HPV Vaccination Willingness and Knowledge among Parents: A Family Decision-Making Perspective

A convenience sampling method was used to conduct a self-administered questionnaire survey among 3,751 parents in Shanghai in 2025. The survey covered sociodemographic characteristics, HPV-related knowledge, vaccination willingness for different family members, and perceptions of priority vaccination age groups. Descriptive analysis, univariate analysis, and binary logistic regression models were employed for statistical analysis.Results The mean HPV knowledge score of parents was 3.32±1.31 (out of 9).

Only 53.0% were aware of HPV types. Awareness of cervical cancer was the highest (94.5%), while awareness of penile cancer (36.4%) and oropharyngeal cancer (24.1%) was low; 15.0% mistakenly believed HPV could be transmitted through the digestive tract. Parents' willingness to vaccinate daughters (72.7%) was significantly higher than that for sons (61.4%), with actual vaccination rates of 7.9% and 2.5%, respectively.

Multivariate logistic regression showed that for daughters, female gender (OR=1.43), junior high school education or below (OR=1.45, using bachelor's degree as reference), and higher HPV knowledge score (OR=1.23) were facilitating factors, while unwillingness to disclose income was a barrier (OR=0.75). For sons, facilitating factors included non-local household registration (OR=1.34), having two children (OR=1.30), and higher HPV knowledge score (OR=1.20), while unwillingness to disclose income was also a barrier (OR=0.70).

Parents identified 9-12 years as the priority vaccination age for females, but "at birth" for males, indicating a misconception of excessively early vaccination for males.Conclusion Parents show generally high acceptance of HPV vaccines, but their knowledge level needs improvement. It is recommended to strengthen HPV vaccination promotion for males, optimize health communication strategies, and provide scientific guidance on vaccination age to promote HPV vaccination coverage among adolescents.