H1

 August 2024

By Angelica M. Roncancio, PhD

HPV vaccination is crucial for preventing HPV-associated cancers, yet vaccination rates among young adults, particularly in rural areas, remain low. The CDC recommend that unvaccinated young adults aged 18-26 receive three doses of HPV vaccination. However, baseline analyses of our federally qualified health center (FQHC) partners—Community Health Centers of South Central Texas and Community Health Network—revealed very low HPV vaccination rates among their young adult patients.

The University of Houston-Downtown (UHD) is addressing HPV-related cancer disparities in rural Texas with a comprehensive, multi-level strategy supported by a three-year grant from the Cancer Prevention & Research Institute of Texas (CPRIT). In collaboration with FQHCs in twelve clinics across seven rural Texas counties, UHD is developing and implementing tailored interventions at both the practice and provider levels to improve HPV vaccination coverage.

This initiative focuses on primary prevention efforts to reduce HPV-related cancer disparities, specifically targeting residents of medically underserved areas and health professional shortage areas, known as MUAs and HPSAs, in Texas. Each clinic is receiving a customized plan to boost HPV vaccination rates, utilizing the CDC’s Immunization Quality Improvement for Providers (IQIP) framework. Additionally, UHD’s community outreach efforts aim to deliver evidence-based education to young adults on college and university campuses and at various community events. The objective is to connect these young adults with partner clinics to receive HPV vaccinations, fostering preventive health behaviors and establishing medical homes.

While numerous evidence-based HPV education programs exist for parents and adolescents, there are significantly fewer for young adults. To address this gap, UHD has created materials specifically for healthcare providers, clinics, and young adults. Each clinic will also have an Immunization Champion to implement system-based interventions that enhance patient access to HPV vaccination services. Furthermore, UHD is training undergraduate students to serve as peer health educators within the community. This initiative not only provides valuable training opportunities for these students but also enables them to give back to their communities effectively.

Despite these efforts, the Texas Department of State Health Services' recent budget cuts to the Adult Safety Net (ASN) Program, which provided vaccines (including HPV) at no-cost or low-cost to uninsured Texans, pose a significant challenge. This removal of the safety net complicates our mission and threatens to widen health disparities. Moving forward, it is essential to foster collaborative efforts between clinics, community organizations, and educational institutions. Support in the form of funding for vaccines for uninsured young adults is critical to sustaining our efforts and reducing HPV-associated cancers.

Increasing HPV vaccination among rural young adult populations requires collaborative teams of healthcare providers, health researchers, community health educators, and higher education administrators. These teams are actively engaged in outreach efforts but depend on the support of programs like ASN to vaccinate uninsured young adult populations.