Determinants of HPV vaccination acceptance among young adult women in Japan’s catch-up generation: A cross-sectional study

Despite the initiation of catch-up human papillomavirus (HPV) vaccination in Japan in April 2022, uptake remains suboptimal. Understanding determinants of vaccination behavior is essential to develop effective strategies to improve coverage. We aimed to identify factors associated with HPV vaccination acceptance in the target population. An online survey was conducted in May 2024 among all students at Saga University (n = 5777) using a web-based questionnaire. The survey included 30 items covering background characteristics, knowledge about HPV vaccine, and attitudes toward HPV vaccine. Female respondents aged 17-27 y, corresponding to the catch-up HPV vaccination target population, were included. Factors associated with vaccination acceptance were examined using multivariable logistic regression, adjusting for possible confounders related to baseline characteristics, knowledge, and attitudes. Data from 406 female respondents were analyzed, including 275 in the acceptance and 131 in the non-acceptance groups (acceptance rate, 68%). The median age was 20 y (interquartile range [IQR], 19-21) in both groups. The proportions of participants with ≥3 doses of COVID-19 vaccine (77% versus 59%) and those enrolled in the Faculty of Medicine (45% versus 15%) were higher in the acceptance group. Adequate knowledge about free vaccination (adjusted odds ratio [aOR] 3.86), routine vaccination (aOR 5.72), and obligation to make efforts to receive vaccination (aOR 2.21) were positively associated with acceptance, whereas anxiety about vaccination was negatively associated (aOR 0.37). These findings suggest that targeting knowledge gaps and vaccine-related anxiety through interventional studies may be key to improving HPV vaccine uptake in the catch-up generation.