Interest in the HPV vaccine and the potential role of financing and health promotion policies: A perspective from California

Initial uptake of the HPV vaccine has been limited, and there is mixed evidence regarding disparities in vaccine coverage across sociodemographic and health care access subgroups. We assessed whether cross-group differences in vaccine coverage may be attributable to differences in (a) interest in vaccination and (b) willingness to pay full price for the vaccine, or receive it for free or much lower cost. Using data from the California Health Interview Survey (CHIS) 2007, we examined correlates of interest in, and willingness to pay for, the HPV vaccine among unvaccinated adult women ages 18 to 27 (n = 1,878), and parents of unvaccinated daughters ages 12 to 17 (n = 2,866). Independent variables of interest included sociodemographics, including race/ethnicity, education, income, immigration status, and marital status; and health care access, including health insurance, number of physician visits in the last 12 months, and usual source of care other than the emergency room. Among adult women ages 18 to 27 who had not received the HPV vaccine, 59.8% were interested in being vaccinated. There were no significant differences in vaccine interest across sociodemographic and health care access subgroups. Ninety-eight percent of vaccine-interested adult women were either willing to pay $360 for the vaccine, or willing to receive it if it were available for free or at much lower cost. Among parents of daughters ages 12 to 17 who had not received the HPV vaccine, 58.6% were interested in giving daughter the HPV vaccine. Parents who were Hispanic, had fewer than 12 years of education, and were on Medicaid or other public health insurance were more likely to be interested in the vaccine than parents of other ethnicities, those with more education, or those with private insurance. More than 99% of vaccine-interested parents were either willing to pay $360 for the vaccine, or willing to give the vaccine to a daughter if it were available for free or at much lower cost. Interest in HPV vaccination is high among some groups at highest risk of cervical cancer. Across subgroups, there is extraordinarily high willingness to receive HPV vaccines for free or at low cost. These findings suggest the potential of private and public access and financing programs to promote widespread HPV vaccine coverage.