National assessment of the HPV acceptance: Public attitudes and policy climate

Abstract Background: Human Papillomavirus (HPV) is a common sexually transmitted infection that has been associated with the development of cancers, most of them preventable if the HPV vaccine is administered before exposure. HPV school-entry policies could affect the HPV rates at a population level, hence the need for monitoring nationally the support of policies to assess acceptance at different levels. Objective: This study describes the state-level immunization program managers’ (IPMs) perception of the degree of the general public and policymakers’ acceptance or opposition to the HPV vaccine policies to increase HPV vaccination across their state or territory. Methods: As part of the study entitled Implementation of School-Entry Policies for Human Papilloma Virus Vaccination (HPV-PIVac), IPMs were surveyed about their perception regarding the acceptance or opposition of either (1) the public and (2) policymakers towards HPV vaccine policies. Five questions inquired about the degree of public concern towards HPV-related cancers, public hesitancy towards the HPV vaccine, public opposition towards HPV policies, and acceptance or resistance from policymakers regarding HPV vaccine policies using a five-item scale transformed into a three-item scale. Descriptive statistics were used to assess the managers perception about HPV vaccine policies. Fisher’s exact test was conducted to assess regional differences and the relationship between perception items from the public and policymakers. Results: 49 IPMs from 32 different states and territories participated in this study. In relation to the public concern towards HPV-related cancers, 93.8% of IPMs perceived that the public from their participant states and territories had moderate/mild concern. In comparison, only 6.3% perceived strong/overwhelming concern. For public hesitancy towards the HPV vaccine, 81.3% of IPMs perceived that the public had moderate/mild hesitancy, while 18.8% perceived strong/overwhelming reluctance. For public opposition towards HPV vaccine policies, 21.9% of IPMs perceived strong/overwhelming opposition. On the other hand, 40.6% of IPMs reported that the policymakers were resistant to education policies that promote the HPV vaccine. Similarly, 59.4% of IPMs reported that policymakers were resistant to HPV-school entry vaccination policies. No significant differences between regions were observed in the items analyzed (p>0.05). Fisher’s exact test indicated a significant association between the public opposition towards the HPV vaccine policies and the posture of policymakers towards HPV education policies (p<0.05). Conclusion: Results highlight that IPM’s perceive moderate/mild hesitancy and moderate/mild opposition by the public towards HPV vaccines and HPV policies; these attitudes could translate into resistance towards HPV policies by policymakers in the US. Findings support the need for active public engagement strategies to increase policymakers' support for promoting HPV vaccine policies and requirements. Funding: NCI Grant #R01CA232743. Citation Format: Yiana G. Toro-Garay, Alondra K. Mercado-Andino, Olga L. Diaz-Miranda, Diana T. Medina-Laabes, Ana P. Ortiz, Katelyn Wells, Erick Suárez, Vivian Colón-López. National assessment of the HPV acceptance: Public attitudes and policy climate [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A129.