Attitudes of mothers of pre-adolescent girls on HPV vaccine in Italy. Do we need a turning point?

To investigate the knowledge, awareness and attitude of mothers of preadolescent girls regarding the HPV vaccination and cervical cancer, and to understand how to improve the efficacy of the Italian vaccination campaign through the gathered data.A questionnaire-based survey was conducted in mothers of unvaccinated 9 to 12-year-old (yo) girls in Italy from November 2018 to July 2019, to evaluate their awareness and the attitude toward HPV, its vaccination and the information sources of the vaccination campaign. The selection of the distribution sites of the questionnaire was performed with randomization of 50 major places of aggregation located throughout the Italian territory.Three hundred mothers of unvaccinated girls were included in the study and divided into two groups (191 subjects45yo, 109 subjects45yo). Results showed that 79.6% of45yo knew what HPV is, compared to 60.6% of45yo (p-value0.001); only 60.2% (45yo) and 54.1% (45yo) showed awareness about the HPV vaccine (p-value 0.03). The percentage of parents against vaccination in pre-adolescent was higher in the45yo (29.4%); however, most of them appeared favorable to the information campaigns regarding the vaccine (p-value0.001).Our study showed that mothers of unvaccinated pre-adolescent girls have suboptimal knowledge on the topic. Moreover, the implementation of communication strategies dedicated to the population segment appears as a central aspect. As HPV vaccination keeps being a public health concern, it is fundamental to understand which trigger should be managed by healthcare decision makers in order to boost the vaccination campaigns.