Beyond Political Lines: How Reproductive Health Attitudes Drive Caregivers’ HPV Vaccine Decisions

Abstract Human papillomavirus (HPV) vaccine hesitancy remains a critical public health issue, with political identity and reproductive health beliefs potentially influencing caregivers’ decisions. This study investigated the interplay between birth control attitudes, political identity, and HPV vaccine hesitancy among caregivers of children aged 9–17 years. A cross-sectional survey was administered to 2,086 participants across the Northeastern and Southeastern/Mid-Atlantic United States. The sample was weighted to reflect demographic distributions. Political identity (Conservative, Moderate, Liberal), birth control attitudes, and HPV vaccine hesitancy were assessed. Multiple regression analyses examined the main effects and interactions.Over half of the sample showed HPV vaccine hesitancy. Positive birth control attitudes strongly predicted lower HPV vaccine hesitancy in all. Although political identity contributed additional variance, its effect was more pronounced in the Northeast than in the Southeast/Mid-Atlantic. Moderates and Liberals generally reported lower hesitancy than Conservatives. These findings highlight the importance of reproductive health attitudes in shaping HPV vaccination decisions. While political identity also matters, it is overshadowed by the stronger predictive role of birth control attitudes. Interventions aiming to reduce HPV vaccine hesitancy may benefit from integrating broader reproductive health education and carefully navigating political influences to foster more positive vaccine views.