Organizational barriers in HPV vaccination amongst health sciences students

Abstract Background Human Papillomavirus (HPV) is the most diagnosed sexually transmitted infection causing significant global cancer burden. Despite effective vaccination, Italian coverage is suboptimal. Healthcare students are crucial future promoters; their adherence impacts public health. This study investigates HPV vaccination determinants (organisational and individual) amongst health sciences students informing targeted interventions. Methods Cross-sectional study, from October through December 2024 at the University of Naples Federico II, surveyed healthcare students using a validated and anonymous questionnaire. Data included socio-demographics, HPV vaccination status (outcome), invitation status, attitudes (Likert scale), and knowledge (true/false test). Multivariate logistic regression identified predictors, with sensitivity analysis including knowledge/attitudes. Results Amongst 354 health sciences students (mean age 23; 73.45% female), HPV vaccination coverage was 54.80%. Sensitivity analysis showed lower odds with increasing age (OR 0.80; 95% CI 0.71-0.91) and higher odds for females (OR 6.82; 95% CI 3.57-13.01). Receiving invitations (OR 2.57; 95% CI 1.33-4.97) and positive attitudes (OR 2.79; 95% CI 1.56-4.98) predicted higher adherence to HPV vaccination. Knowledge was non-significant (OR 0.98; 95% CI 0.95-1.01). Course year, geographic origin and smoking status showed no association with vaccination outcomes in any model. Conclusions HPV vaccination coverage (54.80%) amongst healthcare professions is suboptimal. Key drivers for adherence to vaccination are females, young age, receiving invitations, and positive attitudes. Knowledge alone is not a determinig factor. Proposed strategies are: active calls, focusing interventions on attitudes especially males, and facilitating university access. The expected Public Health impact is an increase in coverage amongst future healthcare professionals, enhancing their ability to act as vaccination promoters. Key messages • 55% HPV coverage amongst healthcare students in Naples. Age, gender (OR 6.82), invitation (OR 2.57) and attitude (OR 2.79) key factors; knowledge non-significant. • Targeted interventions on attitude (OR 2.79) and active call (OR 2.57) are crucial to increase HPV vaccine adherence amongst future healthcare professionals.