Sociocultural determinants influencing HPV vaccine acceptance in parents, adolescents, and young adults: A systematic review

Cultural and social beliefs significantly shape norms around HPV vaccination and influence decisions made by parents and individuals. Understanding behaviors related to HPV vaccine uptake is essential for reducing HPV-related cancers. This systematic review examined sociocultural determinants of HPV vaccine acceptance among parents, adolescents, and young adults, using a wide geographic scope and including both Persian and English studies. Following PRISMA guidelines, databases such as PubMed, Scopus, Web of Science, SID, and Google Scholar were searched for articles published up to August 30, 2025. Study selection was guided by the PICO framework, and MeSH terms including Papillomavirus Vaccines, Vaccination Hesitancy, Vaccine Acceptance, Social Factors, and Sociocultural Factors were used. Findings showed that HPV vaccine acceptance is shaped by multiple interrelated factors. Key barriers included limited knowledge, misinformation, misconceptions, and poor understanding of HPV-related risks. Safety concerns, fear of side effects, and sociocultural stigma linking vaccination to sexual activity further reduced uptake. Economic challenges—such as high costs, lack of insurance coverage, and limited access to healthcare—also hindered acceptance. In contrast, strong facilitators included physician recommendations, trust in the healthcare system, family support, belief in vaccine efficacy, higher perceived risk, positive media exposure, and availability of free vaccination. Parental age and education also exerted varying effects. Overall, HPV vaccine acceptance is deeply influenced by social and cultural determinants, including knowledge, stigma, religious norms, trust in healthcare, and economic accessibility. To improve uptake, national immunization strategies and reproductive health programs must integrate these determinants. Policymakers should prioritize evidence-based communication, culturally tailored education, equitable financing, and strong intersectoral collaboration to support sustainable HPV vaccination efforts and advance health equity.