Untangling the Roots of HPV Vaccine Acceptance in West Virginia: How Hesitancy and Misinformation Shape Parental Decisions.

BACKGROUND

West Virginia is of particular concern regarding HPV vaccine hesitancy, currently ranking 45th among U.S. states in HPV vaccine uptake. General vaccine hesitancy and HPV- and HPV vaccine-specific misinformation, both associated with lower vaccination, have increased in recent years, complicating efforts to identify key drivers of HPV vaccine acceptance and effective intervention targets.

METHODS

This study used a Qualtrics survey of n = 330 parents of children aged 0-14 in West Virginia. Measures included parental HPV vaccine acceptance for their youngest child (reflecting either completed vaccination or intention to vaccinate), general vaccine hesitancy measured using the Vaccine Hesitancy Scale (VHS), and endorsement of nine common HPV- and HPV vaccine-specific misinformation statements. Misinformation items were summed and demonstrated good internal reliability (Cronbach's α = 0.868).

RESULTS

Hierarchical logistic regression analyses indicated significant racial/ethnic differences across all model steps, with non-White parents less likely to report HPV vaccine acceptance for their child (p < 0.001). In Step 2, lower levels of general vaccine hesitancy predicted higher HPV vaccine acceptance (p < 0.001). In the final model, higher endorsement of HPV- and HPV vaccine-specific misinformation was associated with lower HPV vaccine acceptance (p = 0.035).

CONCLUSIONS

These findings underscore the independent and additive influence of general vaccine hesitancy and HPV- and HPV vaccine-specific misinformation on parental HPV vaccine acceptance in West Virginia. Community-engaged public health strategies should prioritize strengthening vaccine confidence and directly addressing HPV- and HPV vaccine-specific misinformation, particularly among underserved populations.