Sociodemographic determinants of HPV vaccine awareness, uptake, and intention among parents of adolescents in France 2021-22

Abstract

Human Papillomavirus (HPV) vaccine coverage was <50% in France in 2022 and even lower among socially disadvantaged populations. We aimed to evaluate socio-demographic determinants of HPV vaccine awareness, uptake, and intention among parents of adolescents, and related attitudes and knowledge items. Parents of adolescents attending middle schools across France, who participated in a randomized trial responded to an anonymous baseline survey, conducted between November 2021 and February 2022. We used logistic regression models adjusting for a child's age and sex to explore sociodemographic determinants (including at-home multilingualism, occupational categories, local deprivation index and urbanity) of HPV vaccine awareness, uptake, and intention. Among the 1889 participants from 61 schools, parents working as factory workers/farmers had significantly lower odds of vaccine awareness compared to executives/professionals, both if they reported (OR = 0.07; 0.03-0.15) or not (OR = 0.20; 0.11-0.36) speaking also another language than French at home. Parents in lower occupational categories with multilingual families were less likely to have the intention to vaccinate their child (OR = 0.19; 0.07-0.56). Recent physician visit or vaccine offer was strong positive determinants of awareness, uptake and intention. A substantial gradient across occupational categories was observed for attitudes and knowledge around HPV vaccine usefulness, safety, and accessibility. This study confirms the disparities on HPV vaccine uptake in France and provides insight into mechanisms of social disparities in HPV vaccine awareness, access and intention.

Keywords: HPV; adolescent vaccination; awareness; human papillomavirus vaccine; intention; parents; social determinants; uptake.

Figure 1.

HPV-related outcomes among included parents of adolescents in France, 2021–2022 (N = 1,889).

Figure 2a.

Figure 2b.

Distribution of attitude (a) and knowledge (b) items regarding HPV vaccination among parents who have heard about HPV vaccination or are not sure, by occupation. France, 2021-22 (N=1,717). * = p-value <0.05; ** = p-value <0.01; Chi-square test on prevalences across the categories.

Figure 3.

Distribution of occupational categories across all respondents and respondents who link (correctly or falsely) various diseases to HPV infection. Parents who have heard about HPV vaccination or are not sure, France, 2021–22 (N = 1,717).