Sallam Malik, Al-Mahzoum Kholoud, Eid Huda, Assaf Areej M, Abdaljaleel Maram, Al-Abbadi Mousa, Mahafzah Azmi
Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan.
Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan.
Vaccines (Basel). 2021 Dec 3;9(12):1432. doi: 10.3390/vaccines9121432.
Cervical cancer is a leading cause of morbidity and mortality in women worldwide. The availability of prophylactic vaccines for high-risk types of human papillomavirus (HPV) infection represents an important advancement in the prevention of cervical cancer. In Jordan, the availability of the HPV vaccination is restricted to individuals who are willing to pay. The aim of the current study was to evaluate the willingness and attitude of female university students in health schools/faculties in Jordan to get HPV vaccination and their knowledge about the virus. A self-administered online questionnaire was distributed in October 2021, which comprised 27 items to evaluate HPV knowledge, history of HPV vaccination, intentions to get the HPV vaccine, and the reason(s) behind vaccine refusal for those who rejected vaccination. The study sample comprised 836 participants: medical students (39.7%), pharmacy students (26.0%), dental students (21.2%), and nursing students (13.2%). Only 524 participants had heard of HPV prior to the study (62.7%), of which 48.7% knew about the availability of HPV vaccines. The lowest level of HPV knowledge was observed among nursing students. Only 19/524 students reported a history of HPV vaccination (3.6%). The overall willingness to receive HPV vaccination if provided freely was 75.0%, while only 16.0% were willing to pay for the vaccine. The most common reason for HPV vaccine rejection was the perceived low risk to get HPV infection. Significantly higher intentions to get HPV vaccination were found among older participants and medical students. The embrace of vaccine conspiracy beliefs was associated with a significantly less willingness to get the HPV vaccination ( < 0.001). Dependence on the internet/social media as the source of HPV knowledge was associated with a significantly lower intention to get HPV vaccination ( = 0.002). The coverage of the HPV vaccination among female university students in health schools in Jordan appeared extremely low; however, three-fourths of the students who had heard of HPV were willing to receive the HPV vaccination if provided freely. Complacency appeared as a major factor for HPV vaccine rejection. Increasing the levels of knowledge and awareness of HPV infection and its association with cervical cancer through reliable sources is recommended. This can be helpful for the individual benefit of the students besides the potentially positive role they can play in community education. Countering vaccine conspiracy beliefs with proper education and awareness programs can be helpful to appraise the role of HPV vaccines in cancer prevention.
宫颈癌是全球女性发病和死亡的主要原因之一。高危型人乳头瘤病毒（HPV）感染预防性疫苗的出现是预防宫颈癌的一项重要进展。在约旦，HPV疫苗仅提供给愿意付费的人群。本研究的目的是评估约旦卫生学校/学院的女大学生接种HPV疫苗的意愿和态度以及她们对该病毒的了解情况。2021年10月发放了一份自填式在线问卷，其中包含27个项目，用于评估HPV知识、HPV疫苗接种史、接种HPV疫苗的意愿以及拒绝接种疫苗者拒绝接种的原因。研究样本包括836名参与者：医学生（39.7%）、药学专业学生（26.0%）、牙科专业学生（21.2%）和护理专业学生（13.2%）。在研究之前，只有524名参与者听说过HPV（62.7%），其中48.7%知道有HPV疫苗。护理专业学生的HPV知识水平最低。只有19/524名学生报告有HPV疫苗接种史（3.6%）。如果免费提供HPV疫苗，总体接种意愿为75.0%，而只有16.0%的人愿意付费接种疫苗。拒绝接种HPV疫苗最常见的原因是认为感染HPV的风险低。年龄较大的参与者和医学生接种HPV疫苗的意愿明显更高。接受疫苗阴谋论与接种HPV疫苗的意愿显著降低相关（<0.001）。依赖互联网/社交媒体作为HPV知识来源与接种HPV疫苗的意愿显著降低相关（=0.002）。约旦卫生学校女大学生中HPV疫苗的接种率极低；然而，四分之三听说过HPV的学生如果免费提供疫苗愿意接种。自满似乎是拒绝接种HPV疫苗的主要因素。建议通过可靠来源提高对HPV感染及其与宫颈癌关联的知识和认识水平。这除了对学生个人有益外，他们在社区教育中也可能发挥积极作用。通过适当的教育和宣传项目对抗疫苗阴谋论有助于评估HPV疫苗在癌症预防中的作用。
