TABLE 2.

Reasons, and their subcomponents, underlying maternal decisions about vaccinating their daughters against HPV

	Vaccine declined (N = 19)	Vaccine received (N = 33)
1	Perceived risk of infection
	n = 7	n = 9
	Not likely to become/not already sexually active	Likely to become/is already sexually active
	No family history of cancer	HPV highly prevalent in society
	Cervical cancer is not deadly.	Cannot tell which partners harbor HPV
	HPV is not very contagious.	Never know when adolescents will start having sex
	Daughter taught the “right thing to do,” so risk is low.	Family history of cancer (general)
2	Age-related
	n = 7	n = 0
	Too young for a vaccine against an STD
	Want to wait till daughter is older
	Vaccination in general can be harmful to a preadolescent.
3	Knowledge
	n = 6	n = 1
	Need more personal information about HPV/vaccine	Wish there were a lot of “data” about the vaccine's long-term effectiveness
	Medical establishment needs to know more about HPV/vaccine.
4	Vaccine safety
	n = 8	n = 7
	Not enough data on long-term safety of vaccine	Vaccine is “too new” to feel completely comfortable with it.
	Vaccines (in general) linked to autism	Generally benefits to vaccination outweigh safety concerns.
	Many vaccines initially declared safe later found to be unsafe
5	Protection/prevention of illness and disease
	n = 2	n = 26
	HPV vaccine will prevent illness. (general)	HPV vaccines are a general safeguard against illness/disease.
	Providing HPV vaccines before sexual activity would afford best protection.	HPV vaccines protect against HPV/cervical cancer.
6	Personal experience with HPV
	n = 1	n = 12
	Mother had personal experience with abnormal exams.	Mother or family member had experience with cervical cancer/abnormal exams/HPV infection.
7	Physician recommendation
	n = 2	n = 11
	Physician gave a reason to wait on vaccine.	Doctor recommended it, so daughter got it.
		Always follow doctor recommendations.
8	General beliefs about vaccination
	n = 2	n = 5
	Problematic to get multiple vaccines at one time	Believe strongly that vaccines are beneficial
	Don't generally “like” vaccines	No big deal—just one more vaccine
9	Control over health-related decisions
	n = 2	n = 4
	Want to wait until daughter can make her own decision about the vaccine	Want to get daughter vaccinated while mother can control medical decisions
	Daughter expressed opinion that she doesn't want the vaccine.	Daughter voiced a desire to get the vaccine.
10	Financial issues
	n = 3	n = 2
	Wanted vaccine but could not get because of lack of/unsure of insurance coverage	Daughter was going to “age out” of insurance coverage for vaccine soon so wanted to get now.
		Would not have been able to get the vaccine if there had not been coverage
11	Religious values
	n = 1	n = 0
	Religious values “played a role” in the decision.

STD = sexually transmitted disease.