Determinants of Human Papillomavirus (HPV) Vaccine and Factors of Hesitancy to Vaccinate Adolescent Girls against HPV Faced by their Parents in Pakistan: A Community-Based Study

Abstract

Background: Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical cancer, yet parental vaccine hesitancy remains an important barrier to achieving adequate vaccination coverage. Evidence regarding the factors of parental HPV vaccine hesitancy in Pakistan remains limited.

Objective: To assess determinants of HPV vaccine hesitancy among parents of adolescent girls in Pakistan and evaluate the factors associated with reluctance or refusal to vaccinate.

Methods: A community-based cross-sectional study was conducted among 500 parents of adolescent girls in Islamabad, Pakistan. Data were collected using a structured questionnaire assessing sociodemographic characteristics, HPV-related knowledge, vaccine perceptions, information sources, reasons for hesitancy, and factors of delayed or refused vaccination. Factors associated with HPV vaccine hesitancy were evaluated using multivariable logistic regression, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) reported.

Results: HPV vaccine hesitancy was identified among 293 (58.6%) parents. The most frequently reported concerns were vaccine safety (61.1%), inadequate knowledge (56.0%), adverse effects (48.8%), and infertility (43.7%). Adequate HPV knowledge was independently associated with lower odds of hesitancy (aOR 0.39, 95% CI 0.25–0.61), whereas safety concerns (aOR 2.71, 95% CI 1.78–4.12), infertility concerns (aOR 2.34, 95% CI 1.53–3.59), and misinformation (aOR 2.08, 95% CI 1.38–3.14) were associated with greater hesitancy.

Conclusion: Parental HPV vaccine hesitancy was common and was driven predominantly by modifiable knowledge, safety, misinformation, and counselling-related factors. Targeted healthcare-provider counselling and culturally appropriate community education may improve vaccine acceptance.