Identifying factors associated with intention to recommend HPV vaccination among US parents with vaccinated children

HPV vaccination is effective in preventing cancer and is recommended for children as early as age 9. However, the HPV vaccination rate remains well below the target goal of 80 % for adolescents in the United States. Receiving recommendations from parents who have already vaccinated children can prompt vaccination norms among those who have not. Yet factors associated with recommendation behavior remain underexplored. Our paper identifies behavioral and social determinants associated with intention to recommend HPV vaccination to others among parents who had their children vaccinated. Participants were a national sample of 1019 American adults recruited from a Qualtrics Panel from August to October 2023. The survey assessed key constructs related to vaccination communication and behavior, demographic characteristics, and attitudes to HPV vaccination. We used the path model of Structural Equation Modeling to examine relationships among the constructs. We found that HPV-related risk appraisal, HPV vaccine effectiveness and safety, vaccination norms, recommendations received, and ability of information seeking are primarily correlated with attitudes towards HPV vaccination and intention to recommend HPV vaccination to others. The study makes unique contributions in several ways, as it is among the first to examine relationships among parents who have already vaccinated their children.