine uptake disparities when vaccine supply is constrained, especially in low- and middle-income countries. The aim of this study was to investigate inequities of HPV vaccination and related factors under the constrained vaccine supply in China. METHODS A cross-sectional survey was conducted in a developed eastern coastal province and a developing western one in China between November and December 2022. Employing multistage stratified cluster random sampling, the study collected data from parents of children aged 9-14. Mixed-effects logistic regression models with school units as random effects were used for analysis. RESULTS From 4,127 eligible parents (as vaccine decision makers for girls), 1,346 (32.6%) intended to vaccinate their daughters against HPV, of which 836 (62.1%) attempted to schedule a vaccination appointment. Only 16.4% succeeded in booking an appointment. More than half of the intended parents expected the imported 9-valent HPV vaccine. There were significant disparities in HPV vaccine awareness, intention, and vaccination behavior across educational, income, geographic, ethnic, gender, and health literacy levels. Vaccine awareness and intentions were higher among parents with higher socioeconomic status; however, girls from lower socioeconomic families were more likely to receive the HPV vaccine and had a higher domestically produced vaccination rate. Significant disparities exist in vaccination intentions and actual vaccination behaviors, primarily due to large supply constraints of the HPV vaccine. CONCLUSIONS Sustained health education campaigns are needed to raise awareness of the HPV vaccine, improve health literacy, and decrease over-preference for the 9-valent HPV vaccine. A mother's HPV vaccination behavior was positively associated with increased intention and actual vaccination behavior for her daughter. This study advocates for complementary cervical cancer prevention programs targeting both mothers and daughters.
Collapse
Affiliation(s)
- Xiaomin Wang
- School of Public Health, Hangzhou Normal University, No. 2318 Yuhangtang Road, Yuhang District, Hangzhou, 311121, China
| | - Jiayi Pan
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China
| | - Bo Yan
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China
| | - Ran Zhang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Tianchi Yang
- Institute of Immunization and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No.1166, Fan Jiangan Road, Haishu District, Ningbo City, 315000, Zhejiang Province, China.
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China.
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
| |
Collapse
|
6
|
Zhou W, Guo X, Lu J, Lu X, Fu X, Lu Y. Parental willingness to accept and pay human papillomavirus vaccine for boys aged 9-14 in a metropolis area of China: Evidence for developing a vaccination strategy. Vaccine 2024; 42:2246-2253. [PMID: 38423812 DOI: 10.1016/j.vaccine.2024.02.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/25/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Increasing countries are expanding the human papillomavirus (HPV) vaccination to men, which has not yet been licensed in China. This study investigated the parental willingness to accept (WTA) and pay (WTP) HPV vaccine for their sons aged 9-14. METHODS In Shanghai, a metropolis area of China, parents with boys aged 9-14 were recruited to complete an online questionnaire using a convenience sampling strategy. Parental WTA were determined for parents themselves and for their sons. Parental preference of HPV vaccine was measured using discrete choice experiment in two assumed government subsidy scenarios that referred to HPV vaccination subsidy mechanisms for girls in China. Additionally, parental WTP was estimated using contingent valuation method. RESULTS A total of 2493 parents with boys aged 9-14 were included in the study. Majority of mothers (88.99 % and 90.99 %) and fathers (79.57 % and 85.04 %) showed WTA HPV vaccine for themselves and sons, respectively. Parental gender, age, monthly household income, knowledge, and awareness were positively associated with parental WTA for their sons (each P < 0.05). Remarkably, more mothers showed specific preference of HPV vaccine for themselves (53.67 %) and sons (47.78 %), while more fathers showed no preference for themselves (46.76 %) and sons (53.81 %). In the two assumed government subsidy scenarios, parents mostly preferred domestic HPV vaccines for themselves and sons (each P < 0.05). Additionally, mothers had significantly higher WTP for sons (mean value, 2122.75 CNY) than fathers did (1695.40 CNY) (P < 0.001). However, parental WTP was similar between for themselves and for sons, regardless of mothers and fathers (each P > 0.05). CONCLUSION Parents have high WTA and WTP HPV vaccine for boys aged 9-14 in Shanghai, which may provide evidence for preparing HPV vaccination strategy. Acceptance of HPV vaccines and roll-out in boys could be enhanced through the availability of government subsidy mechanism and domestic HPV vaccines.
Collapse
Affiliation(s)
- Weiyu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Xiang Guo
- Institute of Immunization Planning, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Jia Lu
- Department of Immunization Planning, Minhang District Center for Disease Control and Prevention, Shanghai 201101, China
| | - Xinyue Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Xiaoya Fu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety (Fudan University), School of Public Health, Fudan University, Shanghai 200032, China.
| |
Collapse
|
7
|
Yim VWC, Wang Q, Li Y, Qin C, Tang W, Tang S, Jit M, Smith JS, Larson HJ, Tucker JD, Li J, Lin L, Wu D. Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China. BMC Public Health 2024; 24:183. [PMID: 38225563 PMCID: PMC10790461 DOI: 10.1186/s12889-024-17697-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
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 and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, 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.
Collapse
Affiliation(s)
| | - Qianyun Wang
- Department of Social Welfare, University of California, Los Angeles, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Yifan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuanyun Qin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Weiming Tang
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
| | - Shenglan Tang
- Global Health Research Centre, Duke Kunshan University, Jiangsu, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, GB, UK
| | - Jennifer S Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Joseph D Tucker
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Room 360, Keppel St, London, WC1E 7HT, UK
| | - Jing Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, GB, UK
- Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Dan Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA.
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue, Nanjing Jiangsu, China.
| |
Collapse
|
8
|
Aragaw GM, Anteneh TA, Abiy SA, Bewota MA, Aynalem GL. Parents' willingness to vaccinate their daughters with human papillomavirus vaccine and associated factors in Debretabor town, Northwest Ethiopia: A community-based cross-sectional study. Hum Vaccin Immunother 2023; 19:2176082. [PMID: 36794293 PMCID: PMC10026865 DOI: 10.1080/21645515.2023.2176082] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The Human Papilloma Virus (HPV) is the primary causative agent of cervical cancer. Vaccination against the HPV infection is an effective prevention measure for HPV-related diseases. This study aimed to assess parents' willingness to vaccinate their daughters with Human Papillomavirus vaccine and associated factors in Debre Tabor town. A community-based cross-sectional study was conducted among parents of daughters in Debre Tabor town, and a cluster sampling technique was used to select 738 study participants. A structured and interviewer-administered questionnaire was used to collect the data. Data were entered into EPI data version 4.6 and exported to SPSS version 26 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. In this study, parents' willingness for HPV vaccination was found to be 79.10% (95% CI: 76.00, 82.00). Parents having media exposure, had good knowledge of HPV infection, and HPV vaccine, positive attitude, and positive perceived behavioral control toward the HPV vaccine had statistically significant association with willingness for the HPV vaccination of their daughters. Parents' willingness to HPV vaccination for their daughters was higher compared with a previous study done in the setting. Parental knowledge and their beliefs on HPV vaccination, and media exposure play an important role in the HPV vaccination of adolescents. Strengthening community-based education and effective promotion through multimedia on HPV infection and its prevention, addressing parental safety concerns and promoting their positive beliefs about the vaccine are important to increase parents' willingness.
Collapse
Affiliation(s)
- Getie Mihret Aragaw
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Saron Abeje Abiy
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulunesh Abuhay Bewota
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getie Lake Aynalem
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
9
|
Wassie M, Zegeye AF, Worku W, Sisay T, Eyob T, Gebeyehu DA. Willingness to accept human papilloma virus vaccination and its associated factors among parents with eligible daughters in Addis Zemen town, Northwest Ethiopia. Infect Agent Cancer 2023; 18:84. [PMID: 38129887 PMCID: PMC10740298 DOI: 10.1186/s13027-023-00551-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Cervical cancer is one of the most common cancers in women. Evidences show that, routine immunization of girls at age 14 year and immunization of girls at age 9 year through a 5 years extended interval between doses are the most efficient to control the disease. Despite this, there is very little information on parents' willingness to accept the human papilloma virus vaccine. Therefore, assessing willingness to accept human papilloma virus vaccination and its associated factors among parents with eligible daughter will help to designing, implementing and monitoring effectiveness of HPV vaccine immunization program. METHODS A community-based cross-sectional study was conducted among 386 parents with eligible daughters from 8July-6August, 2022. The multistage sampling technique was used. Data was collected using an interviewer-administered questionnaire. Responses were coded and entered into the computer using EPI data version 4.606 statistical packages, and SPSS version 23 was used for data analysis. Frequencies, percentages and means were as to describe the study variables in relation to the participants. Bivariable and multivariable logistic regression were employed. The statistical significance was set at a p-value of < 0.05 with its respected odds ratio. RESULTS A total of 386 study participants were included in the study. Among participants, 80.3% (95% CI: 76.3, 84) were willing to vaccinate their daughters for HPV vaccination. The parents' willingness was affected by the male parents ([AOR = 3.5; 95% CI (1.673-7.371)], fear of side effects [AOR = 0.385; 95% CI (0.206-0.718)], and with poor awareness on the HPV vaccine [AOR = 0.483; 95% CI (0.259- 0.900)]. CONCLUSION The study has shown that willingness to accept the HPV vaccine is about 80% and significantly affected with parental sex, information on the HPV vaccine, and fear of side effects. As such, it may be helpful for the health care providers and the health care policy makers to emphasize on providing easily understandable information using mass media and social campaign. In addition giving trainings more targeted to female parents might be important.
Collapse
Affiliation(s)
- Mulugeta Wassie
- School of nursing, College of Medicine and health sciences, University of Gondar, Gondar, Ethiopia.
| | | | - Wondesen Worku
- School of nursing, College of Medicine and health sciences, University of Gondar, Gondar, Ethiopia
| | - Tiruye Sisay
- School of nursing, College of Medicine and health sciences, University of Gondar, Gondar, Ethiopia
| | - Tsadik Eyob
- School of nursing, College of Medicine and health sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Ayelegne Gebeyehu
- Department of Psychiatry, school of Medicine, College of Medicine and health sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
10
|
Tilahun S, Wondiye H, Anteneh Yigzaw Z. Mothers' intention to vaccinate their daughters against human papillomavirus in NorthWest Ethiopia, using the theory of planned behavior. Hum Vaccin Immunother 2023; 19:2288390. [PMID: 38111322 PMCID: PMC10760316 DOI: 10.1080/21645515.2023.2288390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/23/2023] [Indexed: 12/20/2023] Open
Abstract
Human papillomavirus (HPV) is the second most common cause of cancer worldwide among females. HPV vaccination is highly protective against HPV infection and can reduce 56% of HPV infections. Therefore, the study aims to assess mothers' intention to vaccinate their daughters aged 9-14 years old against human papillomavirus in Debre Tabor town, Northwest Ethiopia, using the theory of planned behavior. A community-based cross-sectional study design was employed using the theory of planned behavior from November 1 to 30, 2022, in Northwest Ethiopia. A total sample of 449 study participants was enrolled. The study participants were selected using a multi-stage random sampling technique. Data was collected using an interview-administered questionnaire. The data was entered into EPI data version 4.6 and then, exported to SPSS version 23 for analysis. Those variables with a p-value <.05 with 95% CI were considered significant predictors. Mothers' positive intention to vaccinate their daughters aged 9-14 years against HPV was 67.5%. Attitude, perceived behavioral control, and subjective norm were significant predictors with (AOR = 10.09, 95% CI = 6.23-16.32), (AOR = 4.12, 95% CI = 2.71-6.26), and (AOR = 16.397, 95% CI = 9.69-27.748), respectively. Only two-thirds of mothers have a positive intention to vaccinate their daughters against human papillomavirus. Attitude, perceived behavioral control, and subjective norm were predictors. Therefore, it is better to do community mobilization toward the advantage of HPV vaccination.
Collapse
Affiliation(s)
- Samrawit Tilahun
- Communicable and Noncommunicable Disease Prevention and Control Office, Tesfaye Getachew Primary Hospital, South Gondar, Ethiopia
| | - Habtamu Wondiye
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zeamanuel Anteneh Yigzaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
11
|
Xie P, Zhao J, Li X, Zou X, Liu G, Han X. Preference for human papillomavirus vaccine type and vaccination strategy among parents of school-age girls in Guangdong province, China. Prev Med Rep 2023; 36:102463. [PMID: 37854667 PMCID: PMC10580040 DOI: 10.1016/j.pmedr.2023.102463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/20/2023] Open
Abstract
In China, the human papillomavirus (HPV) vaccination coverage among age-eligible girls is rather low, and parent's attitude often plays a determinant role in their girls' HPV vaccination. To accelerate HPV vaccination coverage, several cities and Guangdong province in China offered different HPV vaccine types with different reimbursement methods. In April 2022, we conducted a province-wide survey to investigate parents of children aged 9-15 in Guangdong province, and analyzed factors associated with their preference for HPV vaccine type and vaccination strategy. Of the 4,967 surveyed respondents, 2,610 (58.1%) have not yet vaccinated their children. Among these parents, 67.9% preferred to vaccinate their children with the nine-valent vaccine, while only 8.1% preferred the quadrivalent vaccine and 7.4% preferred the bivalent vaccine. More parents preferred fixed subsidies with free choices of HPV vaccine type over the domestic bivalent vaccine provided by the government (58.1% vs. 39.3%). The multinomial logistic regression showed that parents' relationship with children, educational level, household income, and vaccination status were significantly associated with parents' preference for HPV vaccine type. Parent's relationship with children, workplace, household income, vaccination status, and age of children, were significantly associated with parents' preference for HPV vaccination strategy. Our findings suggest that policymakers may consider adjusting the current vaccination strategy by offering more vaccination choices. More health education on HPV vaccine and vaccination should also be provided to parents of age-eligible girls. Future research should examine which HPV vaccination strategy is more effective in promoting HPV vaccine uptakes in China.
Collapse
Affiliation(s)
- Pei Xie
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Jie Zhao
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Xiaoheng Li
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xinxin Han
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| |
Collapse
|
12
|
Fok CL, Fifita M, Tanjasiri SP. Decision-Making Regarding Elective Child and Adolescent Vaccinations Among Native Hawaiian and Pacific Islander Parents in Orange County. Health Promot Pract 2023:15248399231193707. [PMID: 37772336 DOI: 10.1177/15248399231193707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations-that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over side effects. This study also found two general types of parents-those who treat vaccines the same and those with varying opinions about each vaccine. Results from this study demonstrate the family- and community-oriented nature of NHPI communities, suggesting that future interventions target not only parents but also their families and communities to cultivate vaccine acceptance through social networks. Furthermore, addressing all three vaccines during well-child visits may benefit parents who view each vaccine as separate entities with individual pros and cons. Such interventions could contribute toward reducing the burdens of particularly chronic health disparities.
Collapse
Affiliation(s)
| | - Melenaite Fifita
- University of California, Irvine, CA, USA
- Pacific Islander Health Partnership, Santa Ana, CA, USA
| | | |
Collapse
|
13
|
Yao H, Zhang X. A comprehensive review for machine learning based human papillomavirus detection in forensic identification with multiple medical samples. Front Microbiol 2023; 14:1232295. [PMID: 37529327 PMCID: PMC10387549 DOI: 10.3389/fmicb.2023.1232295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023] Open
Abstract
Human papillomavirus (HPV) is a sexually transmitted virus. Cervical cancer is one of the highest incidences of cancer, almost all patients are accompanied by HPV infection. In addition, the occurrence of a variety of cancers is also associated with HPV infection. HPV vaccination has gained widespread popularity in recent years with the increase in public health awareness. In this context, HPV testing not only needs to be sensitive and specific but also needs to trace the source of HPV infection. Through machine learning and deep learning, information from medical examinations can be used more effectively. In this review, we discuss recent advances in HPV testing in combination with machine learning and deep learning.
Collapse
Affiliation(s)
- Huanchun Yao
- Department of Cancer, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xinglong Zhang
- Department of Hematology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
14
|
Chen L, Sun X, Luo J, Zhang Y, Ha Y, Xu X, Tao L, Mu X, Gao S, Han Y, Wang C, Wang F, Wang J, Yang B, Guo X, Yu Y, Ma X, Liu L, Ma W, Xie P, Wang C, Li G, Lu Q, Cui F. A Case-Control Study on Factors of HPV Vaccination for Mother and Daughter in China. Vaccines (Basel) 2023; 11:vaccines11050976. [PMID: 37243080 DOI: 10.3390/vaccines11050976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/20/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: To explore the influencing factors of human papillomavirus (HPV) vaccination among mothers and daughters so as to provide evidence and strategies for improving the HPV vaccination rate of 9-18-years-old girls. (2) A questionnaire survey was conducted among the mothers of 9-18-year-old girls from June to August 2022. The participants were divided into the mother and daughter vaccinated group (M1D1), the mother-only vaccinated group (M1D0), and the unvaccinated group (M0D0). Univariate tests, the logistic regression model, and the Health Belief Model (HBM) were employed to explore the influencing factors. (3) Results: A total of 3004 valid questionnaires were collected. According to the regions, Totally 102, 204, and 408 mothers and daughters were selected from the M1D1, M1D0, and M0D0 groups, respectively. The mother having given her daughter sex education (OR = 3.64; 95%CI 1.70, 7.80), the mother's high perception of disease severity (OR = 1.79; 95%CI 1.02, 3.17), and the mother's high level of trust in formal information (OR = 2.18; 95%CI 1.26, 3.78) were all protective factors for both the mother and her daughter's vaccination. The mother's rural residence (OR = 0.51; 95%CI 0.28, 0.92) was a risk factor for vaccination of both mother and daughter. The mother's education of high school or above (OR = 2.12; 95%CI 1.06, 4.22), the mother's high level of HPV and HPV vaccine knowledge (OR = 1.72; 95%CI 1.14, 2.58), and the mother's high level of trust in formal information (OR = 1.72; 95%CI 1.15, 2.57) were protective factors of mother-only vaccination. The older the mother (OR = 0.95; 95%CI 0.91, 0.99) was classed as a risk factor for mother-only vaccination. "Waiting until the daughters are older to receive the 9-valent vaccine" is the main reason why the daughters of M1D0 and M0D0 are not vaccinated". (4) Chinese mothers had a high willingness to vaccinate their daughters with the HPV vaccine. The higher education level of the mother, giving sex education to the daughter, the older ages of mothers and daughters, the mother's high level of HPV and HPV vaccine knowledge, a high level of perception of the disease severity, and a high level of trust in formal information were promoting factors of HPV vaccination for mother and daughter, and rural residence was a risk factor to vaccination. To promote HPV vaccination in girls from 9-18 years old, communities could provide health education to rural mothers with low education levels; the government could advocate for HPV vaccination through issuing policy documents; and doctors and the CDC could popularize the optimal age for HPV vaccination to encourage mothers to vaccinate their daughters at the age of 9-14 years old.
Collapse
Affiliation(s)
- Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xihong Sun
- Jining Center for Disease Control and Prevention, Jining 272209, China
| | - Jing Luo
- Suzhou City Center for Disease Control and Prevention, Suzhou 234000, China
| | - Yuanshan Zhang
- Lingcheng Center for Disease Control and Prevention, Dezhou 253500, China
| | - Yu Ha
- Disease Control and Prevention Center of Jiuzhaigou County, Aba 623400, China
| | - Xiaoxia Xu
- Longxi Center for Disease Control and Prevention, Dingxi 748000, China
| | - Liandi Tao
- Chengguan Center for Disease Control and Prevention, Lanzhou 730020, China
| | - Xuefeng Mu
- Yilan Center for Disease Control and Prevention, Harbin 154800, China
| | - Shengnan Gao
- Nangang Center for Disease Control and Prevention, Harbin 150006, China
| | - Yongchao Han
- Qingfeng County Center for Disease Control and Prevention, Puyang 457000, China
| | - Chi Wang
- Nangang Center for Disease Control and Prevention, Harbin 150006, China
| | - Fuliang Wang
- Xiaoshan Center for Disease Control and Prevention, Hangzhou 311201, China
| | - Juan Wang
- Disease Control and Prevention Center of Jiuzhaigou County, Aba 623400, China
| | - Bingying Yang
- Si County Center for Disease Control and Prevention, Suzhou 234300, China
| | - Xiaoyan Guo
- Qingfeng County Center for Disease Control and Prevention, Puyang 457000, China
| | - Yajie Yu
- Yilan Center for Disease Control and Prevention, Harbin 154800, China
| | - Xian Ma
- Chengguan Center for Disease Control and Prevention, Lanzhou 730020, China
| | - Lijian Liu
- Jinxiang Center for Disease Control and Prevention, Jining 272200, China
| | - Wenmin Ma
- Jinxiang Center for Disease Control and Prevention, Jining 272200, China
| | - Pengmin Xie
- Longxi Center for Disease Control and Prevention, Dingxi 748000, China
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
| | - Guoxing Li
- Puyang Center for Disease Control and Prevention, Puyang 457000, China
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
| |
Collapse
|
15
|
Setiawan D, Annisa AN, Lianawati, Hutubessy RCW, Ting Yeung KH. The Cost Analysis of Human Papillomavirus Vaccination Program in Indonesia. Value Health Reg Issues 2023; 35:102-108. [PMID: 36934486 DOI: 10.1016/j.vhri.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/05/2022] [Accepted: 01/20/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVES This study aimed to analyze and describe the cost of HPV vaccination program in Indonesia. METHODS This study identified the cost-related HPV vaccination program implemented in Makassar, Manado, and Surabaya cities, Indonesia, according to the previous activities performed. Cost information was collected and analyzed in each specific activity for each cost components, using the HPV vaccination module of the World Health Organization Cervical Cancer Prevention and Control Costing tool. RESULTS According to the Cervical Cancer Prevention and Control Costing tool, the recurrent costs, both financial and economic costs, dominated the HPV vaccination program costs in Surabaya (US dollars [USD] 264 618; USD 268 724), Makassar (USD 166 852; USD 293 300), and Manado (USD 270 815; USD 270 946), with a total cost of USD 702 285 for financial cost and USD 832 970 for economic cost. Vaccine procurement drives the recurrent cost. CONCLUSIONS The implementation of demonstration program in Surabaya, Makassar, and Manado cities was considerably succeed. Any prediction related to the cost of implementation of HPV vaccination in Indonesia can be calculated and used to advocate regional or national government.
Collapse
Affiliation(s)
- Didik Setiawan
- Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia; Center for Health Economics Studies, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia.
| | - Andi Nurul Annisa
- Center for Health Economics Studies, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia
| | - Lianawati
- Center for Health Economics Studies, Universitas Muhammadiyah Purwokerto, Purwokerto, Central of Java, Indonesia
| | - Raymond C W Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Switzerland
| | - Karene Hoi Ting Yeung
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Switzerland
| |
Collapse
|
16
|
Lin Y, Cai CZ, Hu Z, Zimet GD, Alias H, Wong LP. The influence of men on HPV vaccination of their spouse/partner in China. Hum Vaccin Immunother 2022; 18:2049132. [PMID: 35380926 PMCID: PMC9196783 DOI: 10.1080/21645515.2022.2049132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Men involvement in HPV vaccine advocacy is important in a patriarchal society. This study aimed to investigate the influence of men on HPV vaccination of adult women. An online cross-sectional survey was undertaken between June and August 2019. Participants were fathers of children enrolled in schools in Fujian Province. A total of 1953 participants responded to our survey. Just over 60% reported they would definitely or likely support their spouse/partner to receive HPV vaccine. Physician recommendation (adjusted odds ratio [aOR] = 5.68, 95%CI = 3.89–6.86) and spouse/partner communication about HPV vaccination (aOR = 5.30, 95%CI = 3.72–7.55) were significant covariates associated with higher willingness to support women’s HPV vaccination. Perceiving HPV vaccination as only for women who have had multiple sex partners and HPV vaccination as a sensitive topic were significantly associated with lower willingness to support HPV vaccination. Over two-thirds (67.3%) reported joint HPV vaccination decision-making and 2.8% reported that it was entirely the man’s decision. The role of men in HPV vaccine acceptance and hesitancy among adult women is evident in China and warrants educational interventions to target men to enhance women’s HPV vaccination uptake.
Collapse
Affiliation(s)
- Yulan Lin
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Carla Zi Cai
- Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Gregory D Zimet
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN USA
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Li Ping Wong
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.,Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
17
|
Guo Q, Zhou W, Wen X, Lu J, Lu X, Lu Y. Discrepancy of human papillomavirus vaccine uptake and intent between girls 9-14 and their mothers in a pilot region of Shanghai, China. Hum Vaccin Immunother 2022; 18:2132801. [PMID: 36306482 PMCID: PMC9746362 DOI: 10.1080/21645515.2022.2132801] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Human papillomavirus (HPV) vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls aged 9-14 years. We conducted a cross-sectional online survey in Minhang district of Shanghai, a pilot region for the program, to investigate HPV vaccination status among mothers and their daughters 9-14. A total of 1031 parents and 1122 daughters 9-14 were included. Of them, 18.6% of mothers and 4.5% of daughters had been vaccinated with HPV vaccines or made an appointment; additionally, 62.7% and 78.4% intended to receive vaccination but did not make an appointment. Notably, 6.2% of parents did not intend to receive vaccination for themselves (or their wives) but intended to vaccinate their daughters. Moreover, we calculated parental knowledge and awareness scores toward HPV infection and vaccination. Both scores were significantly higher among the parents who had received HPV vaccination than those who intended to across mothers' vaccination status (P < .001 for knowledge and P = .019 for awareness), whereas similar between the two groups across daughters' vaccination status (P = .694 and P = .737). Parents believed mothers had a significantly higher susceptibility to HPV infection and lower health consequences, compared to daughters 9-12 (P = .002 and P < .001) or those 13-14 (both P < .001). In conclusion, HPV vaccine uptake remains a discrepancy between mothers and their daughters 9-14. However, their intents to receive HPV vaccination were both high. Parental knowledge and awareness may improve vaccination intent for daughters 9-14 in China. It warrants a certain health education toward susceptibility to HPV infection and health consequences.
Collapse
Affiliation(s)
- Qi Guo
- Department of Adolescent and School Health, Minhang District Center for Disease Control and Prevention, Shanghai, China
| | - Weiyu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Xiaosa Wen
- Department of Adolescent and School Health, Minhang District Center for Disease Control and Prevention, Shanghai, China
| | - Jia Lu
- Department of Immunization Planning, Minhang District Center for Disease Control and Prevention, Shanghai, China
| | - Xinyu Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China,CONTACT Yihan Lu Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Fosun Tower, 131 Dong An Road, Shanghai200032, China
| |
Collapse
|
18
|
Lu X, Ji M, Wagner AL, Huang W, Shao X, Zhou W, Lu Y. Willingness to pay for HPV vaccine among female health care workers in a Chinese nationwide survey. BMC Health Serv Res 2022; 22:1324. [PMID: 36335333 PMCID: PMC9637298 DOI: 10.1186/s12913-022-08716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
Background Payment methods for human papillomavirus (HPV) vaccine could substantially influence vaccination behavior. In China, HPV vaccination uptake remains currently low. This study aims to determine willingness to pay (WTP) for HPV vaccines among Chinese female health care workers under different payment scenarios. Methods This is a nationwide online survey recruiting female health care workers aged 18–45 years from 31 provinces throughout China. We collected the respondents’ vaccination status of HPV vaccines and their sociodemographics. Two WTPs were defined and estimated in the study. A general WTP for HPV vaccination was determined using the contingent valuation method with double dichotomous choice bidding. A WTP out-of-pocket was estimated for each HPV vaccine under two scenarios, including partial coverage by governmental subsidy or partial incorporation in basic medical insurance. Accordingly, a multivariable linear regression model was employed to determine the association between sociodemographis and general WTP. Then the maximum WTP out-of-pocket was compared among the respondents’ attitude shift towards HPV vaccination, payment scenarios, and levels of vaccine attributes, using non-parametric Kruskal-Wallis test. Results A total of 15,969 respondents were included in the study. The median general WTP was 2000 CNY (interquartile range, 1000–3200 CNY), positively associated with younger age, unmarried status, higher monthly income, fewer children, more positive vaccination behavior, working in tertiary hospital, higher local GDP and HDI (each P < 0.05). Moreover, the median WTP out-of-pocket was 1250 CNY (540–2000 CNY). It was significantly higher for vaccines partly covered by governmental subsidy (median, 1250 CNY; interquartile range, 560–2000 CNY), imported vaccines (1260 CNY; 630–1960 CNY), and 9-valent vaccines (1400 CNY; 750–2240 CNY) (each P < 0.001). Additionally, majority of respondents did not change their attitude towards HPV vaccination between two payment scenarios; those remaining with more expensive HPV vaccines (51.1%) had higher WTP out-of-pocket (1400 CNY; 560–2250 CNY) than those with cheaper vaccines (39.0%) (1120 CNY; 490–1960 CNY) (P < 0.001). Conclusion Chinese female health care workers have high WTP for HPV vaccines. A direct public funding for HPV vaccination is more preferable. Our findings may facilitate the adjustment of HPV vaccination strategy and payment mechanism in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08716-6.
Collapse
|
19
|
Abuduxike G, Asut O, Cali S, Vaizoglu S. Knowledge and Awareness of Parents Towards Human Papillomavirus (HPV) and HPV Vaccines, and Vaccine Acceptability in Northern Cyprus. JOURNAL OF PREVENTION (2022) 2022; 43:225-240. [PMID: 35286543 DOI: 10.1007/s10935-021-00657-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
The human papillomavirus (HPV) vaccine is one of the most cost-effective public health measures for preventing cervical cancer and other HPV-related diseases. However, the vaccine uptake in many countries remains suboptimal. This cross-sectional study aimed to assess the knowledge and awareness of parents towards HPV, related diseases, and HPV vaccines, as well as to examine the effect of brief educational information on parents' vaccine acceptability. We used a structured interviewer-administered questionnaire to collect information from 227 outpatient visitors to a healthcare center who had children under the age of 19 years. We asked parents again about their acceptance of HPV vaccines after being provided brief educational information. Of all the parents, 43% were aware of HPV and related diseases, and 59% of those had sufficient knowledge regarding HPV while 45% of them reported that they were aware of HPV vaccines. Being Northern Cypriot was a predictor of having good knowledge, whilst being a female, having a higher education level, being 35 years or older, and being employed were the significant predictors of having greater awareness of HPV and related diseases. The HPV vaccine acceptance of the parents increased substantially in all sociodemographic groups after the provision of the educational information. The findings demonstrated that the vaccination rates of children of parents who have insufficient knowledge and awareness of HPV and vaccines are also very low. Effective educational interventions based on the specific sociodemographic characteristics of the patients should be given a stronger focus to improve vaccine acceptability among this population.
Collapse
Affiliation(s)
- Gulifeiya Abuduxike
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus.
| | - Ozen Asut
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| | - Sanda Cali
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| | - Songul Vaizoglu
- Department of Public Health, Faculty of Medicine, Near East University, Yakin Dogu Bulvari, 99138, Nicosia, Northern Cyprus
| |
Collapse
|
20
|
Wan X, Huang H, Shang J, Xie Z, Jia R, Lu G, Chen C. Willingness and influential factors of parents of 3-6-year-old children to vaccinate their children with the COVID-19 vaccine in China. Hum Vaccin Immunother 2021; 17:3969-3974. [PMID: 34344258 DOI: 10.1080/21645515.2021.1955606] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The impact of Coronavirus disease 2019 (COVID-19) on children aged 3-6 can be severe. Vaccination for COVID-19 is one of the most important primary preventative measures to reduce disease transmission. Parents are hesitant to vaccinate their children against COVID-19 because it was reported in the news that some adults have had adverse reactions to the vaccine. This study aims to investigate the willingness of Chinese parents of 3-6 year old children to vaccinate them with the COVID-19 vaccine and identify what factors influence their decisions. A survey was conducted using a two-stage stratified random sampling method from December 2020 to February 2021. We used univariate analysis and multivariate binary logistic analysis to explore potential factors that may determine the acceptance of the COVID-19 vaccine. Of the 468 parents who participated, 86.75% were willing to vaccinate their children with the COVID-19 vaccine. Parents who were female (OR = 2.591; 95% CI: 0.432-4.689), recognized their children in the high-risk category (OR = 2.494; 95% CI:1.244-5.002), often followed-up with COVID-19 vaccine-related information (OR = 9.065; 95% CI: 3.220-28.654), believed in the safety of the COVID-19 vaccine (OR = 3.068; 95% CI: 1.313-7.168), or thought the COVID-19 vaccine could prevent COVID-19 (OR = 13.750; 95% CI: 2.516-75.140) were more willing to vaccinate their children. To ease parents' hesitation about vaccines, the authority organization should release updated information on the safety and reliability of vaccines, target gender-specific health education for parents, and ask the media to report scientifically support information.
Collapse
Affiliation(s)
- Xiao Wan
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Haitao Huang
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Jia Shang
- Arts Department, School of Kaifeng Culture and Tourism, Kaifeng, China
| | - Zhenxing Xie
- School of Basic Medicine, Henan University, Kaifeng, China
| | - Ruiying Jia
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Guangli Lu
- Institute of Business Administration, School of Business, Henan University, Kaifeng, China
| | - Chaoran Chen
- Institute of Nursing and Health, Henan University, Kaifeng, China
| |
Collapse
|