Table 2.

Domains/key themes related to context for HPV vaccination, reactions to community-based delivery, additional suggestions

Domains	Key themes
1.Vaccination decision-making context
1.A. Vaccine-related concerns	Adolescents had mainly negative reactions regarding vaccines (generally and specifically for the HPV vaccine), with concerns about pain and anxiety related to anticipating the shot, as well as side effects. Caregivers had mixed reactions, with concerns about side effects (and potential long-term impact on the reproductive health of young women receiving the vaccine) and positive expectations about the protective benefits of the vaccines. They also voiced an additional concern related to the reproductive health of young women who have received the HPV vaccine.
1.B. Information environment	Adolescents noted wanting information about HPV, including reassurance around vaccination (particularly from a trusted source). Their primary sources of information included parents, doctors, and the internet. Caregivers expressed interest in additional information, emphasizing a need for a balance between the pros and cons of receiving the HPV vaccine. Trusted sources included doctors, the internet, family, and friends.
1.C. Family decision-making processes	Both adolescents and caregivers identified parents as the primary drivers of general healthcare decisions and vaccination specifically, with variation in the extent to which adolescents were involved. For HPV, there was more discussion of consulting outside trusted sources.
1.D. Importance of a trusting relationship with the provider	Both adolescents and caregivers emphasized the need to know and trust the provider, though adolescents noted that the vaccine was acceptable as long as their parents trusted the provider.
2. Community-based vaccine delivery strategy
2.A. Concerns raised	The negative reactions centered on the receiving the HPV vaccine in community settings and mainly related to concerns around engaging with an unknown provider.
2.B. Opportunities highlighted	The positive reactions were mainly related to opportunities for outreach and engagement. Caregivers were interested in attending educational events focused on HPV, particularly those geared towards adolescent health. They also wanted additional information on both the positive and negative consequences of the vaccine.