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TABLE 1

Definition, Exemplar Quotes, and Prevalence of Each Type of Parental HPV Vaccine Hesitancy During the Visit (n = 37 Visits With Parental Hesitancy)

Type of Parental HesitancyaDefinitionExample QuotesPrevalence of Hesitancy Type (Not Mutually Exclusive), n (%)Prevalence of First Hesitancy (Mutually Exclusive), n (%)
Question Question or statement that functions as a question on the basis of phrasing or tone of voice “So it’s supposed to help prevent cancer, cervical cancer?” 16 (43) 7 (19) 
“But now about this one, it’s new?” 
“Do we have to come back every month to come get it?” 
“What are the chances of it causing any reaction- allergic reaction?” 
“Cómo es que se transmite el papiloma en los hombres?” (“How is papilloma transmitted in men?”) 
“¿Y no hay ningún riesgo ya después?” (“And there isn’t any risk afterward?”) 
Assertive response Disagreeing, interrupting, making a request, stating a preference, making a decision, or introducing the topic of HPV vaccine “So we need to think about that” 27 (73) 21 (57) 
“It is not a worry; it is just more like I just want to wait” 
“Want to do a little reading” 
“Ahorita todavía no lo miro que es necesario para él” (“Right now I still don’t see it as necessary for him”) 
“No, yo pienso que es muy pequeño todavía” (“No, I think he’s still too little”) 
Expression of concern Fear, worry, clearly negative statement, or question; use linguistic markers (eg, tone of voice), not subjective interpretations of communication “I’m just scared of it” 12 (32) 8 (22) 
“I understand your reason, but I mean wow, I don’t know” 
“I think so — at first I wasn’t sure because she’s a girl and I just don’t want to think about that” 
“Yo tenía — tengo dudas — es bueno o no es bueno y si tiene reacción a futuro” (“I had – I have doubts – is it good or is not good and if it has a reaction in the future”) 
Other Hesitancy not expressed as question, assertive response, or expression of concern “It is relatively new” 7 (19) 1 (3) 
“So I’m on the fence — like I was telling her I was on the fence” 
“I don’t really know too much about it” 
Type of Parental HesitancyaDefinitionExample QuotesPrevalence of Hesitancy Type (Not Mutually Exclusive), n (%)Prevalence of First Hesitancy (Mutually Exclusive), n (%)
Question Question or statement that functions as a question on the basis of phrasing or tone of voice “So it’s supposed to help prevent cancer, cervical cancer?” 16 (43) 7 (19) 
“But now about this one, it’s new?” 
“Do we have to come back every month to come get it?” 
“What are the chances of it causing any reaction- allergic reaction?” 
“Cómo es que se transmite el papiloma en los hombres?” (“How is papilloma transmitted in men?”) 
“¿Y no hay ningún riesgo ya después?” (“And there isn’t any risk afterward?”) 
Assertive response Disagreeing, interrupting, making a request, stating a preference, making a decision, or introducing the topic of HPV vaccine “So we need to think about that” 27 (73) 21 (57) 
“It is not a worry; it is just more like I just want to wait” 
“Want to do a little reading” 
“Ahorita todavía no lo miro que es necesario para él” (“Right now I still don’t see it as necessary for him”) 
“No, yo pienso que es muy pequeño todavía” (“No, I think he’s still too little”) 
Expression of concern Fear, worry, clearly negative statement, or question; use linguistic markers (eg, tone of voice), not subjective interpretations of communication “I’m just scared of it” 12 (32) 8 (22) 
“I understand your reason, but I mean wow, I don’t know” 
“I think so — at first I wasn’t sure because she’s a girl and I just don’t want to think about that” 
“Yo tenía — tengo dudas — es bueno o no es bueno y si tiene reacción a futuro” (“I had – I have doubts – is it good or is not good and if it has a reaction in the future”) 
Other Hesitancy not expressed as question, assertive response, or expression of concern “It is relatively new” 7 (19) 1 (3) 
“So I’m on the fence — like I was telling her I was on the fence” 
“I don’t really know too much about it” 
a

Hesitancy is defined as expressing resistance or indecision about the vaccine, communicating a desire to delay vaccination, or providing reasons why they may not want to vaccinate.

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