Screening yes, vaccine no? Women’s attitudes about adolescent HPV vaccination in Central Romania

Background

Romania reports alarming prevalence and incidence rate for cervical cancer compared to the European average. Against this background, our study aims at identifying the predictors of vaccination attitudes of women for their children (to be born).

Methods

This research is based on a survey conducted among participants at a free cervical cancer screening caravan in Romania’s Central Region. Data collection was carried out with the assistance of health professionals next to the mobile screening unit. Sample size is 818 women from central Romania with a mean age of 44,5 years. The questionnaire entailed a standardized HPV literacy scale, and HPV vaccination attitude was measured with a simple question with binary answer option. Determinants of vaccination attitudes are assessed in a binary logistic regression model.

Results

56,4% of respondents are planning, whereas 43,6% are not intending to vaccinate their child(ren). Higher HPV literacy is significantly associated with positive vaccination attitudes (Exp(B)=1,339). Women with the lowest education are three times more likely to refuse the vaccination of their children compared to the reference category with tertiary education (Exp(B)=0,304). The odds for a pro vaccination attitude decreases with every additional year of age (Exp(B)=0,972). A history of cervical cancer in the microsocial network significantly increases ro vaccination attitudes (Exp(B)=2,028).

Conclusions

In spite of the fact that our respondents themselves engaged in preventive behaviour and attended the HPV screening, a large share is reluctant to the vaccination of their children against the same infection. The improvement of HPV-related knowledge would contribute to the increase in pro vaccination attitudes. Interventions are needed in all social groups, but most of all among the least educated women. Health campaigns should make use of the fact that women with a cervical cancer history are most genuine ambassadors of health messages.

Key messages

• There is a gap between screening participation and prevention through vaccination against HPV.

• HPV literacy and exposure to cervical cancer in the social network are key drivers of vaccine acceptance.