Awareness and Acceptance of the Human Papillomavirus (HPV) Vaccine and Associated Factors Among Parents of Adolescents (9-18 Years) at a Children's Hospital in Babol, Iran: A Cross-Sectional Study.

BACKGROUND AND AIMS: High-risk human papillomavirus (HPV) infection is a major cause of cervical and other anogenital cancers, and vaccination is an effective preventive strategy when administered during adolescence. Because parental decision-making plays a central role in adolescent vaccination uptake, this cross-sectional study aimed to assess parental awareness, attitudes, and barriers related to HPV infection and HPV vaccination, as well as demographic factors associated with vaccine awareness, among parents of adolescents attending a tertiary pediatric hospital in Babol, Iran. METHODS: In this cross-sectional survey, 300 parents of children aged 9-18 years who attended inpatient wards or outpatient clinics at Shafizadeh Children's Hospital were consecutively recruited. Data were collected using a structured questionnaire assessing demographic characteristics, awareness of HPV and HPV vaccination, attitudes toward vaccination, and perceived barriers and motivators. Associations between parental awareness of HPV vaccination and demographic variables were analyzed using chi-square tests, independent-samples t-tests, and Mann-Whitney U tests, as appropriate. RESULTS: Awareness of HPV infection and HPV vaccination was reported by 43.7% and 38.3% of parents, respectively, while only 14.7% correctly identified the recommended age for vaccination. HPV vaccination uptake was very low; only 4 parents (1.3%) had received the vaccine themselves, and 2 (0.7%) had vaccinated their children. Although 52.7% of parents were classified as having a favorable attitude toward HPV vaccination, 96.7% cited high cost and 34.0% limited availability as major barriers. Knowledge of HPV vaccination was significantly higher among parents who were younger, had a university education, resided in urban areas, worked in medical or professional occupations, and had higher household income (p < 0.001). CONCLUSION: Parental awareness of HPV vaccination and actual vaccine uptake were low despite generally favorable attitudes. Structural barriers, particularly high cost and limited availability, appear to be major factors linked to poor uptake. Integrating HPV vaccination into national immunization programs, improving insurance coverage, and implementing targeted educational interventions may increase vaccination rates among Iranian adolescents.