Analysis of HPV vaccination and influencing factors among 9-14-year-old girls in underdeveloped areas of northwestern China: A cross-sectional survey report on guardians.
Ya Chen, Nan Jiang, Yongzhuo Jiao, Junlian Chen, Aitong Cao, Jing An, Yuhui Dang
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Abstract
Objective: Gansu Province, an underdeveloped region in northwest China, has a low HPV vaccination rate among girls aged 9-14 despite government promotion efforts. This study aims to investigate the current status of HPV vaccination among girls aged 9-14 in Gansu Province, explore guardians' willingness to vaccinate their daughters and analyze the influencing factors, to provide scientific evidence for improving the HPV vaccination rate and government vaccine promotion measures for girls aged 9-14.
Methods: HPV vaccine procurement and usage data (2018-2023) were extracted from provincial platforms, and demographic data were sourced from national census and statistical yearbooks to analyze the current status of HPV vaccination among girls aged 9 to 14 in Gansu Province. From January to May 2024, 1027 guardians of 9-14-year-old girls were surveyed via questionnaires. Logistic regression, restricted cubic spline (RCS), and mediation analysis assessed factors influencing vaccination willingness.
Results: The vaccination rate rose slowly from 2018 to 2022 but surged to 0.76 % in 2023. Among participants, 25.51 % of guardians expressed hesitancy to have their daughters vaccinated against HPV. Socioeconomic status (SES) and HPV and vaccine knowledge positively correlated with willingness (P < 0.001). Guardians with medium (OR = 1.69, 95 % CI: 1.15, 2.51) and high (OR = 7.42, 95 % CI: 4.89, 11.48) knowledge levels showed stronger vaccination willingness. RCS analysis revealed non-linear dose-response relationships between SES/knowledge scores and vaccination willingness (Pnon-linear < 0.01). Mediation analysis revealed that cognition played a completely mediating role between SES and vaccination willingness.
Conclusions: HPV vaccination coverage in Gansu remains low and uneven. Guardians demonstrated high willingness but faced barriers linked to SES and knowledge gaps. Policies prioritizing free vaccines or subsidies, alongside educational campaigns, are critical to improving uptake.
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