Objective   To examine the status and influencing factors of human papilloma virus (HPV)-related recommendation behavior in medical staff engaged in immunization service and vaccination behavior in women in Beijing city.

  Methods   An on-line and on-site survey was conducted at 75 vaccination clinics in 8 districts of Beijing from January to February 2020. A self-designed questionnaire was completed by 900 immunization service personnel, 1 200 women vaccinated with HPV vaccine, and 1 110 unvaccinated women recruited using stratified multistage cluster sampling.

  Results  Of the immunization service personnel, 64.6% reported ever recommending HPV vaccination to potential vaccine recipients or common people and 57.6% expressed the willingness to do the recommendation actively in future. Based on the reporting of the personnel, the three major workloads increased due to HPV vaccination were answering telephone consultation calls, performing appointment notice and dealing with relevant complaints; of which, dealing with relevant complaints was a main factor affecting the willingness to do HPV vaccination recommendation in the future. The top three hindering factors for HPV vaccination reported by the immunization service personnel included staff shortage, increased workload and insufficient vaccine supply. Among the participants at the right age for HPV vaccination, 69.2% and 83.9% reported ever receiving recommendation on HPV vaccination from medical staff and their relatives and friends. Reported by the unvaccinated women, the main reasons for not having HPV vaccination were no time to get the vaccination, considering higher price of the vaccine, and worrying about the safety and effectiveness of the vaccine.

  Conclusion  The recommendation for HPV vaccination from immunization service personnel was at a moderate level in Beijing, suggesting that the service mechanism of vaccination not covered by planned immunization program needs to be improved to promote recommendation and vaccination behavior relevant to HPV vaccination.