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Chen C, Chen T, Huang M, Huang Y, Zhang L, Li P. Factors associated with HPV vaccine hesitancy among college students: A cross-sectional survey based on 3Cs and structural equation model in China. Hum Vaccin Immunother 2024; 20:2309731. [PMID: 38314749 PMCID: PMC10854271 DOI: 10.1080/21645515.2024.2309731] [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: 09/19/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
Despite the high effectiveness of HPV vaccines in preventing infection, vaccine hesitancy remains a concern, particularly in China. This study aimed to explore college students' attitudes toward HPV vaccination and identify associated factors. Data was collected through a cross-sectional survey using self-administered questionnaires in four cities from May to June 2022. Chi-square tests and logistic regression analyses were conducted to identify factors. Additionally, an integrated structural equation model (SEM) based on the 3Cs (confidence, convenience, complacency) was developed to understand underlying factors contributing to hesitancy. The results from 2261 valid questionnaires were enlightening. A significant 89.47% (59.4% for females) considered HPV vaccination necessary, with 9.82% remaining neutral and only 0.71% deeming it unnecessary. Factors like higher education, being a medical student, residing in urban areas, having medical insurance, more extraordinary living expenses, a family history of tumors, and a solid understanding of HPV played a role in perceiving the vaccine as necessary. Among the 1438 female respondents, 84.36% had no hesitancy toward HPV vaccination, 13.53% expressed hesitancy, and 2.11% refused vaccination. Factors like age, understanding of HPV, medical staff recommendations, living expenses, and family history influenced hesitancy levels. SEM revealed that the 3Cs significantly affected vaccine hesitancy. Factors like price, booking process, vaccination times, trust in vaccines, medical staff recommendations, efficiency, and risk perception collectively influenced hesitancy. In conclusion, this study found high acceptance of HPV vaccination but acknowledged the complexity of hesitancy factors. It recommends medical staff disseminate scientific knowledge, offer recommendations, simplify booking procedures, and expand vaccination sites to address vaccine hesitancy effectively.
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Affiliation(s)
- Cheng Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Mingzhao Huang
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Occupational Disease Hazard Identification and Control, Wuhan, China
| | - Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Pindong Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Precision Radiation, Wuhan, China
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Li X, Zhang F, Li M, Lin C, Shi K, Yang F. Effect of vaccine hesitancy on female college students' willingness to receive the HPV vaccine in China: a multicenter cross-sectional study. BMC Public Health 2024; 24:1930. [PMID: 39026282 PMCID: PMC11256702 DOI: 10.1186/s12889-024-19303-1] [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: 12/24/2023] [Accepted: 06/28/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE To analyse the influencing factors of vaccine hesitancy on HPV vaccination willingness of female college students in order to promote the promotion of HPV vaccine in female college student population. METHODS From September-October 2022, a convenience sampling method was used to conduct a questionnaire survey among freshman female students from four higher vocational colleges in Henan Province, China. The survey comprised a general information questionnaire, as well as inquiries regarding vaccine hesitancy and willingness to receive the human papillomavirus (HPV) vaccine. In PSM analyses, vaccine-hesitant students were matched with non-vaccine-hesitant students at a 1:1 ratio; subsequently, both univariate and multivariatble logistic regression analyses were applied to assess the impact of vaccine hesitancy on female university students' willingness to receive the HPV vaccine. RESULTS The results revealed a vaccine hesitancy rate of 44.75% among female university students, with 82.9% expressing willingness to receive the HPV vaccine. The results of the multivariable ordinal logistic regression analysis indicated vaccine hesitancy is a risk factor for HPV vaccination intentions among female university students [OR = 4.38, 95% CI (2.74, 6.99), P < 0.001]. Furthermore, the field of study (P = 0.01) and independently seeking information about the HPV vaccine (P = 0.04) were identified as factors influencing female university students' willingness to receive the HPV vaccine. CONCLUSIONS Non-vaccine-hesitant students were more likely to be willing to receive the HPV vaccine than vaccine-hesitant students. Healthcare providers and educators should focus on vaccine attitudes among female college students to reduce vaccine hesitancy and enhance community education on cervical cancer, HPV infection and prevention through multichannel campaigns.
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Affiliation(s)
- Xiaoxue Li
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan province, 450052, China
| | - Fengzhi Zhang
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan province, 450052, China.
| | - Manman Li
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan province, 450052, China
| | - Chunhui Lin
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan province, 450052, China
| | - Kaige Shi
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan province, 450052, China
| | - Fangfang Yang
- Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, 7 Front Kangfu Street, Zhengzhou, Henan province, 450052, China
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Chen X, Wang L, Huang Y, Zhang L. Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: a cross-sectional study. BMC Public Health 2024; 24:667. [PMID: 38429644 PMCID: PMC10908003 DOI: 10.1186/s12889-024-18166-w] [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: 08/05/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Cervical cancer poses a heavy health burden in China, with the second highest incidence and mortality rate among female tumors, yet human papillomavirus (HPV) vaccination rate among female university students remain remains low. This study conducted a cross-sectional survey to assess the degree of HPV vaccine hesitancy among female university students and to explore the potential association between knowledge, risk perception, trust, and HPV vaccine hesitancy. METHODS A total of 1,438 female university students from four Chinese cities were recruited through stratified, multistage, cluster sampling method. The mediation model was constructed using the Bootstrap method, introducing trust and risk perception as mediating variables to examine the effect of knowledge on HPV vaccine hesitancy. RESULTS The study found that 8.9% (95%CI:7.4%∼10.4%) of the female university students exhibited HPV vaccine hesitancy. Pearson's correlation analysis revealed a negative association between vaccine hesitancy and knowledge, risk perception, and trust. The mediation model showed that knowledge had significant indirect effects on HPV vaccine hesitancy through trust (indirect effect: -0.224, 95% CI: -0.293 ∼ -0.167) and risk perception (indirect effect: -0.013, 95% CI: -0.033 ∼ -0.002). CONCLUSION HPV vaccine hesitancy among female university students has mitigated, but still needs to be addressed. In addition, trust and risk perception are mediators mediating the relationship between knowledge with HPV vaccine hesitancy. Therefore, there is a need to strengthen public health education to improve knowledge, with a particular focus on providing information about trust and risk perception to reduce HPV vaccine hesitancy.
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Affiliation(s)
- Xing Chen
- School of Public Health, Fudan University, Shanghai, PR China
| | - Lei Wang
- School of Public Administration and Emergency Management, Institute of Public Policy, Jinan University, Guangzhou, PR China
| | - Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, PR China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai, PR China.
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Wang H, Xu Y, Zhang H, Chen N. Determinants of HPV vaccine uptake intentions in Chinese clinical interns: an extended theory of planned behavior approach. Front Public Health 2024; 12:1345530. [PMID: 38435300 PMCID: PMC10904661 DOI: 10.3389/fpubh.2024.1345530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Background This study aims to utilize the extended Theory of Planned Behavior (TPB) model to examine the intentions of clinical interns in China towards Human papillomaviruses (HPV) vaccination. It also fills a significant gap in the literature concerning vaccine acceptance in this specific population. Methods This cross-sectional study was carried out with clinical interns in Shandong Province, China, with a total of 1,619 participants. Data were collected through self-reported questionnaires, including demographic characteristics, TPB variables, and HPV-related health knowledge. Hierarchical regression analysis was employed to identify key factors influencing vaccination intentions, and Structural Equation Modeling (SEM) was used to analyze the interrelationships between these factors. Results This study initially identified key predictors affecting clinical interns' intentions to receive the HPV vaccine through hierarchical regression analysis. The preliminary model, which accounted for demographic factors, revealed foundational impacts of household income and HPV-related clinical experience on intentions. After integrating TPB variables-attitude, subjective norm, perceived behavioral control, and HPV-related health knowledge-the model's explanatory power was enhanced to 37.30%. SEM analysis focused on the interplay among TPB constructs and extended variables, confirming their significance in forming vaccination intentions, with subjective norm having the most substantial impact (β = 0.375, p < 0.001). The extended TPB model explained over half of the variance in vaccination intentions, substantiating the hypotheses and revealing the psychological determinants behind clinical interns' decision-making for HPV vaccination. Conclusion The extended TPB model from this study effectively explains the vaccination intentions among clinical interns for HPV, offering theoretical support for public health strategies and educational interventions targeting this group. These findings are of significant importance for public health practice and future health promotion strategies.
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Affiliation(s)
- Huizi Wang
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial QianFoshan Hospital, Jinan, China
| | - Yuedong Xu
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial QianFoshan Hospital, Jinan, China
| | - Hui Zhang
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial QianFoshan Hospital, Jinan, China
| | - Ning Chen
- Center of Digestive Endoscopy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Aldawood E, Dabbagh D, Alharbi S, Alzamil L, Faqih L, Alshurafa HH, Dabbagh R. HPV Vaccine Knowledge and Hesitancy Among Health Colleges' Students at a Saudi University. J Multidiscip Healthc 2023; 16:3465-3476. [PMID: 38024130 PMCID: PMC10656864 DOI: 10.2147/jmdh.s438633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Human papillomavirus (HPV) infection is a widespread sexually transmitted infection linked to various types of cancer. Although vaccination against HPV is available, global HPV vaccination rates remain low. Aim This study aimed to evaluate the awareness and knowledge of the HPV vaccine and to identify predictors associated with vaccine hesitancy among health college students at King Saud University, Saudi Arabia. Methods A cross-sectional survey was distributed during December 2022 to students enrolled in health colleges. The survey link was randomly distributed via social media platforms and in-person interactions. The number of participants was 405 including both males and females. The data was analyzed using the Statistical Package for Social Sciences (SPSS). The correct response rate for all knowledge items was calculated, and they were stratified by gender and college. The association of vaccine hesitancy with sociodemographic characteristics was examined using logistic regression analysis. Results The study found that approximately half of the students (49.9%) were aware of the HPV vaccine. However, only a small percentage of students answered all to all HPV knowledge items correctly. Additionally, only a small proportion (5.2%) reported receiving the vaccine. The overall HPV vaccine hesitancy was 59.1% (43.9% for female and 75.9% for male). The most common reasons for vaccine hesitancy was not knowing enough about it. Males were two times more likely than females to believe that they did not need the HPV vaccine. The odds for HPV vaccine hesitancy were greater among males and younger age groups compared to females and older age groups. Conclusion This study underscores the importance of implementing university-wide interventions and educational campaigns to enhance awareness and knowledge of the HPV vaccine.
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Affiliation(s)
- Esraa Aldawood
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Deemah Dabbagh
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sarah Alharbi
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Lama Alzamil
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Layla Faqih
- Department of Clinical Laboratory Science, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Chen C, Yang Q, Tian H, Wu J, Chen L, Ji Z, Zheng D, Chen Y, Li Z, Lu H. Bibliometric and visual analysis of vaccination hesitancy research from 2013 to 2022. Hum Vaccin Immunother 2023; 19:2226584. [PMID: 37387233 PMCID: PMC10332187 DOI: 10.1080/21645515.2023.2226584] [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: 04/01/2023] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Abstract
Although vaccination is regarded as one of the most significant achievements of public health, there also exists the phenomenon of vaccination hesitancy which refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. In this study, we conducted a bibliometric analysis to provide a comprehensive overview of vaccination hesitancy research from 2013 to 2022. All related publications were retrieved from the Web of Science Core Collection Database. Information on annual publications, countries, organizations, journals, authors, keywords, and documents was analyzed adopting the bibliometix R-package, VOSviewer, and CiteSpace software. A total of 4042 publications were enrolled. The annual publications increased slightly before 2020 but had an extremely dramatic increase from 2020 to 2022. The United States contributed the most articles and had the greatest collaboration with other countries and organizations. The London School of Hygiene & Tropical Medicine was the most active institution. Vaccine was the most cited and influential journal while Vaccines was the most productive journal. It was Dube E who was the most productive authors with the highest h-index. The most frequent keywords were "vaccine hesitancy," "COVID-19," "SARS-CoV2," "immunization," "attitudes," and "willingness." Vaccination hesitancy to some extent hinders the achievement of global public health. The influencing factors vary across time, space, and vaccines. The COVID-19 pandemic and the development of COVID-19 vaccines have made this issue the focus of interest. The complexity and specific contexts of influencing factors of vaccination hesitancy require further study and will potentially be the focus of future research direction.
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Affiliation(s)
- Chaojian Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Qiuping Yang
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Huiting Tian
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Jinyao Wu
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Lingzhi Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zeqi Ji
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Daitian Zheng
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yexi Chen
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhiyang Li
- Department of General Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Hai Lu
- Department of Breast, The First People’s Hospital of Shao Guan, Shaoguan, Guangdong, China
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Kurt O, Küçükkelepçe O, Öz E, Doğan Tiryaki H, Parlak ME. Childhood Vaccine Attitude and Refusal among Turkish Parents. Vaccines (Basel) 2023; 11:1285. [PMID: 37631853 PMCID: PMC10457800 DOI: 10.3390/vaccines11081285] [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: 06/09/2023] [Revised: 07/03/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
We aimed to understand and resolve anti-vaccine attitudes by examining the factors associated with vaccine attitudes and exploring potential strategies to improve childhood vaccination rates. Between 2014 and 2021, a total of 628 families refused vaccination in Adiyaman. A total of 300 families accepted visits and were visited. During the visits, the families were administered a questionnaire to determine the reasons for vaccine rejection and their opinions on the matter. While providing general information about the vaccine, parents were encouraged to reconsider their decision, and at the end, parents completed the questionnaire. The questionnaire included sociodemographic questions, reasons for vaccine refusal, and a vaccine attitude scale. Among the participants in the study, 9.3% were convinced about the vaccine. The mean vaccine attitude scale score was calculated as 23.6 ± 2.5 (min = 15-max = 29). Significantly higher rates of persuasion were observed among fathers (17.3%) compared to mothers (7.7%) (p = 0.038). Participants who had received some vaccinations had a higher rate of persuasion (11.6%) compared to those who had not received any vaccinations (2.6%) (p = 0.02). Childhood vaccine refusal is a complex issue that has been the subject of numerous studies. Studies on this subject will increase awareness of vaccines.
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Affiliation(s)
- Osman Kurt
- Adiyaman Provincial Health Directorate, 02100 Adıyaman, Turkey; (O.K.); (E.Ö.)
| | - Osman Küçükkelepçe
- Adiyaman Provincial Health Directorate, 02100 Adıyaman, Turkey; (O.K.); (E.Ö.)
| | - Erdoğan Öz
- Adiyaman Provincial Health Directorate, 02100 Adıyaman, Turkey; (O.K.); (E.Ö.)
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Tostrud L, Thelen J, Palatnik A. Models of determinants of COVID-19 vaccine hesitancy in non-pregnant and pregnant population: Review of current literature". Hum Vaccin Immunother 2022; 18:2138047. [PMID: 36345571 DOI: 10.1080/21645515.2022.2138047] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Vaccination has proven to be the most effective tool in controlling the COVID-19 pandemic. While pregnant individuals are considered to be a high-risk population and are more likely to experience adverse effects from COVID-19, vaccination rates among pregnant individuals are significantly lower than in the general population. The Health Belief Model (HBM), Theory of Planned Behavior (TPB), 3C model, 5C model, and 5A model have been used to assess vaccination hesitancy behaviors. In this paper, we review the use of each of these models to address vaccine hesitancy, with a focus on the pregnant population and the COVID-19 vaccine. The HBM, TPB, 3C model, and 5C model have demonstrated great versatility in their ability to evaluate, explain, and modify vaccine hesitancy and behavior. Up to date, the HBM and 3C models appear to be the most effective models to study and address vaccination hesitancy within the pregnant persons.
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Affiliation(s)
- Lauren Tostrud
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Julia Thelen
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Ferreira GRON, Formigosa JADS, Lira ALBDC, Reis RK, Gir E, Freitas WLS, Carvalho JN, Gonçalves LHT, Botelho EP, Ramos AMPC. The Family Health Strategy Influence on the Human Papillomavirus Vaccine Acceptance in a Peripheral Community of the Brazilian Amazon Region. Health Equity 2022; 6:852-861. [DOI: 10.1089/heq.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Renata Karina Reis
- Graduate Program in Fundamental Nursing, Ribeirão Preto, Sao Paulo, Brazil
| | - Elucir Gir
- Graduate Program in Fundamental Nursing, Ribeirão Preto, Sao Paulo, Brazil
| | | | - Jacira Nunes Carvalho
- Graduate Nursing Program at the Federal University of Pará (UFPA), Belém, Pará, Brazil
| | | | - Eliã Pinheiro Botelho
- Graduate Nursing Program at the Federal University of Pará (UFPA), Belém, Pará, Brazil
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Huang Y, Chen C, Wang L, Wu H, Chen T, Zhang L. HPV Vaccine Hesitancy and Influencing Factors among University Students in China: A Cross-Sectional Survey Based on the 3Cs Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14025. [PMID: 36360905 PMCID: PMC9657119 DOI: 10.3390/ijerph192114025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The burden of disease caused by cervical cancer ranked second among female tumors in China. The HPV vaccine has been proven to be a cost-effective measure to prevent cervical cancer, but the vaccination rate remained low to date among university students. This study aimed to understand the status quo of HPV vaccine hesitancy among university students across China during the COVID-19 pandemics and systematically analyze determinants of HPV vaccine hesitancy based on the WHO 3Cs model. Cross-sectional data were collected using an online survey of female university students in four cities across China in June 2022. Multinomial logistic regression was adopted to determine factors influencing vaccine hesitancy based on the 3Cs model with three dimensions, namely complacency, convenience, and confidence. Among 1438 female university students surveyed in this study, 89.7% did not hesitate to vaccinate against HPV, only 8.9% hesitated to some extent, and 1.4% refused to vaccinate. The actual vaccination rate for the HPV vaccine was 34.2%. Based on the 3Cs model, this study found that the trust on the efficacy of vaccines, risk perception of being infected by HPV, price, and distance/time were influencing factors of vaccine hesitancy. Knowledge of the HPV vaccine and sociodemographic characteristics, such as education levels, were also statistically relevant. Therefore, it is recommended that relevant scientific knowledge on cervical cancer and the HPV vaccine should be spread on campus, the vaccination appointment procedure should be simplified, and the affordability of vaccination should be increased through strategic purchasing or providing subsidies, so as to reduce HPV vaccine hesitancy.
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Affiliation(s)
- Yan Huang
- Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou 510275, China
| | - Cheng Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
- National Institute of Hospital Administration, National Health Commission, Beijing 100044, China
| | - Lei Wang
- School of Public Administration and Emergency Management, Institute of Public Policy, Jinan University, Guangzhou 510632, China
| | - Huamei Wu
- Shanghai Urban Construction Vocational College, Shanghai 200438, China
| | - Ting Chen
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Luying Zhang
- School of Public Health, Fudan University, Shanghai 200032, China
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