April 2025

By Nicole Blanton, BA and Jessica Reggi, DO

Historically marginalized communities – particularly those in rural areas – face systemic barriers to accessing critical immunizations, including HPV vaccination. In 2021, Alliance for a Healthier Generation launched a Childhood Vaccine Partnership (CVP) with schools, health departments, and community-based organizations to increase uptake of school-required and recommended childhood vaccines in rural Robeson County, North Carolina. 

Robeson County’s 31 public schools serve approximately 4,000 students in grades K-12. At the time of project launch, some schools had dangerously low rates of vaccination. For instance, at two elementary schools, more than 25% of students were non-adherent with one or more vaccinations required for school-entry, which affects school attendance and learning. 

Taking a highly participatory, culturally responsive, asset-focused approach, the CVP implemented a variety of strategies to increase vaccination education and access, including:  

• Offering vaccination assessment stations at school events for families to quickly and conveniently have vaccine records reviewed, and appointments scheduled. 

• Improving health department vaccination appointment accessibility by offering a wider variety of appointment times. 

• Hosting “Ask a Healthcare Professional” forums to increase vaccination literacy and confidence. 

• Encouraging holistic well-child checks or appointments during which routine and recommended vaccinations are offered and administered. 

• Co-creating resources like a Checklist for Caregivers, which categorizes vaccinations by age rather than grade level. 

These strategies complemented simultaneous state-level efforts to increase vaccination uptake—namely, North Carolina’s implementation of the American Cancer Society (ACS) and ACS National HPV Vaccination Roundtable’s Start HPV Vaccination at Age 9 campaign.  

Over the course of the intervention period, HPV vaccination of school-age children in Robeson County increased by 20%, from 269 doses administered county-wide in 2021 to 323 doses in 2023. Uptake of several other required and recommended vaccines, including MMR, polio, Tdap, varicella, and flu, increased notably among school-aged youth (ages 6 to 18) during this time period, as well. 

Ready to implement proven strategies for increasing vaccine uptake in your school community? Access no-cost evidence-based resources to promote vaccination confidence and access on Healthier Generation’s vaccine resource hub for schools and communities, and explore our Ask a Doctor blog series, available in English and Spanish, including What Caregivers Need to Know About the HPV Vaccine. Healthier Generation serves on both the ACS National HPV Vaccination Roundtable and the North Carolina Immunization Coalition HPV Task Force.