TABLE 2.

Exemplar Quotes With Coding Examples by Type of Provider Response to Parental Hesitancy (n = 37 Visits With Parental Hesitancy)

Provider Response Type to Parental Hesitancy	Example Quotes	n (%)
Acquiescence only	Doctor: “In the past his blood count was fine. You don’t need a blood test. You don’t need shots. If you want to start the HPV vaccine — did [nurse] ask you…”	6 (16)
	Parent: “Yeah, I don’t want to do it.” (assertive response)
	Doctor: “Okay. Maybe you’ll change your mind in the future.” (acquiescence)
	Parent: “Okay.”
	Doctor: “We’ll ask each year.”
	Parent: “Okay.”
Mix of acquiescence and persistence	Parent: “Yo no sé si es igual en los niños que en las niñas. Son diferentes sus cuerpos. Pero yo miro — yo he visto. Eso es como mi pregunta que tengo. He visto niñas que les han puesto esa vacuna y se desarrollan bien rápido —” (“I don’t know if it’s the same in boys as in girls. Their bodies are different. But I see — I have seen. That is like the question I have. I have seen girls that have gotten that vaccine and have developed very fast —” (expression of concern)	13 (35)
	Doctor: “No, no. Es —” (“No, No. It is —”) (provider persistence)
	Parent: “No sé. Yo lo he visto en algunas.” (“I don’t know. I have seen it in some.”) (expression of concern)
	Doctor: “No es algo de la vacuna, pero es porque empieza con la vacuna durante de adolescentes, cuando están cambiando sus hormonas, y es cuando cambian los cuerpos. So él ya está cambiando.” (“It is not something from the vaccine, but it’s because one starts the vaccine during adolescence, when their hormones are changing, and it’s when their bodies are changing. So he is already changing.”) (provider persistence)
	Parent: Yeah…como desde los 10, 11. (Yeah, like since 10 or 11.)
	Doctor: “So, I mean, si usted no quiere eso, está bien conmigo. Pero es por seguro, algo que necesita hablar con él en la casa. Y si no está bien seguro que no está haciendo cosas para pasar la infección, no necesita poner la inyección. Porque sí puede causar cosas malos en niños también. En mujeres, es, la primera cosa es cáncer de la cérvix, pero en los — bueno, no los niños — en hombres también, de la — cáncer de la garganta, de su pene, y otras cosas — están pasando a mujeres.” (“So, I mean, if you don’t want that, it’s fine with me. But it’s for safety, something that you need to talk about with him at home. And if you aren’t very sure that he is not doing things to pass the infection, he doesn’t need to get the injection. Because it can cause bad things in boys too. In women, it’s, the primary thing is cervical cancer, but in — well, not in boys — in men too, throat cancer, penile cancer, and other things — they are passing it to women.”) (provider persistence)
	Doctor: “So yo creo que es más importante para los hombres.” (“So I think it’s more important for men.”)
	Parent: “¿Para los hombres?” (“For men?”) (question)
	Doctor: “Hombres, yeah. Uh-huh. Pero si quieres esperar, está bien conmigo, pero cada año que regresa para su físico, voy a preguntar otra vez.” (“Men, yeah. Uh-huh. But if you want to wait, it’s fine with me, but every year that he returns for his physical, I’m going to ask again.”) (provider acquiescence)
Persistence only	Parent: “I think — I mean I’ve been reading up on it uh maybe uh she should get it at 12?” (question)	18 (49)
	Doctor: “Why?” (persistence)
	Mother: “Uh...”
	Doctor: “So one of the reasons — we can give it at age 9...” (persistence)
	Mother: “I see that.”
	Doctor: “We do wait and give it at age 11 cause they are already getting their 11-y-old shots, you know she got hers before school started so she could have them for school. So when they get them when they are younger, their immune system builds up a better response to the vaccine and it does take 6 mo to get all 3.” (persistence)
	Mother: “Okay, that’s fine.”
	Doctor: “We give it all the time.”