Indian Parents Prefer Vaccinating their Daughters against HPV at Older Ages

  • Madhivanan, Purnima ;
  • Srinivas, Vijaya ;
  • Marlow, Laura ;
  • Mukherjee, Soumyadeep ;
  • Narayanappa, Doddaiah ;
  • Mysore, Shekar ;
  • Arun, Anjali ;
  • Krupp, Karl
  • Published : 2014.01.15


Background: Increasing uptake of human papillomavirus (HPV) vaccine should be a priority in developing countries since they suffer 88% of the world's cervical cancer burden. In many countries studies show that age at vaccination is an important determinate of parental acceptability. This study explores parental preferences on age-to-vaccinate for adolescent school-going girls. Materials and Methods: The sample was selected using a two-stage probability proportional to size cluster sampling methodology. Questionnaires were sent home with a random sample of 800 adolescent girls attending 12 schools in Mysore to be completed by parents. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and appropriate age-to-vaccinate. Results: HPV vaccination acceptability was high at 71%. While 5.3% of parents felt girls should be vaccinated by 10 years or younger; 38.3% said 11-15 years; 14.8% said 16-18 years; 5.8% suggested over 19 years; and 33% didn't know. Only 2.8% of parents would not vaccinate their daughters. Conclusions: Delaying HPV vaccination until later ages may signifivantly increase uptake of the HPV vaccine in India.


Age;girls;human papillomavirus;immunization;vaccine;India


  1. Durex Network. "The Face of Global Sex 2007. First Sex: An Opportunity of a Lifetime."2013.
  2. Demarteau N, Breuer T, Standaert B (2012). Selecting a mix of prevention strategies against cervical cancer for maximum efficiency with an optimization program. Pharmacoeconomics, 30, 337-53.
  3. Dempsey AF, Zimet GD, Davis RL, Koutsky L (2006). Factors that are associated with parental acceptance of human papillomavirus vaccines: A randomized intervention study of written information about HPV. Pediatrics, 117, 1486-93.
  4. Diaz M, Kim JJ, Albero G, et al (2008). Health and economic impact of HPV 16 and 18 vaccination and cervical cancer screening in India. Br J Cancer, 99, 230-8.
  5. Gakidou E, Nordhagen S, Obermeyer Z (2008). Coverage of cervical cancer screening in 57 countries: Low average levels and large inequalities. PLoS Med, 5, 132.
  6. Globocan 2008. "Cancer Fact Sheet.", accessed 09/13, 2013.
  7. Madhivanan P, Krupp K, Yashodha MN, et al (2009). Attitudes toward HPV vaccination among parents of adolescent girls in Mysore, India. Vaccine 27, 5203-8.
  8. Marlow Lav, Jo Waller, Jane Wardle(2007). Parental attitudes to pre-pubertal HPV vaccination. Vaccine, 25, 1945-52.
  9. Tsui J, LaMontagne DS, Levin C, Bingham A, Menezes L (2009). Policy development for human papillomavirus vaccine introduction in low-resource settings. Open Vaccine J, 2, 113-22.
  10. Zhang SK, Pan XF, Wang SM, et al(2013). Pereeptons and acceptability of HPV vaccination among parents of young adolescents: A multicenter national survey in China. Vaccine, 31, 3244-9.
  11. Basu P, Roychowdhury S, Bafna UD, et al (2009). Human papillomavirus genotype distribution in cervical cancer in India: Results from a multi-center study. Asian Pac J Cancer Prev, 10, 27-34.
  12. Biellik R, Levin C, Mugisha E, et al (2009). Health systems and immunization financing for human papillomavirus vaccine introduction in low-resource settings. Vaccine, 27, 6203-9.
  13. CDC (2013). HPV Vaccine-Questions & Answers.2013.
  14. Das D, Rai AK, Kataki AC, et al (2013). Nested multiplex PCR based detection of human papillomavirus in cervical carcinoma patients of North-East India. Asian Pac J Cancer Prev, 14, 785-90.

Cited by

  1. Knowledge, Acceptance, and Willingness to Pay for Human Papilloma Virus (HPV) Vaccination among Female Parents in Thailand vol.15, pp.13, 2014,
  2. Mothers' Knowledge and Attitudes about HPV Vaccination to Prevent Cervical Cancers vol.15, pp.17, 2014,
  3. Knowledge, Attitudes and Beliefs about Cervical Cancer and Human Papilloma Virus Vaccination with Related Factors in Turkish University Students vol.15, pp.8, 2014,
  4. Knowledge of Human Papillomavirus Infection, Cervical Cancer and Willingness to pay for Cervical Cancer Vaccination among Ethnically Diverse Medical Students in Malaysia vol.16, pp.14, 2015,
  5. Possible non-sexual modes of transmission of human papilloma virus vol.43, pp.3, 2017,
  6. Perceptions of and barriers to vaccinating daughters against Human Papillomavirus (HPV) among mothers in Hong Kong vol.14, pp.1, 2014,