Objective  To evaluate attitudes and behaviors of human papillomavirus (HPV) vaccine vaccination in mainland Chinese residents to provide evidences for promoting HPV vaccine vaccination in the population.

  Methods  We retrieved relevant researches on attitudes and behavioral factors of HPV vaccination among mainland Chinese residents published from January 1995 through January 2021 by searching the databases of PubMed, Medline, China National Knowledge Infrastructure (CNKI) and Wanfang Database. Two researchers independently screened the literatures and extracted the data; the literatures with literature quality score of greater than or equal to 5 were included into the analysis. Stata 12.0 software was adopted in statistical analyses.

  Results  Totally 52 literatures were included in the study, with a total of 91 762 respondents. The pooled results show that the overall ratio of the respondents reporting the willingness to have HPV vaccination is 66.4% (95% confidence interval 95% CI: 66.1% – 66.6%), with the highest ratio of 65.1% (95% CI: 56.9% – 73.4% ) among the respondents with the education of master degree or above and 68.4% (95% CI: 68.1% – 68.7%) among the respondents surveyed after 2016. Self-protection is a main reason for having HPV vaccination reported by the respondents. Of the respondents, 77.5% (95% CI: 68.9% – 86.0%) reported the willingness to have their children being vaccinated with HPV vaccine. The reported main reasons were without the knowledge about HPV vaccine and worrying about side effect of the vaccine for unwilling to have HPV vaccination, worrying about the safety and effectiveness of HPV vaccine for unwilling to have their children being vaccinated, high price of HPV vaccine for unwilling to have their family members being vaccinated, and without enough knowledge about HPV vaccine and worrying about misleading due to inaccurate interpretation for unwilling to recommend HPV vaccination to others, respectively. Of all the respondents, 76.2% (95% CI : 75.0% – 77.5%) suggested that the government should support HPV vaccination by providing subsidy. No significant impact of income on respondents′ HPV vaccination willingness was observed.

  Conclusion  The willingness to have HPV vaccination is not high among mainland Chinese residents. The awareness on HPV vaccine vaccination should be improved in the residents for the control of cervical cancer.