Knowledge, attitudes and acceptance of human papillomavirus vaccination among parents in Bahrain: a cross-sectional study

Human papillomavirus, or HPV, is a very common virus that spreads easily between people. While many infections cause no symptoms and clear up on their own, certain types of this virus can lead to serious health problems later in life, including cancers of the cervix, throat, and other areas. Because the virus is so widespread and the consequences can be severe, health experts have developed a vaccine to protect against the most dangerous types. This vaccine works best when given to children and young teenagers before they are ever exposed to the virus. However, because these children are too young to make their own medical decisions, the success of vaccination programs depends entirely on their parents. In many parts of the world, parents hesitate to vaccinate their children due to worries about safety, a lack of information, or cultural beliefs. Understanding what parents think and why they make the choices they do is essential for protecting the next generation from preventable diseases.

In Bahrain, a small island nation in the Persian Gulf, the government introduced a school-based program to give the HPV vaccine to boys and girls aged twelve to thirteen in October 2023. This was a significant step, as the country joined a global effort to eliminate cervical cancer. Yet, before this program began, very few adults in Bahrain knew much about the virus or the vaccine. To understand how this new program was being received, a team of researchers from the Arabian Gulf University and other institutions decided to listen directly to the parents. They wanted to know what parents knew about the vaccine, how they felt about it, and whether they would agree to have their children vaccinated if asked. The researchers conducted a survey between July and September 2025, speaking face-to-face with 368 parents who had brought their children to four different government health centers across the country. They asked questions about the parents' education, their jobs, their family income, and their views on the vaccine.

The results revealed a landscape of mixed awareness and cautious optimism. While most parents understood that HPV affects women and can cause cervical cancer, fewer than half had actually heard of the vaccine itself. Among those who had heard of it, knowledge was moderate; many knew the vaccine was for girls, but fewer realized it was also for boys, and many were unsure about how the virus spreads or what specific cancers it causes. Despite this gap in knowledge, the parents' willingness to vaccinate was surprisingly high. When the researchers asked parents who had not yet been offered the vaccine whether they would accept it if it were available, nearly 60 percent said yes. Among the smaller group of parents who had actually been offered the vaccine for their children, 70 percent had already accepted it. The primary reason for acceptance was trust in the Ministry of Health and the recommendation of doctors and nurses. Conversely, the main reason for hesitation was a fear of side effects. More than half of the parents said that worrying about potential side effects stopped them from vaccinating their children, and nearly all of the parents who refused the vaccine cited this fear as their main reason.

What the study found most interesting was that a parent's attitude mattered more than their knowledge. Parents who had a positive outlook on the vaccine were much more likely to be willing to vaccinate, regardless of how many facts they knew about the virus. Even parents who knew a lot about HPV were not necessarily more willing to vaccinate if they were worried about safety. The researchers discovered that two specific feelings drove the decision: confidence in the vaccine's benefits and the absence of fear regarding its safety. When parents trusted that the vaccine was necessary and safe, they were almost six times more likely to say yes. This suggests that simply giving parents more facts and figures about the virus might not be enough to change their minds. Instead, the most effective way to increase vaccination rates is to address their concerns directly and have trusted medical professionals, like the doctors and nurses they see at their local clinics, recommend the vaccine clearly and confidently.

The study also highlighted that social media and the internet were the most common sources of information for these parents, far more than doctors or hospitals. This is a double-edged sword, as online information can be both helpful and misleading. The researchers noted that while many parents said social media encouraged them, it did not significantly change their willingness to vaccinate compared to those who relied on other sources. The most powerful influence remained the personal recommendation from a healthcare provider. The study concluded that while Bahraini parents are generally open to the idea of HPV vaccination, the program needs to do more to inform them. By providing clear, reassuring information about safety and ensuring that doctors and nurses actively recommend the vaccine, the country can turn this existing willingness into actual protection for its children. The findings suggest that the path forward is not just about education, but about building trust and addressing the very real fears parents hold about the safety of the medicine they are asked to give their children.