Factors Influencing Knowledge and Acceptance of Nonavalent Human Papillomavirus Vaccine Among University Population in Southern China: A Cross-Sectional Study

Cancer Control. 2024 Jan-Dec:31:10732748241293989. doi: 10.1177/10732748241293989.

Abstract

Background: Vaccine hesitancy among young Chinese remains a challenge, contributing to low vaccination rates for the nonavalent Human Papillomavirus (HPV) vaccine. This study evaluated the knowledge and acceptance of this vaccine among students at a southern Chinese university and identified factors influencing these outcomes.

Methods: This cross-sectional, anonymous questionnaire survey was conducted from April to November 2023 at a multi-campus university in southern China. The questionnaire was comprised of three sections: the first collected demographic data; the second evaluated students' knowledge of the nonavalent HPV vaccine on a scale from 0 to 15, with cut-off points at 5 and 10 delineating low, medium, and high knowledge levels, respectively; the third section assessed vaccine acceptance on a scale from 8 to 40, using scores above the 50th percentile as the benchmark for positive acceptance.

Results: Among the participants, 18% demonstrated low-level, 40.20% medium-level, and 41.70% high-level knowledge of the nonavalent HPV vaccine. Notably, 71.95% of respondents showed positive acceptance, whereas 28.05% expressed negative acceptance. Male students and those with lower economic conditions (monthly living expenses below 1000 RMB, P = 0.004; 1000-1499 RMB, P = 0.012) exhibited lower knowledge levels. As for acceptance, female students and those with higher monthly living expenses (1000-1499 RMB, P = 0.007; 1500-1999 RMB, P = 0.002; over 2000 RMB, P = 0.002) demonstrated greater vaccine acceptance. A positive correlation was noted between the level of knowledge and vaccine acceptance (rs = 0.256, P < 0.001).

Conclusions: Gender and economic status are significantly associated with nonavalent HPV vaccine knowledge and acceptance among university students. These findings highlight the potential impact of targeted educational initiatives, especially for economically disadvantaged male students, in enhancing vaccine uptake rates.

Keywords: HPV; acceptance; attitude; knowledge; nonavalent HPV vaccine; university students.

Plain language summary

Many young people in China are hesitant to get the nine - valent HPV vaccine, which protects against certain types of viruses that can cause cancer. This study looked at how much students at a university in southern China know about the nine - valent HPV vaccine and whether they are willing to get vaccinated. We asked students to fill out a survey between April and November 2023 to gather this information. The survey showed that knowledge about this vaccine varied: about 18% of the students knew very little, 40% had a moderate understanding, and roughly 42% knew a lot about this vaccine. Interestingly, more than 70% of the students were open to getting the vaccine, but about 28% were not. We found that male students and those with less money generally knew less about the vaccine and were more likely to not accept it. There was also a clear link between how much students knew about the vaccine and their willingness to get vaccinated. This suggests that teaching students more about this vaccine, especially boys and those from poorer backgrounds, could encourage more of them to get vaccinated. This is important because increasing vaccine rates can help prevent diseases spread by the virus.

MeSH terms

  • Adolescent
  • Adult
  • China
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Papillomavirus Infections* / prevention & control
  • Papillomavirus Vaccines* / administration & dosage
  • Papillomavirus Vaccines* / therapeutic use
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data
  • Students* / psychology
  • Students* / statistics & numerical data
  • Surveys and Questionnaires
  • Universities
  • Vaccination / psychology
  • Vaccination / statistics & numerical data
  • Vaccination Hesitancy / psychology
  • Vaccination Hesitancy / statistics & numerical data
  • Young Adult

Substances

  • Papillomavirus Vaccines