Breaking down the barriers to HPV vaccination

Erika ThompsonMuch of Dr. Erika Thompson’s work is focused on HPV research and prevention. Recently, she presented a Grand Rounds talk at The University of North Texas Health Science Center at Fort Worth on “Designing, Implementing and Evaluating Interventions to Increase HPV Vaccination across the Life Course.”

Thompson is an associate professor of population and community health in HSC’s School of Public Health and serves as director of community engagement for the Institute for Health Disparities.

“HPV is a common infection in the U.S.,” she said. “Approximately 42.5 million people – 45% women and 55% men, many in their late teens and early 20s – are infected with HPV. Some types of HPV can cause serious health problems, including six types of cancer, but there are vaccines that can prevent these problems from occurring.”

“HPV vaccination provides safe, effective and long-lasting protection,” Dr. Thompson added.

Barriers to HPV vaccination, she said, include access to care, lack of provider recommendation, lack of requirement for school entry and vaccine hesitancy. As such, she explained, “we need to develop community solutions to address these barriers.”

The HPV vaccination is routinely recommended at age 11 or 12 years, but children can receive the vaccine as early as age 9 and persons not vaccinated can receive the vaccine until age 26. After reviewing new evidence, the U.S. Centers for Disease Control and Prevention has updated its recommendations for adults – persons who have not received the vaccine can discuss this option with a health care provider if they are ages 27 to 45.

“Unfortunately,” Dr. Thompson said, “the rates of HPV vaccine uptake have been lower in Texas and North Texas compared to the rest of the United States.”

Reaching higher levels of vaccination involves a coordinated effort between clinical and community settings, she noted. HSC has launched a program called HPV CHAT (Communicating about HPV vaccination to adults and teens), which includes provider recommendation trainings, audit and feedback for clinics, parent education, reminder calls and coverage of vaccination fees. The HPV CHAT project is a collaboration between HSC and Tarrant County Public Health, JPS Health Network, the North Texas Primary Care Practice-Based Research Network and the Immunization Collaboration of Tarrant County. This initiative is supported by The University of Texas MD Anderson Cancer Center.

“Studies have shown that a strong recommendation and understanding the reasons behind vaccine hesitancy can lead to increased rates of HPV vaccination,” Thompson said.

“Since 2006, more than 135 million doses of the vaccine have been administered. It is one of the most studied medications on the market and is proven to be safe.”

Through HPV CHAT, Tarrant County providers, clinic settings and other community agencies have been successful in confidently communicating about the HPV vaccine.

“Dr. Thompson’s Grand Rounds presentation, her research and the work of HPV Chat exemplify the importance of implementation research, where evidence-based health interventions are adopted into clinical and community settings to improve patient outcomes and benefit population health,” said Dr. Shafik Dharamsi, SPH dean.

“Dr. Thompson’s work demonstrates how SPH prioritizes collaborative problem-solving and actively works with our community and health sector partners to co-create solutions addressing the unique health challenges that our communities face,” he added.

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