The importance of social norms for uptake of catch-up human papillomavirus vaccination in young women

Abstract

Human papillomavirus (HPV) is the cause of almost all cases of cervical cancer. The current UK government immunisation program includes free routine HPV vaccination of girls aged 12-13, with a catch-up vaccination program for 13-18-year-old girls. The aim of this study was to identify correlates of intended and actual uptake of catch-up HPV vaccination. An online questionnaire was completed by 591 young women aged 16-20. Of the 350 women who had been offered catch-up HPV vaccination, 90.6% had accepted. In multivariate analyses, vaccine uptake was significantly correlated with subjective norms more supportive of HPV vaccination, and greater uptake of other childhood vaccinations (χ²(3))=39.34, P<0.01; 91.1% correctly classified; Nagelkerke pseudo-r²=0.23). Among the 241 women aged 16-20 who had not been offered HPV vaccination, the average intention was 3.70 on a five-point scale. Multivariate analyses revealed four significant independent predictors of stronger intentions to accept vaccination: subjective norms more supportive of HPV vaccination, greater worry about sexually transmissible infections, greater support for young people's sexual health services and greater support for childhood vaccination (F((4,236))=18.67, P<0.01; adjusted r²=0.23). Young women rated television advertisements, educational programs and television soaps as the most effective ways to encourage uptake of HPV vaccination. Uptake of HPV vaccination may be increased if interventions use appropriate media to promote social norms supportive of HPV vaccination.