Background: Cervical cancer remains a significant global public health challenge, with persistent human papillomavirus (HPV) infection recognized as its primary cause. Vaccination against HPV is a highly effective primary prevention measure. However, vaccine hesitancy poses a critical barrier to achieving optimal immunization coverage. Varied levels of public awareness, socioeconomic conditions, regional accessibility, and other factors can affect the population’s attitude. Understanding the specific factors in Inner Mongolia Autonomous Region is essential for developing targeted strategies to enhance vaccine acceptance, reduce cervical cancer incidence, and align with national health objectives.
Objectives: To understand the current status and influencing factors of HPV vaccine hesitancy among the female population in the Inner Mongolia Autonomous Region, in order to provide policy recommendations for reducing HPV vaccine hesitancy and lowering the incidence and mortality of cervical cancer among women in this region.
Methods: This study is part of a national multicenter research project. The study used multi-stage sampling, and was conducted among the female population in Inner Mongolia Autonomous Region from August to December 2022. The questionnaire was self-designed based on published literature and originated from the Cancer Hospital Chinese Academy of Medical Sciences. SPSS 24.0 was used for statistical analysis. The demographic characteristics of the participants (including place of residence, education level, and annual household income) were presented using frequencies and percentages. The chi-square test was used to analyze the differences between HPV vaccine knowledge, attitudes towards HPV vaccination, social environmental factors, and HPV vaccine hesitancy. Binary logistic regression was employed to analyze the influencing factors of HPV vaccine hesitancy.
Results: A total of 1200 questionnaires were distributed, with 1037 valid questionnaires recovered, yielding an effective response rate of 93%. The HPV vaccine hesitancy rate among the female population in Inner Mongolia was 24.5%. Logistic regression analysis indicated that the place of permanent residence was an influencing factor for HPV vaccine hesitancy among women in Inner Mongolia (OR=0.718, 95% CI: 0.521-0.991, P<0.05). 
Conclusions: The findings indicate a considerable level of HPV vaccine hesitancy among women in the Inner Mongolia Autonomous Region. Lower annual household income (below 40,000 CNY) and place of permanent residence were identified as significant factors associated with hesitancy. These results underscore the need for targeted public health interventions aimed at improving HPV vaccine awareness and acceptance, particularly among economically disadvantaged groups and across diverse residential settings. Enhancing education, addressing safety concerns, and implementing context-specific vaccination promotion strategies are essential to reduce hesitancy, improve vaccine uptake, and ultimately lower the burden of cervical cancer in the region.

Comparison of HPV Vaccine Hesitancy Across Different Demographic Characteristics