Brumbaugh Kaitlin Quirk, de Figueiredo Alex, Gellert Frances R, Casas Francisco Rios, McCoy Tara, Larson Heidi J, Mokdad Ali H
Population Health Initiative, University of Washington, United States.
London School of Hygiene and Tropical Medicine and Vaccine Confidence Project, United Kingdom.
Vaccine. 2025 Aug 13;61:127395. doi: 10.1016/j.vaccine.2025.127395. Epub 2025 Jun 19.
This study aimed to identify drivers of HPV vaccine hesitancy and effective public health interventions to increase HPV vaccination rates in two U.S. states (New York and Florida) and 12 counties within each state. The findings provide insights into the impact of demographics, state policies, and vaccine confidence on HPV vaccination.
We utilized a mixed-method approach, integrating quantitative analysis of county-level surveys, qualitative interviews, and secondary data on HPV vaccine coverage. Surveys, adapted from the Vaccine Confidence Project (VCP) and the World Health Organization (WHO), assessed HPV vaccine confidence, socio-demographics, and behavioral determinants. Interviews explored barriers, interventions, and policies related to HPV vaccination.
Parents and providers have not prioritized HPV vaccination compared to other vaccines, with less concern about HPV than other vaccine-preventable diseases. Socio-demographic factors, such as race, age, gender, religion, employment, and income impacted children's vaccination status. Female parents aged 35-44 and those with a professional degree were more likely to vaccinate their children. Perceptions of the vaccine's importance and safety significantly influenced vaccination.
Identifying socio-demographic determinants and behavioral motivators can guide targeted interventions. Our study highlights complex factors influencing HPV vaccination at the state and county level, offering policymakers strategies to tailor interventions addressing barriers and hesitancy in areas with lower vaccination rates.
本研究旨在确定美国两个州（纽约州和佛罗里达州）以及每个州内12个县中HPV疫苗犹豫的驱动因素和有效的公共卫生干预措施，以提高HPV疫苗接种率。研究结果为人口统计学、州政策和疫苗信心对HPV疫苗接种的影响提供了见解。
我们采用了混合方法，整合了县级调查的定量分析、定性访谈以及HPV疫苗接种覆盖率的二手数据。调查改编自疫苗信心项目（VCP）和世界卫生组织（WHO），评估了HPV疫苗信心、社会人口统计学和行为决定因素。访谈探讨了与HPV疫苗接种相关的障碍、干预措施和政策。
与其他疫苗相比，家长和医疗服务提供者没有将HPV疫苗接种列为优先事项，对HPV的关注低于其他疫苗可预防的疾病。种族、年龄、性别、宗教、就业和收入等社会人口统计学因素影响了儿童的疫苗接种状况。35 - 44岁的女性家长和拥有专业学位的家长更有可能为孩子接种疫苗。对疫苗重要性和安全性的认知显著影响了疫苗接种。
确定社会人口统计学决定因素和行为动机可以指导有针对性的干预措施。我们的研究突出了在州和县级层面影响HPV疫苗接种的复杂因素，为政策制定者提供了策略，以便在疫苗接种率较低的地区量身定制干预措施，解决障碍和犹豫问题。
