# Acceptability of HPV Vaccination for Daughters: A University Hospital-Wide Questionnaire Survey

## TL;DR

This study explores factors influencing HPV vaccine acceptability among hospital staff in Japan, finding that public funding and knowledge significantly impact willingness to vaccinate daughters.

## Contribution

The study identifies specific demographic and knowledge-based factors affecting HPV vaccine acceptability in a post-policy change context in Japan.

## Key findings

- Acceptability exceeded 75% in publicly funded scenarios but dropped to 45% in self-funded scenarios.
- Younger age, being a medical professional, and higher knowledge levels were positively associated with acceptability in publicly funded scenarios.
- In self-funded scenarios, women were less likely to accept vaccination despite knowledge and awareness of catch-up programs.

## Abstract

Background/Objectives: Japan has experienced a marked decline in human papillomavirus (HPV) vaccination coverage, reaching less than 1%, after the government suspended its proactive recommendation in 2013, following media reports of symptoms alleged to be adverse events caused by the vaccine. Although the recommendation was reinstated in 2022 after comprehensive safety reviews, vaccination rates have remained modest. We aimed to assess HPV vaccine acceptability and identify factors associated with acceptance among staff at a university hospital. Methods: We administered a web-based questionnaire in February 2024 to 2761 hospital employees, assessing demographic and professional characteristics, HPV-related knowledge, awareness about vaccine effectiveness, adverse events, and catch-up programs, as well as acceptability across four hypothetical scenarios reflecting publicly funded and self-funded vaccination programs. Logistic regression analyses were conducted to identify factors associated with acceptability. Results: Among 1132 respondents (response rate 41.0%), acceptability exceeded 75% in the publicly funded scenarios but was approximately 45% in the self-funded scenarios. In multivariable analyses of the publicly funded scenarios, younger age, being a medical professional, greater HPV vaccine knowledge levels, and awareness about HPV vaccine effectiveness or catch-up vaccination were positively associated with acceptability; awareness about adverse events showed negative associations. In the self-funded scenarios, women were less likely to accept vaccination, but greater knowledge levels and awareness of catch-up vaccination remained positively associated with acceptability. Conclusions: These findings suggest that strategies tailored to specific population characteristics are important for improving HPV vaccine acceptability.