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Table 3 Interview themes and example quotes

From: Determinants of human papillomavirus vaccine attitudes: an interview of Wisconsin parents

Parent, Vaccination History of adolescent child

Quote

Theme 1: Perceived likelihood of the HPV vaccine preventing cancer

 Parent, age 36

 Adolescent, age 13

 Vaccinations:

 Tdap

 Meningococcal

[Cancer not motivating] So when I looked up the research on it, it was kind of one of my things was okay, I understand where they’re [physicians are] coming from, but there’s over 100 strains of HPV and this is only protecting against four. There’s the one company that they say it’s like six or seven. But out of all those strains, and the four that they’re covering, only two of those strains of HPV cause cervical cancer. And yes they cause like 70% of all forms of cervical cancer.

Yet out of all forms of cancer, cervical cancer is the most treatable. As long as you’re getting your yearly pap smears, you’re gonna catch it.

 Parent, age 55

 Adolescent, age 12

 Vaccinations:

 HPV (complete)

 Tdap

 Meningococcal

[Cancer as motivating] Just knowing about like what can happen. It could be terminal. It’s just like our fears. Like, parents say whether they’d be more apt to engage in sex – it’s up to me – it’s a lack of trust in your child – your own fears. And obviously, working here in the hospital and seeing people with all sorts of different cancers.

 Parent, age 50

 Adolescent, age 14

 Vaccinations:

 1–2 HPV shots, did not complete by follow-up

 Tdap

 Meningococcal

 Influenza

[Cancer as motivating] Yeah, and I think the association seems to be maybe strongest for that, and maybe the preventive is even stronger too, or the effectiveness, but it’s still very strong for some of the male cancers. And then also, you don’t want to be responsible for transmitting either, so there’s that as well. So I can see where maybe people were thinking it was primarily for girls, because I think it was sort of initially stressed as preventing cervical cancer, but yeah, there’s definitely a big push now for boys to get it.

Theme 2: Agency in adolescence and gauging their adolescent child’s intent for sexual activity

 Parent, age 48

 Adolescent, age 15

 Vaccination:

 Tdap

 Meningococcal

[Allows adolescent more agency] Right. And he said, “You know, there’s always cons to everything. I mean, if you take a Tylenol, you know, I mean – you could come up with something.” So our kids have been – we’ve tried to educate them to make their own decisions with that, so unless we have the better education, I don’t see my mind changing.

 Parent, age 44

 Adolescent, age 14

 Vaccinations:

 1–2 HPV shots, did not complete by follow-up

 Tdap

 Meningococcal

 Influenza

[Allows adolescent more agency, gauging adolescent’s intent for sexual activity] We had a discussion about it and again, I told her the risks as I was aware of them. And we discussed it with her provider a couple different times. I think, too, part of it – I told her what my thought on the timeframe was and she concurred with that. I said if you really want it, if you think that you’re going to be doing things that could put you at risk sooner, then we’ll start sooner.

 Parent, age 41

 Adolescent, age 12

 Vaccinations: 1–2 HPV shots, did not complete by follow-up

 Tdap

 Meningococcal

[Allows adolescent less agency] I didn’t [talk to my child about getting the vaccine]…I didn’t really think it was something that he should decide.

 Parent, age 43

 Adolescent, age 11

 Vaccinations: HPV (complete)

 Tdap

 Meningococcal

 Influenza

[Allows adolescent less agency] I did [talk to my child about the vaccine] a little bit, but just to let her know that she was gonna have it done and what it prevented, but it wasn’t like she had an option.

Theme 3: The credibility of vaccine information sources

 Parent, age 46

 Adolescent, age 12

 Vaccinations:

 None

[Doubtful about credibility of vaccine information sources] And, you know that they’ll [physicians will] get some perks. That’s life, from pharmaceuticals to doctors, doctors to pharma – probably the first way. But, you just have to hope that people do things for the right reason.

 Parent, age 36

 Adolescent, age 13

 Vaccinations:

 Tdap

 Meningococcal

[Doubtful about credibility of vaccine information sources] Yes I understand some of these scientists come up with these things and “Hey look, we just discovered this and we can do this.” Okay, yeah and they want the actual positive outcomes for it. And then of course you do have the drug companies, I mean I’m sorry that’s their business and they’re out there to make money. And quite frankly I mean I’m sorry you’re hearing more and more of it on the news…”

 Parent, age 48

 Adolescent, age 15

 Vaccinations:

 1–2 HPV shots, did not complete by follow-up

 Influenza

[Trusting of vaccine information sources] I’m just a black or white person. I’m also not a person who has time to do a ton of reading on this stuff. I do more like a little bit of reading and a little bit of talking around and a lot of trusting. Like who is telling me the information, where the sources are where I’m getting my information from. So it’s not like I just go into something blindly. But I think it’s probably maybe it has to do with trusting your practitioner somewhat because that would be the source that gives the information from the very beginning.