ArticleBMC public health2024
Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China.
Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Factors that influence caregivers' and adolescents' views and practices regarding human papillomavirus (HPV) vaccination for adolescents: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2025Pooled it
- Trial
- Effect of a pay-it-forward strategy on reducing HPV vaccine delay and increasing uptake among 15- to 18-year-old girls in China: A randomized controlled trial.PLoS medicine · 2025Trial
- A vaccine chatbot intervention for parents to improve HPV vaccination uptake among middle school girls: a cluster randomized trial.Nature medicine · 2025Trial
- Factors affecting caregivers' HPV vaccination decisions for adolescent girls: A secondary analysis of a Chinese RCT.PloS one · 2025Trial
- From local pilots to national policy: key issues and challenges in implementing nationwide HPV vaccination in China.The Lancet regional health. Western Pacific · 2026Review
- Urban-rural disparities in HPV vaccination knowledge, willingness, and uptake among women in the Tibet autonomous region: a multi-center cross-sectional study.Frontiers in public health · 2026Article
- Identifying barriers to human papillomavirus vaccination in China: a topic modelling analysis of social media (2018-2024).BMJ public health · 2026Article
- Human papillomavirus vaccination willingness and influencing factors among women in China: A systematic review and meta-analysis.Preventive medicine reports · 2025Review
- Pay-it-forward strategy reduced HPV vaccine delay and increased uptake among catch-up age girls: A randomized clinical trial.medRxiv : the preprint server for health sciences · 2025Article
- Barriers and enablers of HPV vaccination among caregivers of school-age girls in resource-limited regions of Western Sichuan, China: a mixed-methods study.Frontiers in public health · 2025Article
- Beyond health: exploring women's socio-cultural motivations for HPV vaccination.International journal of qualitative studies on health and well-being · 2024Article
- Nationwide Discrete Choice Experiment on Chinese Guardians' Preferences for HPV Vaccination for Mothers and Daughters.Vaccines · 2024Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundAdolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls.
methodsQuantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14-18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen's Behavioural Model for Health Services Use.
resultsA total of 100 caregivers - 85 were mothers and 15 were fathers - participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active.
conclusionIn urban areas, Chinese caregivers' intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.