Table 1.

Factors Influencing Mothers’ Decisions to Vaccinate Their 11- to 12-Year-Old Daughters Against HPV

Mother’s health-related beliefs and experiences (N)

Favorable beliefs about vaccines

Belief that vaccines are important for health/protect health (7)

Favorable beliefs about HPV/HPV vaccines

Vaccination has health benefits

Prevents cancer (12)

Prevents STI/other diseases (6)

Vaccine is safe, effective, long-lasting (6)

Vaccinating at this age (11–12 years) is important

Recommended for that age group (8)

Best to administer prior to sexual maturity and sexual initiation (11)

Acceptance of vaccination easier at younger ages (2)

Antibody level higher at a younger age (2)

Mother’s experiences increase perceived susceptibility or comfort with vaccination

Personal experience with HPV/other STI increases sense of vulnerability (4)

Family/friend experience with HPV or cancer increases sense of vulnerability (7)

Sibling’s experience with HPV vaccine increases comfort (5)

Interactions with clinicians (N)

Discussions often occurred during a routine physical and/or prior to visit

Clinicians were primarily physicians, and many had spoken to mothers about HPV vaccine prior to visit (15)

Conversations took place during a routine physical for daughter (6)

Conversations took place in context of routine physical for older sister or when older sister was vaccinated (5)

Approach to vaccination (planting the seed, providing practical information)

Planting the seed—that is, broaching subject of HPV vaccination (9)

Providing information needed for mom to make informed decision (4)

Mother trusts clinician and respects clinician’s opinion (would recommend to one’s own child) (7)

Interactions with friends and family (N)

Family contributed to decision making (21)

Daughter’s father

Contributed to decision to vaccinate (3)

Confirmed decision to vaccinate (6)

Mother’s mother (grandmother) (6)

Older daughter (2)

Mother-in-law (1)

Sister (2)

Other family members (1)

Friends contributed to decision making (7)

Media/marketing exposure (N)

Raised mother’s awareness of HPV vaccines (4)

Provided factual information to mothers/educated mothers about HPV and HPV vaccines

Facts about HPV

Infection, transmission, sequelae (2)

Facts about vaccine

Prevents cervical cancer (but not all cervical cancer) (12)

Prevents STIs and genital warts (3)

Targeted to girls in certain age groups (4)

Safety profile is reassuring (2)

Encouraged discussion about HPV vaccination between daughter and mother (3)

Convinced them of the benefits of vaccination

Importance of vaccination as a prevention strategy (12)

Promotion of empowerment for girls (1)

Influence of the tag line “one less” (11)

Promoted seeking out information from other sources (8)

Abbreviations: HPV, human papillomavirus; STI, sexually transmitted infection.