Abstract / Summary
Human papillomavirus (HPV) vaccination is a preventive health intervention for persistent high-risk HPV infection that causes cervical and other HPV-associated cancers. Despite the availability of effective HPV vaccines and the integration of vaccination into national preventive strategies in many countries, uptake depends on factors beyond availability. Therefore, it is important to understand the influence of health literacy on preventive healthcare decisions about HPV vaccination. It is established that the link between health literacy and vaccination varies by group, age, and vaccine, and emerging work on vaccine literacy indicates that this link is not unidirectional. Evidence on HPV-specific health literacy is stronger among university students, showing a positive association between health literacy and knowledge of HPV, with knowledge scores varying between vaccinated and unvaccinated students, and health-literacy issues have been identified as both enablers of and barriers to college students’ vaccination decision-making. Based on the evidence, the paper argues that health literacy should be considered an integral part of HPV vaccination programmes, but not the cure-all for vaccine hesitancy. Health literacy affects vaccination as part of a wider health system alongside other factors such as provider recommendation, social influence, affordability, access, gender-based attitudes, culture, misinformation, and other health-system barriers. The paper also recommends a health-literacy–sensitive framework of accessible communication, trustworthy information, provider engagement, culturally sensitive information, digital health literacy, vaccination decision support, and easy vaccination access.