Parental intentions to vaccinate their daughters for HPV. A cross-sectional nationwide study in Greece using the COM-B model

Human papillomavirus (HPV) infection is a common sexually transmitted disease in men and women worldwide. It accounts for the appearance of benign papillomatous or precancerous lesions, which sometimes can be evolved into cancer, especially in the anogenital area. For prevention, a vaccine is available worldwide including Greece, for girls and boys aged 9-18 years. The responsibility for the vaccination usually lies with parents/guardians. This study aimed to measure parental intention to vaccinate their daughters against HPV and identify the determinants that affect it. From September 2021 to March 2022, a cross-sectional nationwide study was carried out among a representative sample of students, and through them their parents/guardians, using multistage stratified sampling. 46 schools in the territory participated, with a representative sample of 3,203 parents/guardians of female students aged 11-18 years, who completed an anonymous questionnaire created based on the Capability, Opportunity, Motivation - Behavior (COM-B) and Theoretical Domain Framework (TDF) models. 905 parents out of the 1358 who hadn’t vaccinated their daughters (66.6%) mentioned that they intended to do so or complete vaccination. Knowledge about the vaccine (p < .001), fear of possible side effects (p < .001), relief that serious diseases could be avoided (p <.001), expert influence (p < .001), and reminders through email (p = .048) were the significant determinates of parents' intention to vaccinate their daughters. The interconnected COM-B and TDF models are suitable frameworks for targeted interventions to foster HPV vaccination.