Open Access Research article

Parents’ preferences for vaccinating daughters against human papillomavirus in the Netherlands: a discrete choice experiment

Robine Hofman1*, Esther W de Bekker-Grob1, Hein Raat1, Theo JM Helmerhorst2, Marjolein van Ballegooijen1 and Ida J Korfage1

Author Affiliations

1 Department of Public Health Erasmus MC, University Medical Centre, Rotterdam, P.O. Box 2040 3000, CA, The Netherlands

2 Department of Obstetrics and Gynaecology Erasmus MC, University Medical Centre, Rotterdam, P.O. Box 2040 3000, CA, The Netherlands

For all author emails, please log on.

BMC Public Health 2014, 14:454  doi:10.1186/1471-2458-14-454

Published: 15 May 2014



To generate knowledge about potential improvements to human papillomavirus (HPV) vaccination information and organization strategies, we assessed how aspects of HPV vaccination are associated with parents’ preferences for their daughters’ uptake, and which trade-offs parents are willing to make between these aspects.


A discrete choice experiment (DCE) was conducted among parents with a daughter aged 10–12 years. Panel mixed logit regression models were used to determine parents’ preferences for vaccination. Trade-offs were quantified between four vaccination programme aspects: degree of protection against cervical cancer, duration of protection, risk of serious side-effects, and age of vaccination.


Total response rate was 302/983 (31%). All aspects influenced respondents’ preferences for HPV vaccination (p < 0.05). Respondents preferred vaccination at age 14 years instead of at a younger age. Respondents were willing to trade-off 11% of the degree of protection to obtain life-time protection instead of 25 years. To obtain a vaccination with a risk of serious side-effects of 1/750,000 instead of 1/150,000, respondents were willing to trade-off 21%.


Uptake may rise if the age ranges for free HPV vaccinations are broadened. Based on the trade-offs parents were willing to make, we conclude that uptake would increase if new evidence indicated outcomes are better than are currently understood, particularly for degree and duration of protection.

Preferences; Human Papillomavirus; Vaccination; Discrete choice experiment; Parents