Table 3.

Anticipated impact of enacting a requirement on future recommendations.

Themes	Illustrative quotes
Majority reported that recommendation would be simplified and conversation would be shortened	If we could start with ‘Here’s the HPV vaccine. It’s required prior to ninth grade.’, it would be much easier for parents. Parents in general don’t question it as much. (P12) We can discuss what it’s for but the bottom line is they have to have it, so that makes it a lot easier. (P17) I mean, we’d still have to - we have to talk about it anyway…But if it was required for school, maybe the people who need to be convinced wouldn’t need to be convinced as much. We wouldn’t have to spend as much time trying to talk people into it. (P23)
Fewer reported conversation could become more difficult	I think if it were mandated, it’s going to be, ‘You’re telling me to give my child a shot for a sexually transmitted disease? Come on.’ It’s going to make people annoyed. (P1) Yeah, I think the conversation would get longer. I think some of those families that don’t wanna do it, the conversation would go on and on. (P29)
Few also reported no change	Because I treat all vaccines the same regardless of state requirements. I do what’s best for the patient. (P25) The approach probably wouldn’t be any different. I’d still wanna explain why we want to do it as opposed to well, school says you have to so we’re just gonna do ‘em and that’s it. (P31)
Requirement would increase parental acceptance, even if they disagreed	I think many of our parents are happy to do anything that they think they have to do. Then they don’t have to think about it. (P8) I think our adoption rate would go up significantly although we may have some frustrated or you know, aggravated parents who disagree with it. I do think it would help. (P9) They [parents] wouldn’t consider it optional any more, as optional as they seem to consider it now. (P10) If HPV were a school requirement, I am pretty sure that people would go along with it. (P21) I think it would [work]. I think you’d get a lot of grumpy people. (P27) My own personal opinion, I think it sends them [parents] a strong message that this is important. (P28)