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
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, 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
Abstract
Background: Human 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.
Methods: Participants 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.
Results: 4,000 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.
Conclusions: Findings 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: HPV vaccine; Human papillomavirus; Knowledge; Practice; Survey; Willingness.
Conflict of interest statement
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: F. Zhao has received grants through her institution from GlaxoSmithKline Biologicals SA, MSD China and Xiamen Innovax Biotech Co, Ltd to undertake clinical trials or studies on HPV vaccine. R. Bian and X. Zhang report other from MSD China, outside the submitted work; X. Cao and X. Li had been employed by MSD China during the study, and outside the submitted work. The remaining authors declare no conflict of interests.
Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
Source: PubMed