“We fear the unknown”: Emergence, route and transfer of hesitancy and misinformation among HPV vaccine accepting mothers

Although licensed since 2006, US HPV vaccination rates remain suboptimal. Since mothers are decision-makers for young adults’ vaccination, assessing ongoing knowledge deficits and misunderstanding among parents is important for determining the content and mode of interventions to reach parents. Guided by the social-ecological model and health belief model, 30 interviews with vaccine accepting mothers in the U.S. Midwest were conducted from January through June 2020. Researchers examined ecological determinants of acceptance, perceptions of vaccination barriers, and perceived cues to action for empowering other mothers to vaccinate their children. Data were analyzed using thematic analysis. Results found vaccine accepting mothers exhibited ongoing misconceptions and negative attitudes toward HPV vaccine. Physicians, peers and the media were identified as primary pro-HPV vaccine sources, yet hesitancy and misinformation occurred with each source. Trust in provider recommendation was the primary source for decision-making, yet trust was still lacking. While mothers looked to the media for HPV information, the media were identified as the main source of confusion and distrust. Results show that parents who accept the HPV vaccine can still be hesitant. Thus, mothers who have vaccinated their children for HPV may still need attitudinal and educational training prior to establishing them as role models in interventions for empowering other parents to vaccinate their children. Results showing that the media sow confusion and hesitancy also call for more attention to social media policies to guard against misinformation about the HPV vaccine.