Table 4. Thematic results and quotations.

Emergent Findings (Themes)	Supporting Quotations
Vaccine accessibility was associated with pediatric COVID vaccine uptake in rural communities	I just really feel like it’s available here…it’s really an self-initiative type of thing. I think, taking yourself or your children to go. There’s really nothing that prevents them locally here from getting it.
	Oh, yeah, there’s [vaccines] so many of them. So many different categories. It’s weird, Pfizer and Johnson & Johnson or something like that. There’s a lot here. There’s a lot available.
Previous pediatric vaccine behaviors were not associated with COVID-19 pediatric vaccine uptake.	I vaccinate for other things. You know, like I said, I’m not anti-vaccine by any means. It’s [COVID pediatric vaccine] just too soon.
	I’m not against vaccinating my kids, we have our immunizations up to date. However, this one, just, it’s hard for me to wrap my mind around and feel completely comfortable with.
Perceived health status of a child or family member influenced pediatric COVID-19 vaccine uptake.	I think it’s [pediatric vaccine] just another level of protection. You know? I think we feed our kids good food, we encourage our kids to get enough sleep, we get our kids outside, you know, we mentally stimulate them, we physically stimulate them. And this is one more piece of the puzzle that builds their ability to be resilient.
	I just don’t think it should be pushed on every person because as a healthy person who hasn’t had any complications their whole life, and is very active and exercises and is outside getting vitamin D every day. I don’t see the point [in the pediatric vaccine].
COVID-19 health seeking behaviors, like COVID pediatric vaccine uptake, are influenced by an individual’s prosocial or individualistic perspectives.	So it’s as important to protect us and protect others. It should be required for everybody who works in school to be vaccinated. That’s my point of view. So it’s part of like, be part of the solution at the same time, is it safe, I’m responsible and I work, you know, on a school, my responsibility is to get vaccinated to protect toddlers
	I don’t think that me doing something [pediatric vaccine] for someone else [is worth it]. Like putting something in my body that we have no idea what it’s going to actually do in 10 years
	We can’t change the fact that the virus is introduced to the world… So it all boils down to at the end of the day, individually, how you’re going to take care of that for yourself. So for example, myself, I’ve made a choice because I do not want to be vaccinated to practice the self-isolation you know, pretty much self-quarantine but for work for school, for myself, I’ve chose to stay home and practice being very cautious and aware of how I interact with others, my children, my family and, and keeping that regimen very strict.
Child autonomy and “age of consent” frames vaccine decision making behaviors in parents.	We’ve talked about it and she [the child] understands why I got the vaccine but she’s like I still don’t I still don’t want to and I’m like well like you can do your own research on whatever you want to do and figure it out from there
	Well, outside was the fact that she [the child] got, she got to make the choice [to vaccinate or not] … she got the opportunity to participate in an adult like type of decision making. So that was a big benefit, you know, and I know, it’s different being that she’s so close to 18 versus, you know, some younger [children]… was a big benefit to actually have that conversation with her as a pre adult.
	But I don’t know… it was one thing for me to decide for myself [to vaccinate or not]. . . It just feels like a really heavy burden to decide that for my daughter, who’s only 13 and has her whole life.
	I’ve always been like that… to me, it’s like, it’s your bod. So you [the child] get to have a say in it. Because I’m not going to sit there and I’m not going to hold you down and make you do something that you don’t want to do.
Social networks impacted COVID-19 pediatric vaccine decision making.	I tend to trust the medical community, especially locally, because we know them, like my kids’ Doctor, I went to high school with him.
	My sister’s in the medical field. So she had done a lot of research [regarding the vaccine]…my brother and sister in law, my husband. I think they all had gotten it before me. So I guess in my mind, that was like, proof that it [the vaccine] was okay. So that kind of eased my fears. And then my oldest son… he just knew that it was the right thing to do. He didn’t really have any questions about it. And then my daughter… she knew that her aunt had researched it, she felt comfortable with it. And so I mean, we did have conversations about well, what do you want to do? What do you think? And so that was really all that happened.

Footnote: At the time of interviews, eligible children were 5 and older.