1. Efforts to Increase HPV
Vaccination Rates at
Local Health
Departments
Tamara Yates RN, BSN
Ohio Department of Health
Nurse Education Consultant

2. ODH and HPV
• ODH authorizes use of HPV vaccine
• Funding From CDC Grant (PPHF) awarded 2014-2016
– Statewide HPV Joint Initiative
– Marketing Campaign
– Reminder/Recall
– Assessment/Feedback (AFIX)
– Provider Education Program
• STIR Grant (Strategies for Increasing Teen Immunizations) for LHDs
-TIES (Teen Immunization Education Sessions) presentation
- AFIX (Assessment, Feedback, Incentive, eXchange)
• IAP (Immunization Action Plan) Grant for Local Health Departments
• SLVC (School Located Vaccination Clinics)
• ODH Adult/Adolescent Coordinator

3. Estimated vaccination coverage with selected vaccines and doses among
adolescents aged 13–17 years, by survey year — National Immunization Survey–
Teen, United States, 2006–2014

4. Estimated coverage with Selected vaccines among adolescents 13-17 years,
National and State-National Immunization Survey-Teen (NIS Teen),
United States 2014
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6429a3.htm#fig1- updated
7/31/15

5. HPV Vaccine Coverage by Age at
Interview
≥ 3 doses ≥ 3 doses

6. ODH and HPV Vaccine
June 8, 2006, the first Gardasil® 4 vaccine
was licensed
January 1, 2007, ODH authorized
ordering of Gardasil® 4
October 16, 2009, Cervarix® vaccine was
licensed
May 5, 2010, ODH authorized ordering of
Cervarix®
December 10, 2014, Gardasil® 9 vaccine
was licensed
June 5, 2015, ODH authorized the
ordering of Gardasil® 9

7. Doses of HPV Vaccine Shipped
Year Total doses Shipped
by ODH
2013 150,939
2014 210,855
2015 248,518

8. 2014 CDC/PPHF Grant to Increase
HPV Vaccination Rates
Goal: 80% of teens UTD with three doses
Objectives:
1.Statewide HPV Joint Initiative
2.Marketing Campaign
3.Reminder/Recall
4.Assessment/Feedback
5.Provider Education

9. 2014 CDC / PPHF Grant
1. Statewide HPV Vaccine Joint Initiative
• ODH Partners – Reproductive Health, Cancer,
School Nursing
• External Partners – OSU, Ohio AAP, OACHC,
Ohio AFP, etc.

10. 2014 CDC / PPHF Grant
2. Marketing Campaign
• Television campaign
• ‘Close the Door to Cancer!’ (CDC)
– http://www.youtube.com/watch?v=YdLQ2f0hF4g
– http://www.youtube.com/watch?v=ULbB0SdVe94
• Radio campaign
• ‘Get Vaccinated Ohio’ (ODH)
– http://www2c.cdc.gov/podcasts/player.asp?f=8630172
• 10 major markets June – August 2014
• Use of Social Media outlets( Facebook and Twitter)

11. TV and Radio Coverage Area
• Timeline:
• June – Sept 2014
• Target Main Ohio
Markets

12. 2014 CDC / PPHF Grant
3. Reminder/Recall
• Centralized through ImpactSIIS
• Monthly reminder letters
• Mailed over 3,900 letters
• Recall letters
• Two mass mailings
• June-July 2014: Promote adolescent platform
• August-September 2014: HPV recall for doses 2 and 3

13. 2014 CDC / PPHF Grant
4. Assessment/Feedback
Adolescent AFIX
• AFIX with 4-6 month follow-up assessment/feedback
• Review 13 to 15 year old patients
Completed by STIR grantees and ODH
• 170 Adolescent AFIXs
– 159 (93.5%) participated in a follow-up session
– Aggregate HPV vaccination coverage for receipt of
3 doses increased 5.3 percentage points from
27.8% to 33.1%

14. 2014 CDC / PPHF Grant
5. Provider Education
• TIES (Teen Immunization Education Sessions)
Grant
• Developed with OAAP
• Regional Education Days
• STIR grantees
• Focus: Give providers the tools that they need to
make a strong recommendation for HPV vaccine

15. 2014 CDC / PPHF Grant
Implement STIR Grants to LHDs
(Strategies for Increasing Teen Immunization Rates)
• 6 lead counties
• Allen, Clark, Lorain, Lucas, Montgomery &
Summit
• 5 partnering counties
• Auglaize, Henry, Mercer, Van Wert &
Madison/London City

16. IAP Grant
The goal of the IAP program is to achieve and maintain 90% vaccination coverage
levels for universally recommended vaccines among children less than 24 months of
age and for adolescents through:
•Assessing and improving health district immunization rates through use of an Immunization
Information System (IIS) and promoting effective practice changes to improve immunization
rates;
•Assessing the immunization rates of providers throughout the applicant county (or counties)
and promoting effective practice changes to improve immunization rates;
•Identifying disparities of low immunization levels and providing additional immunization
education to parents and health care providers in those areas;
•Educating immunization providers of children and adolescents regarding the importance of
timely immunizations and effective strategies to improve practice behavior;
•Implementing additional and targeted reminder and recall activities to improve local health
department immunization rates. .
•Provide TIES and MOBI trainings
•Provide childhood and adolescent AFIX

17. School Located Vaccination Clinics
• Recommended by ODH to
provide all age-
appropriate vaccines at
school clinics to avoid
missed opportunities.
• Collaborate with LHDs to
provide vaccines for SLVC
Diphtheria Hepatitis A Hepatitis B
HPV Influenza Measles
Mumps Meningococcal Pertussis
Polio Rubella Tetanus
Varicella

18. Encourage Best Practices
• Assessment, Feedback, Incentives, eXchange (AFIX)
• Record-keeping
• Immunization Information Systems
• Recommendations to Parents / Need to Return
• Reminder and Recall Messages to Parents
• Reminder and Recall Messages from Providers
• Reduce Missed-Opportunities and Barriers
18

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20. Tamara (Tami) Yates RN, BSN
Nurse Education Consultant
Ohio Department of Health
Immunization Program
Tamara.yates@odh.ohio.gov
Phone: 614-752-9685
1-800-282-0546