The importance of social norms for uptake of catch-up human papillomavirus vaccination in young women

Background: Human papillomavirus (HPV) is the cause of almost all cases of cervical cancer. The current UK government immunisation program includes free routine HPV vaccination of girls aged 12-13, with a catch-up vaccination program for 13-18-year-old girls. The aim of this study was to identify correlates of intended and actual uptake of catch-up HPV vaccination. Methods: An online questionnaire was completed by 591 young women aged 16-20. Results: Of the 350 women who had been offered catch-up HPV vaccination, 90.6% had accepted. In multivariate analyses, vaccine uptake was significantly correlated with subjective norms more supportive of HPV vaccination, and greater uptake of other childhood vaccinations (chi(2) ((3)) = 39.34, P < 0.01; 91.1% correctly classified; Nagelkerke pseudo-r(2) = 0.23). Among the 241 women aged 16-20 who had not been offered HPV vaccination, the average intention was 3.70 on a five-point scale. Multivariate analyses revealed four significant independent predictors of stronger intentions to accept vaccination: subjective norms more supportive of HPV vaccination, greater worry about sexually transmissible infections, greater support for young people's sexual health services and greater support for childhood vaccination (F((4,236)) = 18.67, P < 0.01; adjusted r(2) = 0.23). Young women rated television advertisements, educational programs and television soaps as the most effective ways to encourage uptake of HPV vaccination. Conclusions: Uptake of HPV vaccination may be increased if interventions use appropriate media to promote social norms supportive of HPV vaccination.