Factors affecting caregivers’ HPV vaccination decisions for adolescent girls: A secondary analysis of a Chinese RCT

PMCID: PMC12173375

PMID: 40526724

DOI: 10.1371/journal.pone.0324260

Journal: PloS one

Publication Date: 2025-6-17

Authors: Yang Y, Lu Y, Li Y, Qin C, He Y, et al.

Key Points

• Pay-it-forward intervention increased HPV vaccine uptake from 17.5% to 34.2%
• Daughters of unemployed/retired caregivers had nearly 4x higher vaccination rates (OR=3.97, 95%CI:1.81–8.72)
• Caregiver knowledge, occupation, and vaccination intention are crucial determinants of adolescent HPV vaccine acceptance

Summary

This two-arm randomized controlled trial investigated HPV vaccine uptake among adolescent girls in China, focusing on caregiver-driven factors and a novel "pay-it-forward" intervention. Among 321 caregivers, overall HPV vaccination rates were low at 25.9%, but significantly improved to 34.2% in the pay-it-forward group compared to 17.5% in the standard-of-care arm. The study revealed multiple complex factors influencing vaccination decisions, with caregiver characteristics playing a critical role in adolescent vaccine acceptance.

The research demonstrated that targeted interventions and specific caregiver attributes substantially impact HPV vaccination rates. Notably, caregivers who were unemployed/retired, had no intention to delay vaccination, and were previously unaware of the HPV vaccine were more likely to have their daughters vaccinated. The pay-it-forward model emerged as a promising strategy, increasing vaccination likelihood by over twofold and suggesting innovative approaches to addressing vaccine hesitancy.