Information provision about cost coverage and parental HPV vaccination intentions: A randomized survey experiment in the Czech Republic

BACKGROUND: Out-of-pocket costs have been identified as a significant barrier to HPV vaccination uptake. To reduce this barrier, HPV vaccination for children is covered by public insurance in many countries, including the Czech Republic. Many parents are unaware of this policy. OBJECTIVE: To estimate the effect of information provision about cost coverage on parental intentions to vaccinate their children against HPV. METHODS: We conducted a survey experiment with two arms. In the control group, respondents were asked about their intentions to vaccinate their child against HPV. In the information treatment group, respondents were informed that the vaccine is provided free of charge for children aged 11-14 before stating their vaccination intentions. The sample consists of 2983 parents of children aged 0-14. RESULTS: Average prior price beliefs were 1880 CZK, indicating substantial misperceptions about the actual zero out-of-pocket cost for eligible children. The treatment and control groups were similar in observable characteristics, including reference-child gender and vaccination attitudes. Providing information about free HPV vaccination increases intended vaccination uptake by 15 pp (95% CI: 6.6-23.3 pp) among parents who believe they would otherwise pay the full market price, corresponding to a 26% increase. The average treatment effect is 7 pp larger for sons than for daughters and 5 pp larger among parents with more positive vaccination attitudes, as measured by COVID-19 vaccination status. CONCLUSION: Informing parents that HPV vaccination is available at no cost can increase intended uptake, indicating that insurance policies may be more effective when accompanied by targeted information campaigns.