Determinants of willingness to vaccinate against HPV among adults: an Italian cross-sectional study

Abstract Background In Italy, heterosexual males over the age of 18 do not participate in the free-of-charge HPV vaccine offer, nor do women over the age of 26, with regional differences; however, they can vaccinate for a fee. This survey aims to assess the vaccination readiness of the 18-40 year old population group, their perceived need with respect to the vaccine, and the determinants of the vaccination choice. Methods A questionnaire-based cross-sectional study targeting the general population in the 18-40 age group has been ongoing since March 2024. Recruitment occurs through social media and flyers. Demographic characteristics, social determinants, deprivation index by area via HAZ (health action zone) method (SR: -15;25), risk factors, main barriers to vaccination are assessed. Our main outcome is HPV vaccination willingness. People already vaccinated were excluded from the analysis. Descriptive and logistic regression analyses were performed with Jamovi. Results Our preliminary results included 159 individuals of whom 57.2% would like to receive HPV vaccine. The main characteristics of the sample were: median age 30 years (IQR:26.5;34), 47.2% female gender, median deprivation index 3.7 (IQR:-0.2;7.1), 75% working, 11.9% from the LGBTQ+ community. Regarding barriers, 31.9% rated fatigue in accessing the vaccine as significant, 10.4% feared a risk in receiving the vaccine. Among the people who did not want to vaccinate or did not know, 75% would do so by paying less than the normal amount, 21.6% if free, and 3.4% would not vaccinate anyway. Vaccination willingness was positively associated with female gender (OR:3.1; p = 0.026) and belonging to the LGBTQ+ community (OR:10.0; p:0.050) and negatively associated with working status (OR:0.19; p = 0.013). Conclusions Socioeconomic barriers appeared to play a significant role in the choice to vaccinate. Policies to reduce economic barriers could increase vaccination in an uncovered but still potentially sexually active population. Key messages • Coverage of HPV vaccine is not yet at optimal thresholds, yet people excluded from free vaccination programs could benefit from vaccination incentive policies. • Vaccination intention among heterosexual men is significantly lower than among women in the same age group, a symptom that there would still be room for awareness-raising interventions on the issue.