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 65 percent of girls 13-17 years old have initiated the vaccine series and completion rates are even lower. Among 19–26 year olds, only 42 percent of women have initiated the vaccine series.

Vaccination rates are much lower among women receiving care at the University of Texas Medical Branch’s gynecology clinics in McAllen and Galveston, Texas (Hidalgo and Galveston Counties). A medical records review indicates that an average of only 18 percent of eligible young women attending these clinics have ...

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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 65 percent of girls 13-17 years old have initiated the vaccine series and completion rates are even lower. Among 19–26 year olds, only 42 percent of women have initiated the vaccine series.

Vaccination rates are much lower among women receiving care at the University of Texas Medical Branch’s gynecology clinics in McAllen and Galveston, Texas (Hidalgo and Galveston Counties). A medical records review indicates that an average of only 18 percent of eligible young women attending these clinics have received even 1 dose of the vaccine. This is concerning given that many patients attending these clinics are low-income or members of racial/ethnic groups with higher rates of HPV-related cancer incidence and mortality. Additionally, a significant number reside in medically underserved areas. Thus, patients attending these clinics would greatly benefit from a CPRIT-funded program that reduced barriers and helped young women easily obtain this highly effective vaccine.

Our strategy to increase the number of young women 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 broader community.

Vaccine-eligible young women who receive care at 2 UTMB clinics will be approached and counseled by a patient navigator (PN). If they agree, they will be vaccinated at that visit. To increase series completion, patients will receive automated text messages and phone calls as reminders as well as personal calls from PNs. To further extend our outreach, we will work with various community stakeholder groups to educate community leaders and inform them of the availability of the vaccine for their constituents.

UTMB will conduct financial screening of patients to determine eligibility for government programs or coverage by private insurance, which we estimate will save CPRIT over $500,000 in vaccine costs. CPRIT funds will be used to cover vaccination costs when other funds are not available to ensure that the vaccine is available to all patients at no cost. Finally, our project will include an extensive provider education component, through which we will educate current and future providers in Hidalgo and Galveston counties and a number of surrounding underserved counties. This aspect of our program will increase physician recommendation of this vaccine and thus vaccination rates throughout the community.

This project will counsel more than 2,000 patients and will ensure that over 1,300 women initiate the vaccine and over 1,000 complete it. We will also educate at least 400 providers to increase their knowledge and comfort level with recommending the HPV vaccine. 

Our use of PNs to increase HPV vaccination rates is innovative as this service is not widely used to increase immunizations rates. We have also formed numerous unique partnerships to establish a community-wide approach to increase vaccination rates in underserved areas.

HPV vaccination has a direct impact on public health and cancer prevention. Our project will dramatically increase HPV vaccination rates in medically underserved areas of Texas with high rates of HPV-associated cancers and low vaccination rates. Moreover, our extensive provider education efforts 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 in their communities.

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