HPV Vaccination Uptake Among Children Attending Polish Primary Schools and Parental Factors Influencing Vaccination: A Cross-sectional Study.

Abstract

Despite the availability of free HPV vaccinations in Poland for children aged 9-18, the vaccination rates remain low. The study aimed to assess HPV vaccination coverage among Polish and Ukrainian children attending primary schools, as well as parental factors influencing children's vaccination. The cross-sectional study was conducted (December 2024-March 2025) among parents of children aged 9-15 years enrolled in 5 primary schools in Zielona Gora, Poland. Respondents filled out a voluntary, anonymous questionnaire. Variables significantly related to the outcome were analyzed using logistic regression models. 152 parents participated (mean age 39.6 ± 6.0; 85.5% women; 9.9% migrants from Ukraine); only 30.3% have vaccinated their child against HPV (fewer from Ukraine than from Poland, p = 0.04). In the remaining group, 35.2% were willing to vaccinate, 37.8% were undecided, and 27.0% were against vaccination. The main motivation was the desire to protect the child from cancer (78.9%), and the main barrier was the concern about vaccination side effects (52.4%). HPV vaccination was associated with older parental age (OR = 1.12; 95%CI:1.03-1.23) - a 1-year increase in age was associated with 12% greater likelihood, higher socioeconomic status (OR = 2.71; 95%CI:1.05-7.37), family history of cancer (OR = 4.22; 95%CI:1.21-19.89), and having ≤ 2 children (OR = 3.48; 95%CI:1.24-11.07). The study showed a worryingly low HPV vaccination uptake among Polish/Ukrainian-origin primary school children, and unsatisfactory vaccination intentions among their parents; this may translate into a high incidence of HPV-dependent diseases. Targeted education campaigns, primarily aimed at younger parents with low socioeconomic status and large families, are urgently needed to increase vaccination rates.