Table 4.

Summary of 7^th and 8^th grade students’ qualitative responses categorized by themes elicited.

Themes	Descriptions	Examples
Perceived vaccine harm	Students were concerned that vaccines could have harmful immediate or long-term side effects. Some of these perspectives were grounded in experiences they had themselves while others expressed a lack of knowledge about the potential harm and wanted to learn more. Predominant concerns included:
	Vaccines cause unspecified illness	“They make me sick!” “Last time I got a vaccine they injected the shot in the wrong place and I got really sick.”
	Association between vaccines and future illness	“The vaccine might not work and the person could get hurt.”
	Illustration of a lack of knowledge about vaccines	“The side effects to them are they cancerous?” “What if they affect someone differently and kill them? Like the Gardasil shot.”
Fear of needles	Students expressed concerns and experiences related to pain with some belief that vaccines do not need to hurt.	“… they hurt.” “They should give tips so shots will not hurt as much.” “I hate the pain of shots! Work on it.”
	Fear of needles causing emotional distress.	“Needles. Some kids are TERRIFIED.” “Some people have “needle phobia”, like I do, and have anxiety, breakdowns.”
	Fear needles may be a potential source of infection	“I’m not sure if the needles are clean.”
Need for more education about vaccines	Unclear if vaccines work and how they work	“Some people have different bodies so vaccine might not work for them.” “What are the vaccines for, how do they help me? Etc.”
	What is in the vaccine?	“What are they putting in my body?” “How much of the virus is in the shot?” “What chemicals are in it?”
	What do vaccine do?	“What illness does the vaccine protect from? What does the illness do?” “What exactly it may be doing” “How well the vaccine works on a scale of 1 to 10.” “What are the vaccines for, how do they help me? Etc” “More about what they are for, the dangers if you don’t get one, and the dangers if you do”
	What kind of harm do vaccines cause?	“I want to know if it’s safe” “The side effects.”