Table 2 Quotations illustrating emergent study themes from interviews with seven newcomers to Ottawa, Canada

1. Lack of HPV Knowledge

 Low Knowledge

Interviewer: Have you heard of HPV before? If yes, what do you know about it?“Nothing” (Participant #3)

“I think – where I come from, it’s not – we’re not – most people are not knowledgeable about it because I think it’s treated with – it’s not treated with as much attention as it should be given.” (Participant #1)

“no, had never heard of it” - (Transcript 5)

 Misconceptions about HPV and the HPV vaccine

“...they go to [the] swimming pool for example, they don’t have boyfriends or girlfriends, but because they go to public places, I’m concerned about that [HPV]... maybe with the public toilets they use. I want to make sure they’re protected. Public toilets, I’m very concerned about that.” (Participant #6)

2. Willingness to accept vaccination

Interviewer: “Do you believe that you would have your children vaccinated against HPV?

“And my kids also, I would love them to get it when they get to the age. Yeah because you don’t play with your health, yeah. Health is wealth like they say.” (Participant #1)

“They are very important [vaccines]. As, there is something said at home, I do not know if here we say it, it is better to prevent than cure. We warn like that.” (Participant #4)

3. Access to vaccination

 Cost

“They should cover it, that’s very sad. Most people those ages [i.e., young adults no longer covered by the school-based programs], they don’t have a permanent job, they’re working here and there, they can’t afford that, it’s very hard for them. They should make it easier for them to protect themselves and then they won’t have to pay for them to be treated and treated for cancer.” (Participant #6)

“Where I’ve come from, most vaccines are free [...] The government paid for them to pay for the – for the health workers at those administration boards, the recipients get it for free.” (Participant #2)

 Lack of time and healthcare provider recommendation

Interviewer: “Did your doctor recommend the HPV vaccine for you (or your kids)”?

“It’s very hard because when you go to the doctor, you have to limit your reason for going, you wait a lot of time and you have to have just one reason to be there, and it’s all a rush. There’s no time to mention that [HPV].” (Participant #6)

4. Cultural norms

“I believe this is a bit difficult to speak about …. Africans don’t talk a lot about sex with their children. If it’s with girls, no it is difficult, with boys I can see us talking a little bit, but not in depth. With girls it is very difficult.” (Participant #7)

Interviewer: “So, do you think you would leave the choice to be vaccinated or not get vaccinated up to your daughter”?

Participant #4: “Yes”.