Factors Associated with HPV Vaccination Among Japanese Women: A Cross-Sectional Study Using the 7 C Vaccination...

Human papillomavirus (HPV) vaccination rates in Japan declined after the suspension of the government's proactive recommendation in 2013. Vaccination behavior is influenced by knowledge as well as psychological and social factors. This study examined factors associated with HPV vaccination among Japanese women using the 7 C vaccination readiness model. A cross-sectional online survey was conducted among Japanese women aged 15-49 years in February 2025. Data on demographic characteristics, HPV vaccination status, self-reported knowledge of the HPV vaccine, and 7 C vaccination readiness were collected. Factors associated with HPV vaccination were analyzed using logistic regression, with separate analyses by student status (students vs. non-students). Among 1,200 participants, 339 (28.3%) had received the HPV vaccine. Multivariable analysis showed that younger age, non-student status, greater self-reported knowledge, and higher Constraints and Compliance scores were independently associated with vaccination. Associations were observed for self-reported knowledge (OR 2.12, 95% CI 1.88-2.38, p < 0.001), Constraints (OR 1.49, 95% CI 1.27-1.76, p < 0.001), and Compliance (OR 1.32, 95% CI 1.15-1.51, p < 0.001). In analyses stratified by student status, greater self-reported knowledge and higher Constraints and Compliance scores were significantly associated with vaccination in both groups. These findings suggest that HPV vaccine education may include vaccine-related information and practical guidance on vaccination sites, costs, eligibility, and appointment procedures. It may also include opportunities to discuss vaccination-related concerns to address barriers reflected in Constraints, as well as balanced explanations of public-health measures intended to promote high vaccination coverage to address attitudes captured by Compliance.