Title: Willingness and hesitancy towards the governmental free human papillomavirus
vaccination among parents of eligible adolescent girls in Shenzhen, Southern China
Version: 0 Date: 01 Mar 2024
Reviewer:  Towhid Rahman
Reviewer's report:
Excellent piece of work. Many developing country governments have recently incorporated
the HPV vaccine into their national immunization schedules. This study proves to be highly
beneficial for them. The study setup is well-structured, and the findings are both remarkable
and intriguing.
Despite the inherent limitations of quantitative research, it is evident that it may not reveal causal
relationships, and one of the primary objectives of the study was to identify vaccine hesitancy
on a scale. However, the discussion section requires further exploration of some findings. This
is because the Vaccine Hesitancy Score might not capture the full spectrum of information.
The statement, "an overwhelming 91.7% of parents of unvaccinated girls expressed willingness
to utilize the government's free vaccination services," is emphasized greatly. However,
concurrently, 80.8% of respondents expressed concerns about serious side effects, 80.2%
believed that important vaccines are safer and more effective than domestic ones, and 81.3%
concurred that new vaccines carry more risks than traditional ones. These aspects should be
discussed in the discussion section as well. Focusing only on the willingness of 91.7% of
parents may overshadow other crucial findings, potentially leading policymakers to overlook the
underlying sentiments of the respondents. This part of the discussion could give the impression
that the authors prioritize positive findings over acknowledging certain concerns.
This study observed that parents and children with more secure medical insurance were more
inclined to refuse free HPV vaccines. Similarly, parents of children in public schools and
those who had been vaccinated against HPV themselves showed less willingness to utilize
governmental vaccination services. This finding is particularly intriguing. The explanation could
delve into greater detail than what is currently provided. This finding suggests that individuals
with the financial means to access medical treatments may not be as inclined to take preventive
measures. Perhaps they rely on regular screenings and other measures against HPV infection
due to their ability to afford them. Since they have alternative options to address the crisis,
they may be less willing to avail the government’s free services. This may also indicate a lack
of confidence in government-provided services, suggesting that if given a second option, they
would prefer that over the government’s service. This group could pose a threat to the overall
infection load.
An even more intriguing finding is that women who received HPV vaccines are less willing
to vaccinate their daughters. This prompts a question: were they vaccinated with a domestic
or imported vaccine? While it seems likely that they received imported vaccines, clarification
on this point is necessary. Exploring why they perceive the vaccine as less important for their
daughters, even after getting vaccinated themselves, could warrant further discussion.
Apart from these findings, I believe the manuscript represents an outstanding piece of scientific
work! I recommend acceptance of the manuscript with a few revisions in the discussion part.