Improving HPV Vaccine Coverage In North Dakota By Enhancing Adolescent AFIX
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1 Improving HPV Vaccine Coverage In North Dakota By Enhancing Adolescent AFIX
2 North Dakota and U.S. Adolescent (Age 13-17) HPV Vaccination Rates (2015 NIS) 80 % Vaccinated U.S. North Dakota 0 HPV1-Female HPV3-Female HPV1-Male HPV3-Male
3 North Dakota Adolescent (13-17) Immunization Rates (NIS) Healthy People 2020 Goal for HPV3 Tdap MCV4 Female 1 dose HPV Female 3 doses HPV Male 1 dose HPV Male 3 doses HPV
4 NHANES Trends in HPV Immunization, Females Males
5 What Are the Barriers to HPV Vaccine Uptake? Necessity? Safety? Why so young? Am I tacitly or subconsciously approving premarital/ promiscuous sex?
6
7 Reasons Parents Don t Vaccinate Against HPV Top five reasons for not vaccinating adolescents with human papillomavirus (HPV) vaccine* - National Immunization Survey-Teen, United States, 2013 Parents of girls Parents of boys Reason % (95% CI) Reason % (95% CI) Lack of knowledge 15.5 ( ) Not recommended 22.8 ( ) Not needed or necessary 14.7 ( ) Not needed or necessary 17.9 ( ) Safety concern/side effects 14.2 ( ) Lack of knowledge 15.5 ( ) Not recommended 13.0 ( ) Not sexually active 7.7 ( ) Not sexually active 11.3 ( ) Safety concern/side effects 6.9 ( ) *Analysis limited to parents reporting that they were not likely to seek HPV vaccination for their teen in the next 12 months or were unsure of their HPV vaccination plans.
8 Survey of Provider Confidence in Vaccine Safety Physicians Reporting Little to No Confidence in Pre-Licensure Vaccine Safety Studies % Reporting Little to No Confidence n = 691/848 n = 532/811 0 Pediatricians Family Physicians O Leary ST., Prev Med 2013.
9 59% of surveyed pediatricians and FPs used a risk-based approach in deciding who to vaccinate Gilkey MB. Cancer Epi Biomarkers Prev 2015
10 ND Enhanced AFIX Project to Increase Adolescent HPV Immunization Assessment exchange AFIX Feedback Incentives
11 Real Incentives? Certificate of Completion Continuing Medical Education AMA Category 1.0 h HPV Infection and Vaccination
12 Dr. Cliff Mauriello Jamestown, ND
13 Allison Peltier, DNP Spirit Lake, IHS
14 1:2 Women Graduating from College Will Acquire HPV, Can You Guess Which One? 50%
15 HPV Vaccine - Not Just for Girls One will get HPV Infection, and will be just as likely to develop a cancer as a female
16 How Does Clinic X Compare to Statewide Rates and National Goals? Healthy People 2020 Goal MCV-4 [1] Tdap [1] HPV- [1] HPV-UTD Clinic "X" North Dakota National Immunization Survey (2015)
17 Clinic X Missed Opportunities % of Clinic Visits With Vaccination Where Did Not Receive Eligible HPV HPV [1] HPV [UTD]
18 HPV Will Affect Far More of Your Patients than Meningococcal Infection and Hib Combined 40,000 35,000 30,000 25,000 20,000 15,000 Pre-Vaccine Era Annual Incidence 15,000 38,795 10,000 5, ,000 Meningococcal Infection Invasive Hib HPV Related Cancers
19 HPV Vaccination Timeline 0 months 6 months 7 months If started prior to 15 th birthday Dobson, JAMA 2013
20 Strategies to Improve HPV Vaccine Acceptance Three pronged communication approach based on the best evidence to date: 1. Announce 2. EASE the main concern 3. Recommend
21 Normalize HPV Vaccination: Sandwich Between the Routine Vaccines Tdap HPV Meningococcus
22 No drug, device, process, or procedure in healthcare is as heavily scrutinized and monitored for safety and efficacy as are vaccines!
23 Vaccinate With Confidence!
24 Traditional vs Enhanced AFIX: HCW and Provider Exposure Traditional 67 Clinic Visits 2017 Enhanced 59 Clinic Visits All HCWs Medical Providers
25 HPV Vaccination Rate Increases with Traditional vs Enhanced AFIX; Jul Dec % Increase HPV Initiation HPV Complete All ND Traditioinal AFIX Enhanced AFIX
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