Human Papillomavirus Vaccinations During the COVID-19 Pandemic in Middle Schools in the Rio Grande Valley of Texas

Rodrı́guez, Ana M.; Do, Thuy Quynh N.; Jibaja‐Weiss, Maria; Chen, Lu; Schmeler, Kathleen M.; Montealegre, Jane R.; Kuo, Yong–Fang

doi:10.2105/ajph.2022.306970

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…However, to accommodate school and community needs, we were able to reschedule two of those schools for November 2020 by changing our clinic protocol to a drive-through process to adhere to social distancing and limited in-person contact. Similarly, outdoor events, increased online activities, and stakeholder engagement through teleconferencing were strategies that allowed a safe environment for middle school students to receive vaccinations in another school-based HPV vaccination project in Texas during the pandemic [ 27 ]. As seen through such adaptations, efforts should focus on executing timely responses and flexible arrangements with strengthened preparedness so that as much of the program as possible can be carried out as planned, rather than completely suspending the program [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

Lessons Learned from All for Them: Best Practices for a Cross-Collaboration Approach to HPV Vaccination in Public Schools

et al. 2023

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The Community Preventive Services Task Force endorses vaccination programs in schools to increase access to vaccinations. However, implementing a school-based approach requires substantial coordination, planning, and resources. All for Them (AFT) is a multilevel, multicomponent approach to increase HPV vaccination among adolescents attending public schools in medically underserved areas in Texas. AFT comprised a social marketing campaign, school-based vaccination clinics, and school nurse continuing education. Process evaluation metrics and key informant interviews to understand experiences with AFT program implementation informed lessons learned. Lessons emerged in six domains: strong champion, school-level support, tailored and cost-effective marketing approaches, mobile provider collaboration, community presence, and crisis management. Strong support at district and school levels is vital for gaining principal and school nurse buy-in. Social marketing strategies are integral to program implementation and should be adjusted to maximize their effectiveness in motivating parents to vaccinate children against HPV, which also can be achieved through increased community presence of the project team. Preparing contingency plans and flexibility within the program can facilitate appropriate responses to provider restrictions in mobile clinics or in the event of unforeseen crises. These important lessons can offer useful guidelines for the development of prospective school-based vaccination programs.

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Section: Resultsmentioning

confidence: 99%

Lessons Learned from All for Them: Best Practices for a Cross-Collaboration Approach to HPV Vaccination in Public Schools

et al. 2023

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“… 43 Their intervention continued to improve HPV vaccine uptake through the COVID-19 pandemic and addressed transportation barriers by using mobile vans and telecommunications for community engagement. 44 Strengthening the schools and SBHCs’ capacity to provide HPV vaccine administration and education through their expanded role during the pandemic and improving appointment compliance in SBHCs could be key for improving uptake among medically underserved adolescents. 45 , 46 …”

Section: Discussionmentioning

confidence: 99%

Multilevel perspectives on school-based opportunities to improve HPV vaccination among medically underserved adolescents: Beyond school entry mandates

Shin,

Sloan,

Baezconde-Garbanati

et al. 2023

Human Vaccines & Immunotherapeutics

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School-based HPV vaccination programs have improved vaccine uptake among adolescents globally. However, school-based HPV vaccination strategies in the United States (US) have mainly focused on school-entry mandates for vaccination, which have passed in only five states/jurisdictions. Many schools and school-based health centers (SBHCs) already provide health services to medically underserved adolescents and opportunities to improve disparities in HPV vaccine education and uptake are underexplored. This qualitative study of clinic and community members assessed potential opportunities within and outside schools to increase HPV vaccination. Data were generated from a larger mixed-methods study designed to understand experiences with HPV vaccination evidence-based strategies in medically underserved communities. The parent study included interviews and focus groups conducted with clinic (providers, clinic leaders, staff) and community (racial/ethnic minority parents, advocates, payers, policy representatives) members in Los Angeles and New Jersey between December 2020-January 2022. We created a reduced dataset of text related to schools/SBHCs (30 in-depth interviews, 7 focus groups) and conducted a directed content analysis. Participants indicated that schools and SBHCs are ideal venues for reaching medically underserved adolescents experiencing barriers to primary care access. Parents/providers expressed mutual interest in HPV vaccine administration/education in schools, but some advocates/policy participants experienced challenges due to increasing politicization of vaccines. Participants highlighted policies for expanding HPV vaccine education and administration in schools, including minor consent and increasing SBHC funding for HPV vaccines. More research is needed to explore existing infrastructure, partner motivation, and opportunities to improve HPV vaccination among medically underserved adolescents within schools beyond vaccine mandates.

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“…This quasi-experimental study is part of a larger funded project evaluating an intervention program to increase HPV vaccine uptake in the RGV (Texas) to meet the 2016 National Immunization Survey – Teen HPV vaccination rates (initiation: 49.3%; completion: 32.9%) 35–37 To be included in this study, students had to receive at least one HPV vaccine dose from our school-based vaccination program (vaccination events). The study outcomes included HPV vaccine initiation and HPV up-to-date (UTD) status.…”

Section: Methodsmentioning

confidence: 99%

“…As described previously, the intervention combined community-based HPV education with school-based vaccinations 35–37 at middle schools to increase HPV vaccine uptake in the RGV. The intervention addressed factors affecting HPV vaccine uptake (e.g., social norms, knowledge, health provider recommendations and risk perception, accessibility, schedule, costs, bundling vaccines).…”

Section: Methodsmentioning

confidence: 99%

“…We continued to strengthen our implementation strategies by having physicians addressing the audience, targeting female and male middle school students at the recommended ages (aged 11–12 years of age), bundling the HPV vaccine with recommended vaccines (e.g., flu, Meningococcal, Meningitis B, Tetanus, Diphtheria [TD], or Tetanus, Diphtheria, and Pertussis [TDAP] and Hepatitis A vaccines), addressing previously identified barriers, and extending the study area for school-based vaccinations from RGCCISD to PSJA ISD, Roma ISD, and Zapata County ISD. 26 , 27 , 31 , 32 , 35–42 Prior to coronavirus disease 2019 (COVID-19), school-based vaccination events were held in the nurses’ offices, conference rooms, nearby clinics at parents’ requests, and community events. When the COVID-19 pandemic hit in the middle of the first year of the school-based vaccination program and caused school closures, adaptions were made.…”

Section: Methodsmentioning

confidence: 99%

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Human papillomavirus vaccinations at recommended ages: How a middle school-based educational and vaccination program increased uptake in the Rio Grande Valley

Rodrı́guez

Chen

et al. 2022

Human Vaccines & Immunotherapeutics

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Human papillomavirus (HPV) vaccination is recommended for U.S. adolescents at ages 11–12 requiring two or three doses depending on if the vaccine series started before age 15. The objective was to compare HPV vaccination rates among medically underserved, economically disadvantaged, students in rural middle school districts (Rio Grande Valley [RGV], Texas) by age of initiation (≤ age 11 years vs. age 12 years and older). This quasi-experimental study included 1,766 students (884 females; 882 males) who received at least one HPV vaccine dose through our school-based vaccination program between 08/2016-06/2022. Summary statistics were stratified by age at initiation and gender. The overall HPV up-to-date (UTD) rate was 59.7% (95% Confidence Interval: 57.4–62.0%). The median age at HPV UTD (range) was 12 years (9–19) and median interval between HPV vaccine doses (range) was 316 days (150–2,855). Most students received the HPV vaccine bundled with other vaccinations (72.4%, 1,279/1,766). There was a higher HPV UTD rate among students who initiated the HPV vaccine on or before age 11 than those who initiated on or after age 12 (73.6% versus 45.1%, respectively). The median age of HPV UTD was age 12 for those initiating on or before 11 years versus age 13 for those initiating on or after 12 years of age. Initiating the HPV vaccine at age ≤11 years increased completion of the HPV vaccine series. Improving HPV vaccine coverage and introduction of pan-gender vaccination programs will significantly decrease HPV-related diseases in the RGV.

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Human Papillomavirus Vaccinations During the COVID-19 Pandemic in Middle Schools in the Rio Grande Valley of Texas

Cited by 4 publications

References 7 publications

Lessons Learned from All for Them: Best Practices for a Cross-Collaboration Approach to HPV Vaccination in Public Schools

Lessons Learned from All for Them: Best Practices for a Cross-Collaboration Approach to HPV Vaccination in Public Schools

Multilevel perspectives on school-based opportunities to improve HPV vaccination among medically underserved adolescents: Beyond school entry mandates

Human papillomavirus vaccinations at recommended ages: How a middle school-based educational and vaccination program increased uptake in the Rio Grande Valley

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