Has your doctor recommended HPV vaccine? Yes No Do not have a doctor |
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HPV vaccine protects against genital warts. True False |
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HPV vaccine protects against genital cancer. True False |
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HPV vaccine protects against head and neck cancer. True False |
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Have you received HPV vaccine? Yes No |
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How many doses of HPV vaccine have you received? 0 1 2 3 4 5 |
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If you have not received all doses, what is the reason for not finishing the HPV vaccine series? |
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What is the main reason you accept/decline HPV vaccine? |
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What source of HPV information do you trust most? Family/Friends Doctor News Media Social Media
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Select one response for each statement
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Strongly agree
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Agree
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Do not know
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Disagree
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Strongly disagree
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HPV vaccine is important for the health of girls/women |
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HPV vaccine is important for the health of boys/men |
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I do not plan to receive HPV vaccine |
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I plan to complete the HPV vaccine series |
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I have already completed the HPV vaccine series |
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HPV vaccine is safe |
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HPV vaccine is effective in preventing genital cancers |
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HPV vaccine is effective at preventing head/neck cancers |
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I have friends who have received HPV vaccine |
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I am concerned about short-term side effects |
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I am concerned HPV vaccine has long-term health risks |
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HPV vaccine is unnecessary |
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HPV vaccine costs more than I can afford |
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Receiving HPV vaccine will change my sexual behaviors |
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It is hard to find time to get all doses of HPV vaccine |
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It is hard to find a place to get all doses of HPV vaccine |
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I would get HPV vaccine if my doctor recommended it |
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I have enough information to make a decision about receiving HPV vaccine. |
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