Abstract
Background: Human papillomavirus (HPV) is a common sexually transmitted infection associated with cervical cancer. Since 2008, HPV vaccines have been available in Saudi Arabia, and in 2022, a nationwide school-based vaccination program was launched to improve coverage and reduce HPV-related diseases. Objectives: This study evaluated parental knowledge and acceptance of the HPV vaccine during a school-based vaccination campaign in Rabigh, Saudi Arabia. It also examined associations between demographic factors, parental knowledge, and vaccine acceptance. Methods: A cross-sectional study involved 261 guardians of girls attending intermediate schools in Rabigh during the academic years 2022/2023, 2023/2024, and 2024/2025. Data were collected through an online questionnaire assessing HPV vaccine knowledge, acceptance, and influencing factors. Chi-square tests were used for analysis. Findings: Vaccine acceptance increased with guardians' educational qualification, from 46.7% among those with primary or middle school to 89.3% among those with higher education (P = 0.007). Acceptance also increased with family income, from 45.2% (income < 5000 SR) to 77.7% (income ≥ 10,000 SR) (P = 0.002), and was higher when information was obtained from health practitioners (90.4%) or the Internet (80.4%) compared to relatives or social media (47%) (P < 0.001). Respondents with a knowledge score ≥80% were more likely to accept the vaccine (84.2% versus 67.3%, P = 0.04). Recommendations from the Ministry of Health (MOH) or physicians were key motivators for vaccination. Concerns about vaccine safety were the primary reason for refusal (48.1%). Among non-accepting parents, 59.5% reported that more information on benefits and safety would encourage acceptance, while 22.8% remained unwilling to vaccinate. Conclusion: Parental knowledge, education, and income significantly influenced HPV vaccine acceptance. Parents informed by healthcare professionals or the Internet were more likely to vaccinate their daughters. Targeted efforts raising awareness of vaccine benefits and safety from trusted sources like physicians and the MOH are essential.