{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:22:41Z","timestamp":1783686161972,"version":"3.55.0"},"reference-count":52,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: West Virginia is of particular concern regarding HPV vaccine hesitancy, currently ranking 45th among U.S. states in HPV vaccine uptake. General vaccine hesitancy and HPV- and HPV vaccine-specific misinformation, both associated with lower vaccination, have increased in recent years, complicating efforts to identify key drivers of HPV vaccine acceptance and effective intervention targets. Methods: This study used a Qualtrics survey of n = 330 parents of children aged 0\u201314 in West Virginia. Measures included parental HPV vaccine acceptance for their youngest child (reflecting either completed vaccination or intention to vaccinate), general vaccine hesitancy measured using the Vaccine Hesitancy Scale (VHS), and endorsement of nine common HPV- and HPV vaccine-specific misinformation statements. Misinformation items were summed and demonstrated good internal reliability (Cronbach\u2019s \u03b1 = 0.868). Results: Hierarchical logistic regression analyses indicated significant racial\/ethnic differences across all model steps, with non-White parents less likely to report HPV vaccine acceptance for their child (p &lt; 0.001). In Step 2, lower levels of general vaccine hesitancy predicted higher HPV vaccine acceptance (p &lt; 0.001). In the final model, higher endorsement of HPV- and HPV vaccine-specific misinformation was associated with lower HPV vaccine acceptance (p = 0.035). Conclusions: These findings underscore the independent and additive influence of general vaccine hesitancy and HPV- and HPV vaccine-specific misinformation on parental HPV vaccine acceptance in West Virginia. Community-engaged public health strategies should prioritize strengthening vaccine confidence and directly addressing HPV- and HPV vaccine-specific misinformation, particularly among underserved populations.<\/jats:p>","DOI":"10.3390\/vaccines14070608","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:43:34Z","timestamp":1783683814000},"page":"608","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Untangling the Roots of HPV Vaccine Acceptance in West Virginia: How Hesitancy and Misinformation Shape Parental Decisions"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6903-7464","authenticated-orcid":false,"given":"Jeanine P. D.","family":"Guidry","sequence":"first","affiliation":[{"name":"Department of Communication and Cognition, Tilburg University, 5037 AB  Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3272-9317","authenticated-orcid":false,"given":"Linnea I.","family":"Laestadius","sequence":"additional","affiliation":[{"name":"Joseph J. Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8138-4741","authenticated-orcid":false,"given":"Yil","family":"Engbersen-Severijns","sequence":"additional","affiliation":[{"name":"Department of Health Psychology, Open University, 6419 AT Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie A.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA 23219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, School of Medicine, West Virginia University, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace W.","family":"Burton","sequence":"additional","affiliation":[{"name":"School of Nursing, York University, Toronto, ON M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie E.","family":"Carlyle","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, School of Public Health, Virginia Commonwealth University, Richmond, VA 23219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6470-3192","authenticated-orcid":false,"given":"Janina-Marie","family":"Huss","sequence":"additional","affiliation":[{"name":"West Virginia University School of Medicine, West Virginia University Health System, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Moffett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-215X","authenticated-orcid":false,"given":"Paul B.","family":"Perrin","sequence":"additional","affiliation":[{"name":"School of Data Science, Department of Psychology, University of Virginia, Charlottesville, VA 22904, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref_1","unstructured":"National Cancer Institute (2025, July 01). 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