In spite of its ability to prevent cancer and strong recommendations for vaccination from the Centers for Disease Control and Prevention, the HPV vaccine remains underutilized in the US. Only 57 percent and 35 percent of girls and boys 13-17 years old, respectively, have initiated the 3-dose series. Among 18-26 year olds, only 35 percent of women and 2 percent of men have received at least one 1 dose. Completion rates are even lower in both groups.

Vaccination rates are particularly low in Texas’ Golden Triangle (Jefferson and Orange Counties); our surveys have found that only 14 percent of 11-26 year olds have received at least 1 dose of the vaccine. This is concerning given that resi...

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In spite of its ability to prevent cancer and strong recommendations for vaccination from the Centers for Disease Control and Prevention, the HPV vaccine remains underutilized in the US. Only 57 percent and 35 percent of girls and boys 13-17 years old, respectively, have initiated the 3-dose series. Among 18-26 year olds, only 35 percent of women and 2 percent of men have received at least one 1 dose. Completion rates are even lower in both groups.

Vaccination rates are particularly low in Texas’ Golden Triangle (Jefferson and Orange Counties); our surveys have found that only 14 percent of 11-26 year olds have received at least 1 dose of the vaccine. This is concerning given that residents of this region are at a much greater risk of being diagnosed with an HPV-related cancer than other Texans. In fact, cervical cancer occurs twice as often and oropharyngeal cancer in men nearly 1.5 times more often in Orange County than the rest of Texas.

It is encouraging that in surveys we conducted in this region, 80 percent of unvaccinated 11-26 year olds (or their mothers, in the case of adolescents) stated they would agree to HPV vaccination if it were available free of charge. Thus, Jefferson and Orange Counties would greatly benefit from a CPRIT-funded program that reduced barriers and helped adolescents and young adults easily obtain this highly effective vaccine.

Our strategy to increase the number of adolescents and young adults vaccinated against HPV includes patient navigation services, vaccination at no cost to the patient, thorough patient tracking, reminder methods, and provider education. We also will employ multiple strategies to reach out to the entire community. Vaccine-eligible adolescents and young adults who receive care at 2 UTMB clinics in the Golden Triangle will be approached and counseled by a patient navigator (PN). If they agree, they will be vaccinated at that visit.

To increase series completion, we will use texting and automated and personal phone calls as reminders. To increase the number of males vaccinated, patients will be encouraged to refer their partners. Mothers receiving care in the clinic who have an eligible child will be encouraged to bring him/her to the clinic for vaccination. To further extend our outreach, we will place newspaper ads and initiate a location- and age-targeted social media campaign. In addition, our partners (which include local clinics and health organizations that do not offer the HPV vaccine) have agreed to refer their patients to program sites.

UTMB will conduct financial screening to determine eligibility for government programs or coverage by private insurance, thereby saving CPRIT $425,294. When needed, CPRIT funds will be used to ensure that the vaccine is available to all patients at no cost. Moreover, we will conduct cervical cancer screening on women 21 years of age or older who need a Pap smear, at no cost to CPRIT. Finally, we will educate regional providers in groups and individually to increase physician recommendation and vaccination rates for this vaccine throughout the community.

This project will counsel more than 2000 patients or their parents. We will increase HPV vaccine initiation rates among 11-26 year olds from 14 percent to 80 percent and completion rates from 8 percent to at least 62 percent. We will also educate 200 providers to increase their knowledge and comfort level with recommending the HPV vaccine.

Our use of PNs to increase HPV vaccination rates is innovative. Moreover, we will reach out to children and partners of patients seen at the regional clinics which, in addition to our referral incentives, will encourage a snowball effect of HPV vaccine awareness and uptake in Jefferson and Orange Counties. This is especially critical for boys and young men, who have particularly low rates of HPV vaccination. The use of social media will also be an innovative approach to improving HPV vaccine uptake in these counties.

 

HPV vaccination has a direct impact on public health and cancer prevention. Our project will dramatically increase HPV vaccination rates in a region of east Texas that has high rates of HPV-associated cancers and very low vaccination rates. Moreover, the education of providers in the area should lead to an increase in physician recommendation over the long term. We will disseminate our results widely and other clinics in Texas could easily adapt our methods to increase HPV vaccination rates.

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