Drivers of HPV vaccine hesitancy in New York and Florida

Background: This study aimed to identify drivers of HPV vaccine hesitancy and effective public health interventions to increase HPV vaccination rates in two U.S. states (New York and Florida) and 12 counties within each state. The findings provide insights into the impact of demographics, state policies, and vaccine confidence on HPV vaccination.

Methods: We utilized a mixed-method approach, integrating quantitative analysis of county-level surveys, qualitative interviews, and secondary data on HPV vaccine coverage. Surveys, adapted from the Vaccine Confidence Project (VCP) and the World Health Organization (WHO), assessed HPV vaccine confidence, socio-demographics, and behavioral determinants. Interviews explored barriers, interventions, and policies related to HPV vaccination.

Findings: Parents and providers have not prioritized HPV vaccination compared to other vaccines, with less concern about HPV than other vaccine-preventable diseases. Socio-demographic factors, such as race, age, gender, religion, employment, and income impacted children's vaccination status. Female parents aged 35–44 and those with a professional degree were more likely to vaccinate their children. Perceptions of the vaccine's importance and safety significantly influenced vaccination.

Interpretation: Identifying socio-demographic determinants and behavioral motivators can guide targeted interventions. Our study highlights complex factors influencing HPV vaccination at the state and county level, offering policymakers strategies to tailor interventions addressing barriers and hesitancy in areas with lower vaccination rates.