HPV vaccine hesitancy among Chinese adults and its influencing factors in the context of improved vaccine accessibility

Background: HPV vaccination is crucial for preventing HPV-related diseases; however, vaccine hesitancy remains a global challenge. In China, given the increasing vaccine supply and optimized vaccination policies, understanding the current status and determinants of HPV vaccine hesitancy among adults is essential for improving vaccination coverage. Methods: A cross-sectional survey was conducted in China in 2024. Data were collected using a sociodemographic information form, an HPV knowledge questionnaire, the Vaccine Hesitancy Scale, and the WHO Vaccine Hesitancy 3Cs model. Descriptive statistics, chi-square tests, Mann-Whitney U tests, and binary logistic regression were utilized for data analysis. Results: A total of 967 adults participated in this study. The mean age was 33.41 years (SD = 8.71), and 84.4% were women. The overall HPV vaccine hesitancy rate was 19.86%, with 26.5% in men and 18.6% in women. Binary logistic regression analysis revealed that higher complacency, lower confidence and lower HPV knowledge were significant predictors of vaccine hesitancy. Conclusion: HPV vaccine hesitancy among adults is influenced by multiple factors, with higher complacency, lower confidence, and lower HPV knowledge being core issues. Future public health practices should develop personalized intervention strategies focused on improving HPV knowledge, particularly among men and older women. Concurrent efforts should be made to alleviate public complacency and rebuild vaccine confidence by disseminating scientific evidence through multiple channels to address cognitive and attitudinal barriers.