Available online 15 February 2024

Author links open overlay panel, , , ABSTRACTObjective

To investigate and compare the attitudes of parents who initiated their daughters’ HPV vaccination with parents who did not.

Methods

Data were collected through telephone interviews with a close-end questionnaire on parents’ knowledge, attitudes towards the vaccine, and the reasons for vaccinating or not their daughters against HPV. The sample was random, stratified by geographic region and urbanization level, national, and representative of the general population of parents of girls aged 11–18 in Greece. Statistical analysis consisted of descriptives, an inferential analysis with hypothesis testing, and a logistic regression model.

Results

Overall, 996 parents were included in the analysis, 99.0% of which were women. 47% of them initiated their daughters’ HPV vaccination, with physician recommendation stated as the most important reason for this decision (50.2%). For those who had not initiated their daughters’ HPV vaccination (53%), lack of information was the most important reason (25.6%). In the hypothesis testing, parents with unvaccinated daughters agreed more with the statements “I do not have enough information for the HPV vaccine to decide”, and “My child is very young to be vaccinated for an STD” (p < 0.05), but no significant difference found for the statement “It's more possible for a vaccinated girl to begin sexual activities” (p > 0.05).

Conclusions

Lack of information, young age of the daughter, and perceived effectiveness of the vaccine are the most important hesitation factors. Physician recommendation is the most important reason to initiate vaccination.

Section snippetsINTRODUCTION

The causal relationship between Human Papilloma Virus (HPV) and cervical cancer (CC) has been established since 19831. Tumor development is linked with persistent infection of high-risk HPV types2. HPV is responsible for approximately 9% of all cancer cases globally, with almost all CC cases attributed to HPV infection3. In 2015, the European Medicines Agency granted authorization for a vaccine that protects against nine types and offers 90% overall protection4.

In Europe, about 14% of women are

MATERIALS AND METHODS

A cross-sectional study was conducted to investigate the attitudes toward HPV vaccination. Data were collected through a close-end questionnaire. The questions concerned parents’ knowledge of the HPV vaccine, their attitudes towards it, whether they vaccinated their daughter, the reasons for their decision, and socioeconomic characteristics.

The study sample was random, stratified by geographic region and urbanization level, national, and representative of the general population of parents of

Descriptive

Most of the participants were women (99.0%), 67.5% of which were in the 40-49 age group, most of them were married or cohabiting (87.9%) and employees (66.0%), while most of them had completed secondary education (56.6%) and the vast majority was insured in α public scheme (95.1%).

Table 1 demonstrates the full results for the sample and the groups.

Regarding the parents whose daughters had received at least one dose of the HPV vaccine, the main reasons were physician recommendation (50.2%) and

Summary of main results

HPV vaccination uptake in Greece is low, well below the necessary threshold to achieve herd immunity. Understanding the beliefs towards HPV vaccination is of great importance in order to increase HPV vaccine uptake. This study attempted to analyze the factors that affect the parental decision on HPV vaccination and to identify the differences between parents who vaccinated their daughters and those who did not. The results show that parents' decision is affected by the lack of information, the

CONCLUSIONS

Lack of information and physician recommendation are the most important factors in parental decision-making regarding the HPV vaccine. There appears to be a gap in the information physicians provide to parents. Except for a plain recommendation, they should provide all necessary information, emphasize extensively the necessity of an early vaccination, and eliminate the fears about an early onset of sexual activity.

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© 2024 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.