Exploring Parental Hesitancy and Acceptance of HPV Vaccination in a Saudi Population

Human papillomavirus (HPV) vaccination is a major concern and highly effective strategy for preventing cervical cancer and other related diseases. Despite the inclusion of the HPV vaccine in the Saudi national immunization program and recent school-based initiatives, vaccine uptake remains suboptimal, mainly due to the hesitancy of parents. Evidence regarding HPV vaccine hesitancy in the Aseer region of Saudi Arabia is limited.

This study aimed to assess the level of the HPV vaccine hesitancy, knowledge, attitude and barriers among parents in the Aseer region of Saudi Arabia using the World Health Organization (WHO) HPV Vaccine Hesitancy Scale (VAS).

A cross-sectional study was conducted among parents residing in the Aseer region, Saudi Arabia. Data were collected using a structured questionnaire that included sociodemographic characteristics, knowledge, barriers and the validated nine-item WHO HPV Vaccine Hesitancy Scale. Data was expressed in numbers (%) for categorical variables and mean ± SD for continuous variables. Independent t-tests and one-way ANOVA were used for inferential statistics.

A total of 379 parents participated in the study. Overall, 49% of parents exhibited high HPV vaccine hesitancy. The most frequently reported barriers were safety concerns (82.6%), insufficient information (80.3%) and fear of side effects (79.4). Lower hesitancy scores were observed among parents aged ≥ 46 years than among those aged 18-25 years (p = 0.022), and respondents with postgraduate education were less hesitant than those with a high school education or less (p = 0.030). Parents whose children were fully vaccinated exhibited significantly lower hesitancy scores compared with those whose children were unvaccinated (p = 0.004).

The HPV vaccine hesitancy among parents in the Aseer region is greatly influenced by the age of the parents, their educational level, and the child's vaccination history. Higher hesitancy among younger parents, those with lower educational levels, and parents of unvaccinated children highlights priority groups for targeted interventions. Strengthening healthcare-provider recommendations and implementing culturally tailored, evidence-based communication strategies may improve HPV vaccine acceptance and support national cervical cancer prevention efforts in Saudi Arabia.