multifaceted hpv vaccination strategies in california achieving the promise avoiding the pitfalls...
TRANSCRIPT
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Multifaceted HPV Vaccination Strategies in California
Achieving the Promise Avoiding the Pitfalls
Heidi M. Bauer, MD MS MPHCalifornia Department of Public HealthSTD Control Branch
ISSTDR Seattle July 2007
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Acknowledgements
Eileen Yamada Terri Thorfinnson Kurt Snipes Tammy Pilisuk Joyce Lisbin Gail Bolan And the many California stakeholders!
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Overview
The rationale
The process: keys to success
Challenges and accomplishments
Future efforts
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What are the benefits of the HPV vaccine in the
US? Cervical cancer is still a problem:
• 11,150 new cases and
• 3,670 deaths projected in 2007
Pap screening is secondary prevention Vaccine affords primary prevention:
• > 10,000 cervical and anogenital cancers• ~ 4,000 head and neck cancers• 160,000 abnormal Pap tests• > 300,000 cases of genital warts
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Rationale for Workgroup
Intervention crosses multiple agencies
Pool resources and expertise
Create and promote consistent messages
Opportunity to create partnerships between
state government and advocacy,
professional, and healthcare organizations
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The Process: Keys to Success
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California HPV Vaccine Workgroup
Lead agencies: Immunization
STD Control
Cancer Detection
State government partners: Office of Women’s HealthDept of EducationMaternal Child Adolescent HealthOffice of Family PlanningOffice of AIDS
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Workgroup Process
Strategic planning
Sharing resources
Stakeholder involvement
• External stakeholder interviews
• Statewide HPV Vaccine Summit
• Meaningful partnerships
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Controversies Framing of the vaccine:
Cancer vs. STD prevention?
Rationing of resources for target populations
Minor consent
School mandates
Unanswered questions
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Challenges and Accomplishments
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Challenge #1:
Lack of public awareness of HPV, the connection with cervical cancer, and the availability of an effective vaccine
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www.HPVvaccineCA.org* 9/06-6/07: > 2,000 hits; 2,600 page views
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www.ccrcal.org
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www.GetImmunizedCA.org
Platform: MCV4 Tdap Varicella HPV Influenza
* 4,000 providers, local PH programs, partner organizations* 26,000 print brochures in English; 15,000 brochures in Spanish
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www.HPVvaccineCA.org
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Challenge #2:
Lack of knowledge about HPV vaccine among health care provider and public health professionals
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www.cdlhn.com * 1/07-6/07: ~ 350 downloads
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* > 35,000 copies to 4,500 VFC providers, local IZ coordinators, etc
www.HPVvaccineCA.org
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www.CalMedFoundation.org
* > 1,700 hits to index page and > 7,500 page views
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Challenge #3:
Ensuring access to the vaccine among those who will benefit most
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California VFC Program
As of June 15: 221,000 doses distributed to 2,400 VFC providers
Estimated 250,000 doses distributed within private sector
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Challenge #4:
Lack of surveillance data to assess the public health impact of the vaccine
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Cervical Disease Surveillance
Collaboration with California Emerging Infection Program:
Demonstration project to monitor CIN 2/3 within one county
Feasibility study for expansion and continuation
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Future Efforts Conduct surveys to assess knowledge of
HPV and vaccine uptake
Provider surveys to understand barriers
Promote immunization registry for preteen vaccines
Provide technical assistance on policy issues
Develop and distribute materials for high-risk populations
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Conclusions The unique challenges of implementing an
HPV vaccination program require an ongoing statewide collaborative effort to engage and coordinate a wide variety of stakeholders
Our work reinforces the effective role that state health departments have in supporting the introduction of HPV vaccines
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Thank You!
Visit us! California HPV Vaccine Workgroup: www.HPVvaccineCA.org
Or write: [email protected]