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Vaccination attitudes and HPV vaccine uptake among Croatian university students

Introduction: The attitudes regarding vaccination are significant for predicting individuals’ vaccination behavior and are connected with one’s knowledge about vaccines. Studies have shown the low uptake of the human papillomavirus (HPV) vaccine among university students. This study aimed to explore associations between the attitudes regarding vaccination and knowledge about HPV and HPV vaccine as well as to explore the association between the aforementioned attitudes and HPV vaccine uptake among Croatian university students. Methods: From the February to May 2021 period a cross-sectional questionnaire study was conducted in a cross-faculty representative student sample of the University of Osijek in Eastern Croatia. A validated, anonymous, self-administered questionnaire that contained questions regarding demographic data, data about HPV vaccine uptake, data regarding knowledge about the HPV virus and the vaccination as well as the Vaccination Attitudes Examination Scale (VAX scale) served as a research tool. The lower scores on the VAX scale reflect more positive vaccination attitudes. Results: The study sample included 840 subjects with, median age of 20 years (interquartile range 20-21), 45.8% males, and 54.2% females. The median VAX scale score was 39.0 (interquartile range 32.0-46.0). The prevalence of HPV vaccination uptake in the observed population was 20.8%. Regarding the knowledge about the HPV virus and the vaccination among all study participants, there were 25.6% of those with poor, 26.4% of those with good, and 48.0% of those with very good knowledge. The participants who were vaccinated with the HPV vaccine had significantly more positive vaccination attitudes in comparison to non-vaccinated participants (p<0.001). The participants with very good knowledge about the HPV virus and the vaccination had significantly more positive vaccination attitudes in comparison to other participants (p<0.001). Discussion and conclusions: Even though the majority of Croatian university students had a satisfactory level of knowledge about the HPV virus and the vaccination present study revealed that the observed population had strong general vaccine hesitancy as well as low HPV vaccine uptake. The study confirmed the existence of associations between vaccination attitudes, knowledge about the HPV virus, and the vaccination and HPV vaccination uptake in the Croatian university student population. A better understanding of the attitudes that underlie vaccine hesitancy and factors that modify these attitudes are important for developing public health interventions intended to increase HPV vaccine uptake among Croatian university students. Further studies are needed.

human papillomavirus ; vaccination ; university students ; attitudes ; knowledge ; Croatia

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