Parents' decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results

The goal of the study was to examine the reasons given by parents who accepted or refused the HPV vaccine for their daughters in the context of a free provincial school-based vaccination program. A random sample of parents of 9-10 y old girls completed a mail-in questionnaire. Parents' responses to 2 open-ended questions were assessed using content analysis. Coding themes were derived from the Health Belief Model. 806 parents returned and answered the relevant items. 88% of these parents decided to vaccinate their daughter. The primary reasons for parents' acceptance was the perceived benefits (e.g., health protection, cancer/HPV prevention) and cues to action (e.g., physician recommendation, trusting the school vaccine program). Reasons for parental refusal included barriers (e.g., fear of side effects) and low susceptibility (e.g., their daughter is not at risk). Both groups of parents had unanswered questions, doubts and often inaccurate information. This study provides unique insight into parents' perspectives concerning the decision making process for their daughter. There appears to be a need for accurate and complete information to assure informed HPV vaccine decision-making by parents and to increase HPV vaccine uptake.