Massachusetts HPV Vaccination Initiative

Update

MDPH 20141

HPV SummittNovember 7, 2014Susan M. Lett, MD, MPH

Medical Director, Immunization ProgramMassachusetts Department of Public Health

Disclosure Slide

• I, Susan Lett, have been asked to disclose any significant relationships with commercial entities that are either providing financial support for this program or whose products or services are mentioned during my presentations. I have no relationships to

• I may talk about off-label recommendations for HPV vaccine in a manner not approved by the U.S. Food and Drug Administration

• But in accordance with the recommendations of CDC’s Advisory Committee on Immunization Practices (ACIP)

MDPH 2014

MA HPV Initiative Activities 1. Development of statewide joint initiative with

partners and stakeholders

2. Educating healthcare providers about burden of HPV disease, HPV vaccine schedule, evidence-based strategies

3. Implementation of media campaign targeting parents

4. Training and supporting a subset of providers to pilot the MIIS (MA Immunization Registry) to use immunization coverage reports and to use reminder/recall

MDPH one of 11 states initially funded by CDC.MDPH 2014 3

Statewide Joint HPV Vaccine Initiative • Partners and stakeholders from 29 external organizations

– More than 100 members on group email

– Wide variety of organizations: professional associations, non-profits, hospitals, universities

– Build on work done in 1st HPV Summit in 2013

• Strong partnership with MCAAP & MA League of Community Health Centers– AAP grant to MCAAP for HPV vaccination activities

• New MA Coalition for HPV/ Cervical Cancer Awareness

• New federal funding just awarded to several national organizations

Activity 1.

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• HPV page on MA Chapter of the AAP website and 4 webinars

• Grand rounds, seminars including residents & students

• Other in-person events such as conferences and annual meetings

• Electronic distribution of information: newsletters, websites, journals, blogs, etc.

• 2nd Annual HPV/Cervical Cancer Summit at Dana Farber Cancer Institute on November 7th

HPV Educational Activities

Total of 50 events reaching more than 2,700 individuals!!

Activity 2.

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Evidence-Based Strategies to Improve HPV Vaccine Rates

Strong, clear, routine recommendation for HPV vaccine at 11-12 years

Assess and vaccinate at every visit

Use reminder/recall systems

Assessment and feedback

Standing Orders

Immunization Champion

Overdue:HPV-2Tdap

Activity 2.

http://www.thecommunityguide.org/about/methods.html MDPH 2014

Flyer available at: https://mcaap.org/immunization-hpv/

URGENT CALL TO PREVENT CANCER TAKE THE HPV VACCINE CHALLENGE

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Start your vaccine discussions with all 11-12 year-olds and their

parents by saying:

“ Your child needs 3 vaccines today – HPV, Tdap and

meningococcal.”

Dr. Rebecca Perkins’ MMS Physician FocusOctober 2014

MDPH 2014

• Audience both general public and providers

• Half hour cable TV segment• Broadcast on public access

stations in 275 communities in MA• Also distributed nationally

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MMS Link:http://www.hcam.tv/physician-focushpv

National ACOG Link:http://www.immunizationforwomen.org/resources/education

ACOG Immunization for Women WebsiteHPV Tool Kit: http://

www.immunizationforwomen.org/immunization_facts/vaccine-preventable_diseases/hpv

Article in Aug. 2014 Pediatrics. Missed Opportunities for HPV VaccinationIn Adolescent Girls: A Qualitative Study. Perkins, Clark, Apt, Sumner, Wall-Haas,Rosenquist and Pierre-Joseph.

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HPV Media Campaign • Campaign ran during June 2014

• Primary target: parents of adolescents with focus on Hispanic & African American audiences

• Primary goal: increase awareness of importance of HPV vaccine to prevent cancer

• Mechanisms– TV & radio 30 second ads – reached >2.4 M people– Tweeting complemented the ads

Activity 3.

Close the Door to Cancer: AN Animated PSA that illustrates the numbers associated with HPV related infections and cancers.

Why HPV Vaccine is Important: We have three separate PSA’s one from a survivor, one from an English speaking pediatrician, and one from a Spanish speaking physician. Each of these PSAs talks about why HPV vaccine is so important. Each runs about 30 seconds.

MA used this PSA.

MA used this PSA.

Video PSAs

HPV Media Campaign, cont.Social Media: Twitter #vaccineagainstcancer• MDPH has an estimated over 18,000 twitter followers• Most popular tweet was:

• Total number of impressions (defined as number of times users saw the tweet) was 28,673 – much greater than we anticipated!!

If there were a #vaccine against #cancer wouldn’t you get it for your child? There is its #HPV vaccine: http://ow/ly/xxsBw

Activity 3.

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MA Parent Teacher Association – Health Committee

• Have embraced HPV vaccination education for parents

• Presentations given and materials distributed at various state and regional chapter meetings

• Several youth activities– HPV session held with Kids United by Service (KUBS): high

school student leaders bring info back to their peers– First MA Youth Summit on 11/8: leadership & advocacy

training to prepare youth leaders to mobilize their peersaround specific issues in their school & community.

Activity 3.

Using the MA Immunization Information System (MIIS)

• Pilot of 10 CHCs and 10 pediatric practices will receive technical assistance and training to:– Run practice-based adolescent vaccination coverage

reports– Generate reminder/recall materials for adolescents due

and overdue for adolescent vaccines– “Using the MIIS to Improve HPV Rates in Your Practice”

Webinar 10/9/14 and Workshop at MIAP 10/24/14– Assessments began in October

Activity 4.

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Where Are We Now and

What Lies Ahead?

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• NIS Data• CDC HPV Quarterly Reports• CDC Funding of New Initiatives• New MA Coalition for HPV/ Cervical Cancer

Awareness

Adolescent Vaccination CoverageUnited States, 2006-2013

MMWR 2014; 63(29);625-633.MDPH 2014 16

62%

39%

95%

90%

53%

22%*

0%

20%

40%

60%

80%

100%

2008 2009 2010 2011 2012 2013Year

% V

acci

natio

n Co

vera

ge

Tdap

MenACWY

1 HPV - Females

3 HPV - Females

1 HPV - Males

3 HPV - Males*

Adolescent Vaccination Coverage, Massachusetts, 2008 – 2013

NIS Data, CDC

*Data for 3 HPV in males only available in 2013

MDPH 2014

In MA, 176,000 teens havenot received ANY doses of HPV vaccine:About 4 in 10 girls and 5 in 10 boys.

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HPV Missed Opportunities in Massachusetts, 2013 NIS Teen

100% of girls who were unvaccinated against HPV had a missed opportunity (MO).

100% of girls could have started the series if MO’s wereeliminated.

CDC. HPV Quarterly Report 10-14

CDC Federal Funding of 6 New Projects• Academic Pediatric Association

– Promote partnerships, provide training of providers and for faculty for primary care pediatric residents

– https://www.academicpeds.org/

• American Academy of Pediatrics– Outreach, education and training for pediatric offices, includes QA activities, interface with

immunization registries and outreach to state AAP chapters– http://www2.aap.org/immunization/

• American Cancer Society– Increase rates at safety net clinics and CHCs by identifying best interventions and outreach to state

health departments and other state agencies– www.cancer.org

• American Cancer Society – Roundtable Project– Will convene a network of organizations involved with cancer prevention, immunization, healthcare delivery,

public health and other stakeholders. Pilot projects will focus on overcoming barriers in priority areas– www.cancer.org

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• National Area Health Education Centers (AHEC) Network– Will develop and provide training to clinicians across disciplines

nationwide, work with state health departments, inventory resources and develop what is needed

– http://www.nationalahec.org/

• National Association of City and County Health Officers (NACCHO)– Build capacity for local health departments to implement HPV

recommendations– http://www.naccho.org/

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CDC Federal Funding, cont.

11 more states/projects just received funding for HPV

initiatives for a total of 22.

MA Coalition for HPV/Cervical Cancer Awareness

• Comprised of advocates, health care professionals, agencies, and stakeholders

• Ensure MA continues to be a leader in HPV vaccine uptake to decrease HPV-related cancers

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15-40 ConnectionAmerican Cancer Society-New England DivisionBC/BS of MassachusettsBoston Public Health CommissionBrigham and Women’s HospitalCape Cod HealthcareDana-Farber Cancer InstituteMA Caucus of Women LegislatorsMA Department of Public HealthMA Commission on the Status of WomenMA Chapter - American Academy of PediatricsMA League of Community Health Centers

Coalition website has been donated by Team Maureen.

Learn more or join at: TeamMaureen.org

Pediatrics WestSalem State University

Sociedad LatinaTeam Maureen

UMass Memorial Children’s Medical CenterYellow Umbrella Organization

Current Members

MDPH 2014

CDC “You Are the Key” Website

http://www.cdc.gov/vaccines/who/teens/for-hcp/hpv-resources.html 22

Reviews HPV materials from reliable websites and has quick

links to key materials:

http://mcaap.org/immunization-hpv

/

MA Chapter of the AAP “HPV Vaccine Initiative”

Website

Immunization Program Main NumberFor questions about immunization recommendations, disease reporting, etc.• Phone: 617-983-6800• Fax: 617-983-6840• Website: www.mass.gov/dph/imm

MIIS Help Desk• Phone: 617-983-4335• Fax: 617-983-4301• Email: miishelpdesk@state.ma.us• Websites: www.contactmiis.info | www.mass.gov/dph/miis

MDPH Vaccine Unit• Phone: 617-983-6828• Fax: 617-983-6924• Email: dph-vaccine-management@state.ma.us• Website: www.mass.gov/dph/imm (click on Vaccine Management)

MDPH Immunization Program Contact Information

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THANKS FOR ALL

YOU DO!!!