Acceptance and the willingness to pay for human papilloma virus (HPV) vaccine: A systematic review

Human papillomavirus (HPV) is a major global health concern due to its link to cervical and other cancers. Although HPV vaccination is highly effective, acceptance and willingness to pay (WTP) differ widely across populations. This review summarizes global evidence from 2015-2025. A systematic search of PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar was conducted in 2025 following PRISMA guidelines. Studies reporting data on knowledge, acceptance, attitudes, and WTP across any population were included. Quality assessment used ISPOR checklists, and data were synthesized in Excel 2019. Thirty-five studies met inclusion criteria, with China and Nigeria contributing most. WTP ranged from 52.68% in lower-middle-income countries to 65.38% in low-income countries. Mean WTP was highest in upper-middle-income settings. Knowledge, positive attitudes, socioeconomic status, and trust increased WTP, while cost remained the primary barrier. Improving affordability, awareness, and policy support is essential to enhance global HPV.