Human papillomavirus vaccination willingness and influencing factors among women in China: A systematic review and meta-analysis

Abstract

Objective

This study aims to comprehensively review the human papillomavirus (HPV) vaccination willingness among Chinese women and explore the factors influencing their vaccination intentions.

Methods

A comprehensive systematic search was conducted across nine electronic databases—China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Journal Integration Service Platform, SinoMed, PubMed, Embase, Scopus, Cochrane Library, and Web of Science—from database inception to February six, 2025, to identify studies examining HPV vaccine acceptance among Chinese women.

Results

The pooled willingness to receive the HPV vaccine among Chinese women was estimated at 65.7 % (95 % CI: 55.2 %–76.2 %). Subgroup analyses indicated higher intent among women with a college education or above (71.1 % versus 60.1 %), urban residents (68.3 % versus 56.0 % in rural areas), southern China residents (69.0 % versus 59.7 % in northern regions), individuals with medical-related backgrounds (84.2 % versus 35.7 %), and those with prior HPV or vaccine knowledge (66.1 %/76.4 % versus 50.2 %/57.8 %), Willingness was also higher among women with a family cancer history (74.5 % versus 55.3 %), and those impacted by COVID-19 (67.5 % versus 57.5 %). Anonymous questionnaires yielded higher willingness (71.8 % versus. 58.8 %). Other influencing factors included age, attitudes toward premarital sex, and awareness of HPV risks and vaccine benefits.

Conclusions

Chinese women's overall willingness to receive the HPV vaccine remains below the World Health Organization (WHO)’s 90 % target, with significant disparities across subpopulations. Targeted public health efforts are urgently needed to enhance vaccine awareness and acceptance, especially among women in rural or underdeveloped areas, with lower education, non-medical backgrounds, or no family history of cancer.