HPV Vaccination in a Large Cervical Cancer Screening Program
Introduction
Infection with high-risk types of human papillomavirus (HPV) are associated with more than 95% of cervical cancers. Vaccination for HPV protects against nine types of HPV, including high risk types. The HPV vaccine series is recommended at ages 11-12 with 2 doses delivered 6 months apart. Evidence shows vaccination is still effective through age 26 with guidelines recommending 3 doses (0, 2, and 6 months) for those who initiate the series at age 15 or older. While Texas has seen an increase in the percentage of female teens with at least 1 dose of HPV vaccine from 48.8% in 2011 to 73.1% in 2020, the number of up-to-date females remains lower at 57% in 2020; both rates are below the Healthy People 2030 goal of 80%. As part of a CPRIT expansion grant (PP200064), Moncrief Cancer Institute expanded services to include HPV vaccination for patients ages 18-26 who were not up-to-date or have never started the vaccine series.
Methods
Patients are asked about their HPV vaccination status when they come to Moncrief Cancer Institute for cervical cancer screening services. Patients who are eligible for the HPV vaccine based on age and previous vaccination status, receive education and an order for the vaccination series to be completed at our collaborating pharmacy. After the first full year of vaccine distribution, from March 1, 2022 to February 28, 2023, we evaluated the program outcomes.
Results
We examined trends in participation. Data is available for 99 patients who completed at least one dose of the HPV vaccine during the first year of implementation. We further summarize patient demographics, stratified by dose completion.
Conclusion
While we originally proposed our pilot would serve 60 patients, interest in vaccination for the “catch-up” population was greater than anticipated. As are result, we have doubled the number of patients initiating vaccination, with more than 120 patients having completed at least one vaccine through June 2023. We anticipate these outcomes will be largely beneficial as we consider the makeup of the catch-up population and how best to serve them.