Cited by 17Cervical Cancer and HPV ResearchVaccine Coverage and HesitancyWomen's cancer prevention and management

Indian Parents Prefer Vaccinating their Daughters against HPV at Older Ages

Open access
Madhivanan, Purnima, Srinivas, Vijaya, Marlow, Laura, Mukherjee, Soumyadeep, Narayanappa, Doddaiah, Mysore, Shekar, Arun, Anjali, Krupp, Karl·2014·Asian Pacific Journal of Cancer Prevention

Abstract

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 significantly increase uptake of the HPV vaccine in India.

AI snapshot

Written from the paper’s full text.

TL;DR

This survey of parents of adolescent schoolgirls in Mysore, India found high HPV vaccination acceptability (71%) but a preference for vaccinating daughters at older ages, with 38.3% choosing 11–15 years and 20.6% choosing 16 years or older. Only 2.8% said they would not vaccinate their daughters.

Key findings

  • HPV vaccination acceptability was high at 71%; 5.3% of parents preferred vaccination by age 10 or younger, 38.3% preferred 11–15 years, 14.8% preferred 16–18 years, 5.8% preferred over 19 years, and 33% did not know.
  • Of the 43.6% of parents who thought the appropriate age to vaccinate was less than 15 years, 81% were likely to accept HPV vaccination for their daughter, compared with 70% of those who thought the appropriate age was over 15 years; among the 35.9% unsure of the appropriate age, 60.6% found HPV vaccination acceptable.
  • Religion was associated with preferred age: about 41% of Hindus, 51% of Muslims, and 64% of parents of other religions said they would consider early vaccination for their daughters (p=0.0009); no association was found with other demographic characteristics.
  • Main vaccine information sources included television (85%), newspaper or radio (79%), internet (43%), doctors (86%), friends or neighbors (60%), other healthcare workers (54%), daughter’s school (82%), and family members or relatives (63%).

Methods

  • Between February and December 2010, a questionnaire survey was conducted among parents in a cluster of 12 schools in Mysore City, India; eligible parents had an adolescent school-going daughter ages 11–15, could read and understand English or Kannada, and could give informed consent.
  • A two-stage probability proportional to size cluster sampling methodology was used; 800 female students in 7th–10th grades were randomly selected to take surveys home, with one parent per household completing and returning the questionnaire within seven days.
  • Of 797 returned surveys, 19 were excluded because they lacked a signed consent form, leaving 778 for analysis; data were analyzed using Stata 10.1 and SAS 9.3, with cluster sampling adjusted via “proc surveyfreq,” descriptive statistics, and bivariate Chi-square tests (2-tailed, p<0.05).

Limitations

  • The paper states that the study used only parents of school-going children, so it may not represent the population as a whole; even among parents of school-going children, certain segments may not have been represented in the selected institutions.
  • The paper notes strengths including a high response rate, minimal missing data, and a randomly selected study population.
  • Evident from the text: the design is a cross-sectional, self-reported questionnaire survey, and a large proportion of parents (33%) were unsure about the appropriate vaccination age, which may limit interpretation of preferences.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.7314/apjcp.2014.15.1.107

Cites

12 of 12 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

1 of 8 cited sources checked · 1 supported · 0 flagged

  • Premisecitation

    Screening three times in a lifetime reduces cervical cancer risk by 21-33%.

    “Screening three times in a lifetime reduces cervical cancer risk by 21-33% (Diaz et al., 2008).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Diaz et al., 2008 source
  • Findingown data

    Only 2.8% of parents would not vaccinate their daughters against HPV.

    “Only 2.8% of parents would not vaccinate their daughters.”
    Quote in the paperNot a substantial claim
  • Findingown data

    HPV vaccination acceptability was high at 71% among parents of adolescent school-going girls in Mysore.

    “HPV vaccination acceptability was high at 71%.”
    Quote in the paperNot a substantial claim
  • Findingown data

    5.8% of parents suggested over 19 years as the appropriate age to vaccinate girls against HPV.

    “5.8% suggested over 19 years”
    Quote in the paperNot a substantial claim
  • Findingown data

    20.6% of parents favored late vaccination (16 years or older) for their daughters against HPV.

    “20.6% favored late vaccination (16 years or older)”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 14
  • May combine two claims. 2
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    79% of parents said newspaper or radio was a main way of getting information about vaccines.

    “79% said newspaper or radio”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    82% of parents reported getting information from their daughter's school on vaccinations.

    “A vast majority (82%) reported getting information from their daughter's school on vaccinations”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    54% of parents said other healthcare workers were a source of information about vaccines.

    “54%, other healthcare workers”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    43% of parents said the internet was a main way of getting information about vaccines.

    “43%, the internet”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most parents (85%) reported television as their main way of getting information about vaccines.

    “Most parents (85%) reported television as their main way of getting information about vaccines”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Among parents who thought the appropriate age to vaccinate was less than 15 years (43.6%), 81% were likely to accept HPV vaccination for their daughter, compared to 70% of those who thought the appropriate age was over 15 years.

    “Of the 43.6% of parents who thought the appropriate age to vaccinate was less than 15 years, 81% were likely to accept HPV vaccination for their daughter as compared to 70% of those who thought the appropriate age to vaccinate was over 15 years of age.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    63% of parents said they relied on family members or relatives for information about vaccinations.

    “63% said they relied on family members or relatives for this information.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    About 41% of Hindus, 51% of Muslims, and 64% of parents of other religions said they would consider early vaccination for their daughters (p=0.0009).

    “About 41% of Hindus, 51% Muslims and 64% of parents of other religions said they would consider early vaccination for their daughters (p=0.0009).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    60% of parents said friends or neighbors were a source of information about vaccines.

    “60%, friends or neighbors”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Prophylactic HPV vaccination can reduce the burden of cervical cancer in India by more than 75%.

    “Estimates suggest that prophylactic HPV vaccination can reduce the burden of cervical cancer in India by more than 75% (Basu et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Basu et al., 2009
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Of 797 returned surveys, 19 were excluded from analyses because they were returned without a signed consent form.

    “Of the 797 returned surveys, 19 were excluded from analyses because they were returned without a signed consent form.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    A qualitative study in the same population suggested that many parents preferred vaccinating girls against HPV after puberty.

    “A qualitative study carried out in the same population suggested that many parents preferred vaccinating girls against HPV after puberty.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Madhivanan et al., 2009 source
  • Classified as probably not a substantial claim.

    Premisecitation

    Most parents in the qualitative study felt that younger girls were unlikely to be sexually active and therefore should not receive an HPV vaccination until they were adolescents or young adults.

    “Most felt that younger girls were unlikely to be sexually active and therefore should not receive an HPV vaccination until they were adolescents or young adults (Madhivanan et al., 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Madhivanan et al., 2009 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study had a high response rate.

    “The study also has important strengths including a high response rate, minimal missing data and a randomly selected study population.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study had minimal missing data.

    “The study also has important strengths including a high response rate, minimal missing data and a randomly selected study population.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study had a randomly selected study population.

    “The study also has important strengths including a high response rate, minimal missing data and a randomly selected study population.”
    Quote in the paperNot a substantial claim
16 of 16
  • The paper relies on this without support.

    Little research on vaccine acceptability has been carried out in India.

    “Despite these facts, little research on vaccine acceptability has been carried out in India, a country with one of the highest incidence of cervical cancer in the world.”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Incorrect percentage for 36-40 age-group respondents who were unsure

    Minor

    The table reports 84 unsure respondents out of 257 in the 36-40 age group as 34.71%. The percentage is 32.68%.

    Reported 34.71 · recomputed 32.684825

  • Conflicting percentages unsure about vaccination age

    Minor

    The abstract says 33% did not know when girls should be vaccinated, while the Results describes 35.9% as unsure of the appropriate age.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. 2009, Asian Pac J Cancer Prev, 10, 27

Cited by

Sorted by citations

Authors
Madhivanan, P., Srinivas, V., Marlow, L., Mukherjee, S., Narayanappa, D., Mysore, S., Arun, A., & Krupp, K.
Affiliations
Florida International University (US)
Venue
Asian Pacific Journal of Cancer Prevention
Published
2014-01-15
Volume
15
Issue
1
Pages
107-110
ISSN
1513-7368 (ISSN-L)
OpenAlex
W2165561342
Cited by
17
References
11
Citations by year
2026: 2 · 2025: 3 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 2 · 2014: 4
FWCI
2.03
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Asian Pacific Journal of Cancer Prevention (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Commons (Providence College) (submittedVersion, cc-by)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
Cancer Research UK (14134)
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords
HPV vaccination, HPV vaccine, parental preferences, age at vaccination, vaccine uptake, adolescent girls, cervical cancer prevention, vaccine acceptance, India
MeSH terms
Adolescent, Adult, Age Factors, Uterine Cervical Neoplasms, Child, Female, Humans, India, Health Knowledge, Attitudes, Practice, Middle Aged, Parent-Child Relations, Parents, Surveys and Questionnaires, Vaccination, Papillomavirus Infections, Young Adult, Patient Preference

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-16.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-16.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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