The association between adolescents' knowledge and perception of HPV vaccination and parents' characteristics: A cross-sectional study

Background: In Italy, the anti-Human Papillomavirus (HPV) vaccination campaign began in 2008. To date, despite the effectiveness and safety of HPV vaccines, coverage among Italian adolescents is still suboptimal. Evidence suggests that different factors could influence parents' choices regarding their children's vaccination uptake. Aim: This study aimed to assess the association of parents' sociodemographic characteristics and vaccine hesitancy with adolescents' perceptions and knowledge of the HPV/HPV vaccine. Methods: A cross-sectional study was conducted among Italian students aged 11-13 and their parents. The data were collected by structured questionnaires including sociodemographic questions, the HPV Adolescent Vaccine Intervention Questionnaire (HAVIQ) to assess students' knowledge and perceptions on HPV/HPV vaccination, and the Parent Attitudes about Childhood Vaccines (PACV) Survey to measure parents' vaccine hesitancy. Results: This study involved 74 adolescents and 74 parents. Overall, adolescents showed high levels of confidence in "involvement in decision-making", "self-efficacy", "feelings" and "knowledge" factors of the HAVIQ. 94.6 % of parents were categorized as "non-hesitant" reporting a PACV overall score < 50. Having one or both parents with a university degree in the family was statistically associated with higher students' knowledge (p = 0.048) and lower feelings of fear and anxiety (p = 0.011). Conclusions: This study identified parents' characteristics related to adolescents' knowledge and perceptions regarding the HPV/HPV vaccination. Specifically, results showed that parents' educational level was associated with adolescents' knowledge and feelings about HPV and HPV vaccination. These factors in turn could play a pivotal role in a shared vaccine decision-making process between parents and their children.