A Systematic Review on the Factors Influencing Human Papillomavirus Vaccination Uptake among Asian Americans and Pacific Islanders in the U.S.

Asian Americans and Pacific Islanders (AAPI) have low vaccination rates of Human Papillomavirus (HPV) and a high incidence rate of HPV-related cancers, particularly cervical cancer. HPV-related diseases are preventable with the HPV vaccine, which has been widely recommended but nonmandatory in the U.S. This research aims to examine the attitudes and behaviors towards HPV vaccination uptake. By examining current literature, it asks: What are the key factors that influence vaccine hesitancy in the AAPI population in the U.S. Vaccine hesitancy refers to the behavior to delay acceptance or refuse vaccines, even though vaccination services are available. A systematic review was conducted on databases PubMed, ProQuest, and Academic Search Premier using inclusion and exclusion criteria. After title/abstract screening and full-text assessment, 31 articles were eligible and included in this research. The conceptual model of vaccine hesitancy was adapted and used to guide thematic analysis. Fifteen themes were identified based on vaccine hesitancy and HPV vaccine uptake. Although some themes may have a greater weight on an individual’s decision to vaccinate; collectively, these themes portray a comprehensive picture of the AAPI population. The results align well with the conceptual model of vaccine hesitancy and its 4 domains: the role of public health and vaccine policies, the role of media and communications, the role of health professionals, and the individual decision-making process. The findings in this systematic review have future implications in vaccination policies, population-based research, and culturally competent interventions.