Ignorance is not bliss: the impact of sources of information on HPV vaccination knowledge, attitudes, and intentions among unvaccinated young adults in Israel

Background: Human papillomavirus (HPV) is the leading cause of cervical cancer worldwide. Despite inclusion in Israel’s national immunization program, HPV vaccine uptake among young adults remains suboptimal. Understanding how information sources influence HPV vaccination knowledge, attitudes, and intentions may aid the design of effective public health interventions. Methods: This cross-sectional study (December 2023-February 2024) surveyed unvaccinated Israeli adults (18–26) to assess HPV vaccine knowledge, attitudes, intentions, and self-reported sources of HPV vaccine information. Sources were categorized as formal interpersonal, informal interpersonal, formal online/media, and informal online/media. Multivariable linear regression models examined associations between source types and three outcomes, HPV and HPV vaccine knowledge, attitudes, and intentions, adjusting for demographics. Results: Of 1972 respondents, 39% reported no prior HPV vaccine awareness. Among those reporting priori awareness, formal interpersonal sources were the most commonly cited (58.4%), while informal online/media was least used (25.3%). Participants who utilized multiple sources of information had significantly higher knowledge (β = 0.45, 95% CI: 0.17, 0.72, P =.001), attitudes (β = 1.33, 95% CI: 0.48, 2.18, P =.002), and intentions (β = 0.77, 95% CI: 0.47, 1.07, P <.001) scores compared to participants who did not use any sources of information. Compared to the use of at least one formal interpersonal source of information, lack of prior awareness was associated with lower scores across all outcomes (knowledge: β = -0.81, 95% CI: -1.05, -0.58, P <.001; attitudes: β = -2.72, 95% CI: -3.79, -1.64, P <.001; intentions: β = -0.96; 95% CI: -1.23, -0.69, P <.001). Using online/media sources was associated with lower attitude scores (β = -1.14, 95% CI: -1.96, -0.33, P =.006) compared to the use of at least one formal interpersonal source. Conclusion: Exposure to multiple source categories positively influences awareness of HPV vaccination outcomes, underscoring the need for multi-platform communication strategies. While formal interpersonal sources remain the most effective in fostering positive attitudes, further research is required to translate these attitudes into increased vaccine uptake.