Decision-making process and support needs regarding the human papillomavirus vaccine in Japan: a qualitative interview study with mothers

This study aimed to clarify the decision-making process and support needs of mothers with daughters eligible for human papillomavirus (HPV) vaccination. We conducted semi-structured interviews with 15 Japanese mothers, representing 17 eligible daughters aged 12–20 years. Thematic analysis was performed for data analysis. We extracted 41 concept codes and 15 categories and classified them into four analytical themes: “facilitators of decision-making,” “inhibitors of decision-making,” “fluctuations in the decision-making process,” and “support that mothers need.” Mothers experienced emotional fluctuations and conflicts throughout the decision-making process, repeatedly feeling anxious and reassured and weighing their expectations against their concerns while trying to make a decision they considered satisfactory. Their information and support needs varied across the decision-making process. Mothers experienced emotional fluctuations and conflicts throughout the HPV vaccination decision-making process, and their information and support needs varied according to their individual concerns and readiness to make a decision. Therefore, decision-making support should be responsive to each mother’s concerns and needs throughout the decision-making process. Interprofessional collaboration may also be important in providing mothers with appropriate information and support. These findings may contribute to the development of tailored support for HPV vaccination decision-making in Japan.