U.S. Vietnamese experience HPV-related cancer disparities and HPV vaccine underutilization. We explored practice-, provider-, and patient-level influences on U.S. Vietnamese mothers' HPV vaccine decision-making for their female and male adolescent children. Using purposive sampling, we conducted 32 interviews among U.S. Vietnamese mothers. Data were analyzed using a hybrid thematic analysis approach. Findings indicated that practice-level barriers included limited clinic-based HPV promotion materials in Vietnamese and challenges in appointment scheduling. While provider recommendation emerged as a key facilitator of vaccine uptake, several mothers received either no recommendation or a low-quality recommendation. We found diverging patterns of vaccine acceptance following recommendation receipt. Patient-level barriers included misconceptions regarding the vaccine (particularly eligibility for males to get the vaccine), lack of health care utilization, perceived sexual inactivity, and safety concerns. We discuss the need for interventions addressing modifiable multilevel barriers to HPV vaccine acceptance and uptake among U.S. Vietnamese.
