Factors Influencing Maternal Acceptance of Human Papillomavirus Vaccination for Their School-Aged Daughters in Fukuoka Prefecture, Japan

Aims: The aim of this study was to elucidate the factors that influence maternal acceptance of human papillomavirus (HPV) vaccination for their school-aged daughters.
Study Design: The survey was cross-sectional and conducted using an anonymous self-administered questionnaire.
Place and Duration of Study: Two middle schools and 10 high schools in Fukuoka prefecture, between November 2012 and April 2013.
Methodology: The cross-sectional survey was conducted on mothers (n=1,407) with daughters aged 13-16 years, and an anonymous self-administered questionnaire was used. The items were HPV vaccination status of daughter, knowledge of the HPV vaccine and cervical cancer, attitude toward the HPV vaccine and general vaccinations, and communication with daughters about cervical cancer. The questionnaire was distributed and collected through the junior high school students and the high school students. Variables were extracted related to the daughters’ state of vaccination, and subsequently multivariate logistic regression analysis was performed.
Results: Eight factors of mothers were extracted related to daughters’ HPV vaccination in order of strong influential: attitude placing importance on cost-free vaccination (OR, 9.26; 95% CI,3.42-25.0), sense of parental obligation (OR, 4.65; 95% CI, 2.30-9.43), trust in the effectiveness of vaccine (OR, 3.91; 95% CI,2.41-6.34), trust in the government’s handling of vaccination (OR, 2.40; 95% CI,1.49-3.86), communication with daughters (OR, 2.04; 95%CI, 1.28-3.22), trust in the safety of vaccine (OR, 1.81; 95% CI,1.04-3.15), threat of cervical cancer (OR, 1.80; 95% CI,1.14-2.86), and knowledge of the HPV vaccine (OR,1.23; 95%CI, 1.06-1.43).
Conclusion: HPV vaccination of school-aged girls was promoted by passive factors of mothers: attitude toward free vaccination through a public subsidy and a sense of parental obligation. Further enhancement of education for HPV prevention is urgently needed.