Stage of adoption of the human papillomavirus vaccine among college women

Prev Med. 2009 May;48(5):420-5. doi: 10.1016/j.ypmed.2008.12.005. Epub 2008 Dec 24.


Background: Certain types of human papillomavirus (HPV) can cause cervical and other cancers. A vaccine that protects against HPV types responsible for 70% of cervical cancers is available to females ages 9-26.

Objective: To examine correlates of stage of vaccine adoption among women ages 18-22.

Methods: In 2007, female students (n=4774) at a New England University in the U.S. were invited to complete an on-line survey that assessed knowledge of HPV, perceived susceptibility, severity, vaccine benefits/barriers, social and subjective norms, and stage of vaccine adoption

Results: 1897 women (40%) responded; complete data were available for 1401. About half (53%) were planning to be vaccinated, 12% had received the vaccine, 15% were undecided, and 7% had decided against vaccination. HPV knowledge was low (mean 58%). In multivariate analyses, social norms was the strongest correlate of stage; each standard deviation increase in social norms score was associated with more than four times the odds of intending to be vaccinated within the next 30 days, compared with those who had decided against vaccination (OR=4.15; 95% CI 2.17-6.36).

Conclusions: Acceptance of the vaccine was high, although misconceptions about viral transmission, availability of treatment, and the role of Pap tests were common. Perceived norms were strongly associated with intentions. Interventions on college campuses should stress vaccination as a normative behavior, provide information about viral transmission, and stress the role of continued Pap screening.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Health Care Surveys
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Immunization Programs / statistics & numerical data*
  • Intention
  • New England
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / therapeutic use*
  • Patient Acceptance of Health Care / psychology*
  • Students
  • Universities
  • Uterine Cervical Neoplasms / prevention & control
  • Young Adult


  • Papillomavirus Vaccines