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Table 3 Individual and Structural-level Barriers to HPV Immunization

From: Barriers to HPV immunization among blacks and latinos: a qualitative analysis of caregivers, adolescents, and providers

Category Row # Participant Representative Quotation
Caregiver perceptions 1 Black caregiver of an adolescent girl “Well, the earlier vaccines – the measles and mumps and all that – I am fine with those… It’s the newer ones that I am not.”
Caregiver perceptions 2 Black caregiver of an adolescent girl “We don’t know what’s inside of the vaccines, and they can be harmful if you don’t know what it is. It might not mix well with bodies and cells. They should just be more careful. It is like we’re being picked like guinea pigs.”
Adolescent perceptions 3 Latino adolescent boy Interviewer: “Do you trust the vaccine?”
Adolescent: “Not at all…because I don’t know what it does…I never heard it…it depends how big the needle is.”
Lack of education
Adolescent perceptions 4 Latina adolescent girl “They usually just give you a handout, like a little sheet explaining what it is and the side effects and what could possibly happen. And so, that is it. I really don’t know much about it.”
Caregiver perceptions 5 Black caregiver of an adolescent girl “I didn’t know that I needed to come back. I had no clue that you had to give me more than one, and I wasn’t told that at the time.”
Healthcare provider perceptions 6 Physician “With HPV—a lot of them haven’t heard about it… A lot of times I look at the adolescents and say have you seen those ads on TV—Gardasil? They will be the ones who recognize it. Their parents, not so much.”
Challenges associated with the dosage schedule
Healthcare provider perceptions 7 Nurse “I think getting them back for their second and third is a real problem. It would be nice if we had a better system to remind parents… I find that a lot of times you see them and they get their second [shot] a year later. They come then because the adolescents only come once a year.”
Lack of Routinization
Healthcare provider perceptions 8 Physician “We’re under the gun in terms of time. So if our primary directive at a visit is to get these kids up-to-date with immunizations, then the goal is to sort of get that done with as little conversation and resistance as possible, and then hopefully you have time to have meaningful conversations about real-world stuff like with what’s going on with sexual activity or dating or boyfriends or parent relationships or whatever else the myriad of things that are going on. So all these conversations that we are having around HPV are really—we’re just trying to sell it, for lack of a better word. We’re just trying to get it done so that we can move on to the more meaningful points of the visit.”
Administration of multiple vaccines at the same visit
Healthcare provider perceptions 9 Nurse “I think that, you know, that offering it to children at eleven and just sort of matter of fact tell them this is what we do at eleven, along with their Tdap and their meningococcal vaccine. It works pretty well.”