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A nationwide post-marketing survey of knowledge,attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China
Authors:Shangying Hu  Xiaoqian Xu  Yanyang Zhang  Yawen Liu  Chunxia Yang  Yueyun Wang  Yan Wang  Yanqin Yu  Ying Hong  Xingxing Zhang  Rui Bian  Xian Cao  Lili Xu  Fanghui Zhao
Institution:1. Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Institute for Expanded Program on Immunization, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China;3. Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, China;4. Department of Epidemiology and Biostatistics, West China School of Public Health/West China Forth University Hospital, Sichuan University, Chengdu, China;5. Department of Healthcare, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China;6. Department of Cancer Institute, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China;7. School of Public Health, Baotou Medical College, Baotou, Inner Mongolia, China;8. Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;9. MRL Global Medical Affairs, MSD China, Shanghai, China
Abstract:BackgroundHuman papillomavirus (HPV) vaccine has been increasingly discussed in mainland China since its first approval in 2016. To date, nearly all studies assessing HPV vaccine perceptions and attitudes were implemented during pre-licensure period. Therefore, the nationwide post-marketing survey was conducted to update knowledge, attitudes and practice on HPV vaccine among general population in mainland China.MethodsParticipants aged 18–45 years living in mainland China were recruited in April 2019 by multi-stage non-randomized sampling. Sociodemographic factors, HPV and HPV vaccine related awareness, knowledge, attitudes, vaccine uptake and potential obstacles were assessed in questionnaires. Bivariate analysis and multivariate regression were used to identify disparity among subgroups with different sociodemographic characteristics.Results4,000 women (32.1 ± 7.81y) and 1,000 men (31.8 ± 7.96y) were included in final analysis. Less than one third of participants had heard of HPV (female: 31%; male: 22%) and HPV vaccine (female: 34%; male: 23%). Knowledge score was also unfavorable on HPV (female: 3 out of 13; male: 1.8 out of 13) and HPV vaccine (female: 3 out of 6; male: 2 out of 5). Only 3% females had been vaccinated three years after HPV licensure in China, although willingness to get vaccinated among those unvaccinated were high (mean willingness score ± SD: female: 3.3 ± 0.97; male: 3.0 ± 0.98). Industry of employment and household income were the major factors related to awareness and knowledge of vaccine, whereas HPV and HPV vaccine awareness were key influential factors for willingness. The main obstacles of vaccination were safety concerns, lack of knowledge, and high price of HPV vaccines.ConclusionsFindings highlight a lack of vaccine awareness, knowledge, and poor uptake in mainland China and underscore the necessity of health education campaigns. The identified priority groups, contents to be delivered and practical obstacles could furthermore provide insight into health education to reduce disparities and accelerate HPV vaccine roll-out in China.
Keywords:Human papillomavirus  HPV vaccine  Survey  Knowledge  Willingness  Practice
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