Background:
As programs are initiated for STD vaccination, it will be crucial to understand vaccine decision-making among parents and their adolescent children.

Objective:
To examine concordance in decision making for STD vaccination between parent-adolescent pairs across three race/ethnic groups.

Method:
363 parents (ages 24-66; 92% female) and adolescents (ages 12-17; 63% female) were recruited at pediatric clinics and completed separate audio computer-assisted self-interviews. Parent/child race/ethnicity was 33% Latino, 25% African American, and 42% Non-Hispanic White. Locus of decision-making for STD vaccination was measured by a 5-point scale ranging from exclusively parent to exclusively adolescent decision with the middle value designated as an equally shared decision. Parent-adolescent concordance was measured using the Signed-Rank test, and differences between race/ethnic groups were analyzed using non-parametric tests: Kruskal-Wallis (overall) and Wilcoxon (pair-wise).

Result:
34.5% of parents reported that they would be the primary decision-makers regarding STD vaccination, whereas only 15.5% of adolescents saw their parents in this role. Conversely, 33.1% of adolescents reported that they would be the primary decision-maker, whereas only 9.7% of parents saw their adolescents in this role. The largest proportion of parents (55.8%) and children (51.4%), however, selected “equal say”. There were differences between parents and their children in terms of locus of decision-making for all subjects combined and within each race/ethnic subgroup (all Ps<0.05). However, patterns of results differed across ethnic groups (P=0.002), with less Latino parent/adolescent discrepancy compared to other subgroups (both Ps<0.02).

Conclusion:
Many parents and adolescents see decisions around STD vaccination as a shared process. However, a substantial number of adolescents expect greater involvement in decision-making than their parents accord them.

Implications:
As new STD vaccines emerge, immunization programs may need to consider the adolescents' attitudes as well as the attitudes of their parents in order to optimize program effectiveness.