Parental knowledge, attitude and acceptability of Human Papillomavirus vaccine: implications for the prevention of cervical cancer in India

Abstract The Human Papillomavirus (HPV) vaccine is a key tool for cervical cancer prevention; however, vaccine uptake in India remains low despite its recent introduction as a free single-dose vaccine through the public health system. Parental acceptance to vaccination is key to ensure vaccine uptake of adolescent girls. Hence, this study was conducted to assess the knowledge, attitude and acceptability of HPV vaccination parents of adolescent girls, during the early phase of HPV vaccine rollout. This community-based cross-sectional study was conducted among 422 parents of adolescent girls, during the early phase of HPV vaccine rollout in the country, to assess their knowledge, attitude and acceptability of HPV vaccination. Only 18.2% of participants had heard of HPV infection, 6.6% identified HPV as the primary cause of cervical cancer, and 8.5% had heard of the HPV vaccine, with only 5.9% demonstrated good knowledge of vaccination. Despite limited knowledge, 48.8% had a positive attitude, 62.6% demonstrated good acceptability, and 72.7% expressed willingness for vaccination. Higher parental education and healthcare-related occupations were associated with greater vaccine acceptability in bivariate analysis. Significant positive correlations were observed among knowledge of HPV infection and cervical cancer, HPV vaccine knowledge, attitudes, and vaccine acceptability ( p < 0.001). These findings highlight persistent knowledge gaps despite moderate-to-high acceptability. Targeted interventions using community health workers (ASHAs) and digital platforms are needed to improve informed decision-making and support equitable HPV vaccine uptake in disadvantaged settings, contributing to India’s cervical cancer elimination goals.