Human Papillomavirus Vaccination Uptake in the Rio Grande Valley: Results from a Pilot Community-Based Educational and School-Based Vaccination Program and Its Expansion

Abstract

Human papillomavirus (HPV) vaccine is a safe and effective strategy for reducing HPV morbidity and mortality. Schools have become an increasingly attractive setting for delivering vaccinations and supporting vaccination health literacy and decisional support. This study assesses the effectiveness of a community-based, physician-led HPV education campaign (starting in 2016) and onsite middle school-based HPV vaccination program across six school districts (2017, 2019, 2020) in a rural, medically underserved Texas area (Rio Grande Valley). Pre- and post-intervention HPV vaccination rates were tracked against the 2016 National Immunization Survey-Teen target rates (initiation: 49.3%; completion: 32.9%). Summary statistics were stratified by gender, school district, and grade level. The study reached 19,951 students who received HPV vaccines directly or indirectly through our program (10,289 females; 9662 males) (August 2016-August 2022). Of those, 2145 students (1074 females; 1071 males) were vaccinated directly through our program. The overall HPV up-to-date (UTD) rates were 58.8%. The overall median age at HPV vaccine initiation and HPV-UTD (range) was 11 years (9-21) and 12 years (9-20). The overall median interval between HPV vaccine doses (range) was 291 days (146-2968). Recommending HPV vaccine initiation at younger ages increases HPV vaccine completion and providing access to HPV vaccines encourages on-time vaccination and completion.

Keywords: Rio Grande Valley; adolescent health; human papillomavirus vaccine; human papillomavirus-related cancers and diseases; provider recommendation; school-based vaccination.

Figure 1

HPV vaccination rates in the RGCCISD pilot program and its expansion in PSJA ISD: (a) HPV vaccine initiation and HPV-UTD rates in the pilot program in RGCCISD from 2016–2020; (b) HPV vaccine initiation and HPV-UTD rates in the expansion in PSJA ISD.

Figure 2

Male and female HPV vaccine initiations and HPV-UTD in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD: (a) Male HPV vaccine initiation in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD; (b) female HPV vaccine initiation in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD; (c) female HPV vaccine completion in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD; and (d) female HPV-UTD in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD.

Figure 2

Male and female HPV vaccine initiations and HPV-UTD in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD: (a) Male HPV vaccine initiation in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD; (b) female HPV vaccine initiation in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD; (c) female HPV vaccine completion in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD; and (d) female HPV-UTD in RGCCISD, Roma ISD, San Isidro ISD, Zapata ISD, and Jim Hogg ISD.