Health beliefs and vaccine costs regarding human papillomavirus (HPV) vaccination among a U.S. national sample of adult women.

Abstract

Health beliefs have been found to be significant predictors of vaccine acceptability and uptake, including attitudes about HPV vaccine. In this study, we examined whether the predictive strength of health beliefs varied as a function of vaccine cost among adult women. During April 2009, data were collected from a nationally representative internet sample of 1323 US-resident women aged 27-55 years. Participants completed items related to sociodemographics, health beliefs, and HPV vaccine acceptability. Acceptability was measured at three levels of cost: free, $30/dose, and $120/dose. Multiple linear regression (MLR) revealed that health belief variables accounted for 29.7% of the variability in overall HPV vaccine acceptability. However, there was a linear and significant decrease in R(2) values from 0.31 for a free vaccine, to 0.25 for a $30/dose vaccine, to 0.11 for a $120/dose vaccine. The results confirm previous findings that health beliefs predict HPV vaccine acceptability. However, the predictive strength of the association decreased with increasing cost. These findings suggest that interventions designed to increase vaccination by modifying health beliefs may have limited effect unless cost is minimized as a barrier.