HPV vaccination services and incentives preferences of Chinese daughters’ caregivers: a discrete choice experiment

Abstract Objective To investigate Chinese caregivers’ preferences for human papillomavirus (HPV) vaccine attributes, vaccination service delivery models, and incentive strategies for adolescent girls. Methods In this cross-sectional study, two discrete choice experiments (DCEs) were conducted to examine the preferences of caregivers of unvaccinated adolescent girls aged 9–18 for HPV vaccination. The two DCEs respectively addressed vaccine profile attributes and vaccination service delivery attributes. Data were collected from hospitals and community health service centers in Jiangsu and Zhejiang provinces in China. Mixed logit models were used to estimate caregivers’ preferences and predict uptake across different vaccine and service delivery scenarios. Results A total of 301 caregivers completed DCE questionnaires. The median age of the caregivers was 41 years (interquartile range (IQR): 38–44). Protection against cervical cancer (relative importance (RI) = 25.2%) and risk of severe side effects (RI = 21.3%) were the most influential factors in caregivers’ vaccination decisions, followed by protection against genital warts (RI = 20.3%), cost (RI = 11.9%) and place of manufacture (RI = 11.6%), all showing statistically significant effects ( p < 0.05). Regarding HPV vaccination service, the sources of recommendations (RI = 35.3%), incentives (RI = 19.5%), vaccination location (RI = 17.5%), message frame (RI = 13.1%) and appointment methods (RI = 12.4%) were found to have significant effects ( p < 0.05). Predicted vaccine uptake increased by 40.8% when raising protection against both cervical cancer and genital warts to 90%, and service uptake rose by 54.5% when combining doctor recommendations, school-based vaccination and altruistic incentives. Conclusion These findings highlight that integrated strategies combining evidence-based HPV vaccine education, culturally sensitive service delivery, and incentives may improve vaccination coverage among adolescent girls in China and support progress toward global cervical cancer elimination targets. Clinical trial number Not applicable.