Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou 510275, China.
School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
Int J Environ Res Public Health. 2022 Oct 28;19(21):14025. doi: 10.3390/ijerph192114025.
The burden of disease caused by cervical cancer ranked second among female tumors in China. The HPV vaccine has been proven to be a cost-effective measure to prevent cervical cancer, but the vaccination rate remained low to date among university students. This study aimed to understand the status quo of HPV vaccine hesitancy among university students across China during the COVID-19 pandemics and systematically analyze determinants of HPV vaccine hesitancy based on the WHO 3Cs model. Cross-sectional data were collected using an online survey of female university students in four cities across China in June 2022. Multinomial logistic regression was adopted to determine factors influencing vaccine hesitancy based on the 3Cs model with three dimensions, namely complacency, convenience, and confidence. Among 1438 female university students surveyed in this study, 89.7% did not hesitate to vaccinate against HPV, only 8.9% hesitated to some extent, and 1.4% refused to vaccinate. The actual vaccination rate for the HPV vaccine was 34.2%. Based on the 3Cs model, this study found that the trust on the efficacy of vaccines, risk perception of being infected by HPV, price, and distance/time were influencing factors of vaccine hesitancy. Knowledge of the HPV vaccine and sociodemographic characteristics, such as education levels, were also statistically relevant. Therefore, it is recommended that relevant scientific knowledge on cervical cancer and the HPV vaccine should be spread on campus, the vaccination appointment procedure should be simplified, and the affordability of vaccination should be increased through strategic purchasing or providing subsidies, so as to reduce HPV vaccine hesitancy.
在中国，宫颈癌导致的疾病负担在女性肿瘤中排名第二。HPV 疫苗已被证明是预防宫颈癌的一种具有成本效益的措施，但迄今为止，大学生的疫苗接种率仍然很低。本研究旨在了解 COVID-19 大流行期间中国大学生 HPV 疫苗犹豫的现状，并根据世界卫生组织 3C 模型系统分析 HPV 疫苗犹豫的决定因素。2022 年 6 月，采用在线调查的方式，在中国四个城市的女大学生中收集了横断面数据。采用多项逻辑回归分析，根据 3C 模型的三个维度（自满、便利和信心），确定影响疫苗犹豫的因素。在本研究中，对 1438 名女大学生进行调查，其中 89.7%的人不犹豫接种 HPV 疫苗，只有 8.9%的人在某种程度上犹豫，1.4%的人拒绝接种。HPV 疫苗的实际接种率为 34.2%。基于 3C 模型，本研究发现对疫苗效力的信任、对感染 HPV 的风险感知、价格和距离/时间是疫苗犹豫的影响因素。HPV 疫苗的知识以及教育水平等社会人口学特征也具有统计学意义。因此，建议在校园内传播有关宫颈癌和 HPV 疫苗的相关科学知识，简化接种预约程序，并通过战略采购或提供补贴来提高疫苗接种的可负担性，以减少 HPV 疫苗犹豫。
