J Epidemiol Community Health 63:1010-1015 doi:10.1136/jech.2008.085886
  • Research reports

Ethnic differences in human papillomavirus awareness and vaccine acceptability

Open Access
  1. J Waller
  1. Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
  1. Correspondence to Dr L Marlow, Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, UK; l.marlow{at}
  • Accepted 21 May 2009
  • Published Online First 17 September 2009


Background: Studies of human papillomavirus (HPV) awareness and HPV vaccine acceptability have included few non-white participants, making it difficult to explore ethnic differences. This study assessed HPV awareness and HPV vaccine acceptability in a sample of women representing the major UK ethnic minority groups.

Methods: A cross-sectional study design was used to assess awareness of HPV and acceptability of HPV vaccination. Participants were recruited using quota sampling to ensure adequate representation of ethnic minority women: Indian, Pakistani, Bangladeshi, Caribbean, African and Chinese women (n = 750). A comparison sample of white British women (n = 200) was also recruited.

Results: Awareness of HPV was lower among ethnic minority women than among white women (6–18% vs 39% in white women), and this was not explained by generational status or language spoken at home. In a subsample who were mothers (n = 601), ethnicity and religion were strongly associated with acceptability of HPV vaccination. Acceptability was highest among white mothers (63%) and lowest among South Asians (11–25%). Those from non-Christian religions were also less accepting of the vaccine (17–34%). The most common barriers to giving HPV vaccination were a need for more information, sex-related concerns and concern about side-effects. South Asian women were the most likely to cite sex-related concerns, and were also least likely to believe the vaccine would offer their daughters protection.

Conclusion: These findings suggest some cultural barriers that could be addressed in tailored information aimed at ethnic minority groups. They also highlight the importance of recording ethnicity as part of HPV vaccine uptake data.


  • ▸ Additional material is published online only at

  • Funding This study was supported by Cancer Research UK.

  • Competing interests J Wardle has previously received funds for research and consultancy fees from Sanofi Pasteur MSD and GSK Biologicals. J Wardle, J Waller and L Marlow have received honoraria for speaking at seminars and funding for travel to conferences from Sanofi Pasteur MSD and GSK Biologicals.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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