Human Papillomavirus Vaccine Awareness, Acceptability, and Decision-Making Factors among Chinese College Students

Background: College students are recommended as the target groups for catch-up human papillomavirus(HPV) vaccination. Systematical exploration of awareness, acceptability, and decision-making factors of HPVvaccination among Chinese college students has been limited. Materials and
Methods: A multi-center survey wasconducted in mainland China between November 2011 and May 2012. College students aged 18-22 years werestratified by their grade, gender, and major for sampling. Socio-demographic and HPV-related information suchas knowledge, perceptions, acceptability, and attitudes were collected through a questionnaire.
Results: A totalof 3,497 undergraduates completed the questionnaire, among which 1,686 were males. The acceptability of theHPV vaccine was high (70.8%). Undergraduates from high-level universities, at lower grade, or with greaterprior knowledge of HPV vaccines showed higher acceptability of HPV vaccination (ptrend <0.001). Additionally,undergraduates with vaccination experience outside the National Expanded Program on Immunization (OR=1.29;95%CI: 1.10-1.51) or fear of HPV-related diseases (OR=2.79; 95%CI: 2.28-3.41) were more willing to acceptHPV vaccination. General knowledge of HPV vaccine was low among undergraduates, and safety was a majorconcern (71.05%). The majority of students wished to pay less than 300RMB for HPV vaccine and chose theChinese Center for Disease Control and Prevention as the most appropriate venue for vaccination.
Conclusions:Although most undergraduates demonstrate positive attitudes towards HPV vaccination, challenges pertaining tointroduction exist in China. Corresponding proactive education and governmental subsidy to do so are urgentlyneeded by this age-group population. Suggestions and potential strategies indicated may help shape the futureHPV vaccination program in China.