Perceptions and acceptability of HPV vaccination among parents of female adolescents 9–14 in China: A cross-sectional survey based on the theory of planned behavior

ABSTRACT HPV vaccine uptake remains low in China, especially among girls. Recently, China has initiated a pilot program on HPV immunization for girls 9–14. From November to December 2021, a cross-sectional study was conducted among parents of girls 9–14 in China through a web-based anonymous online questionnaire survey. Descriptive epidemiological analysis was used to analyze parental acceptability. Hierarchical regression analysis and structural equation modeling were to determine associated factors. A total of 5623 participants were included in the analysis. 21.2% girls had received HPV vaccine, and 94.3% parents intended to receive vaccination for their daughters, the Kappa values between them was −0.016. 31.9% of vaccinated mothers had received HPV vaccine for their daughters, vaccination history had a positive impact on behavior ( β  = 0.048). Attitude ( β  = 0.186), subjective norms ( β  = 0.148) and perceived behavioral control ( β  = 0.648) had a positive impact on intention. Vaccination intention mediated the relationships between attitude ( β  = 0.044), subjective norms ( β  = 0.035), and perceived behavioral control ( β  = 0.154) with behavior. There is a gap between vaccination intention and behavior in parents of girls 9–14. Perceived behavior control had a strong association on HPV vaccination behavior.