Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1. Identify sources of HPV vaccine with no cost
2. Locate clinics at which to access HPV vaccine
3. Implement HPV vaccine programs at their public clinics

Background:
Approximately 20 million men and women in the U.S. are infected with human papillomavirus (HPV). The vaccine, Gardasil, prevents cervical cancer and genital warts in females caused by four types HPV. Gardasil, which was developed by Merck & Co., Inc., has been available in the U.S. since mid-2006, following FDA approval. The national Advisory Committee on Immunization Practices recommends the vaccine for females ages 9 – 26. Missouri parents and citizens are encouraged to consider adding the HPV vaccine into the medical routine for their daughters or themselves. However, the vaccine's commercial cost – approximately $360 for the three-dose regimen – severely limits access for low-income, uninsured, or underinsured girls and women.

Setting:
Various public health settings.

Population:
Females ages 9 – 26.

Project Description:
The Missouri Foundation for Health awarded an $11 million grant to providers in its service region for Gardasil. Additionally, the Health Care Foundation of Greater Kansas City awarded a $2 million grant to area providers for the vaccine. These grants combined represent the largest non-governmental funding of the vaccine's distribution in the U.S. and the most comprehensive effort in any state to offer the vaccine at no cost. This initiative enables health care providers to provide the vaccine free of charge to females ages 9 – 26 not covered by insurance or who do not qualify for Missouri's Vaccines for Children Program or Merck's Patient Assistance Program.

Results/Lessons Learned:
Missouri will be able to provide over 35,000 uninsured or underinsured females Gardasil at 162 health centers and clinics around the state. The state has become a national leader in preventing HPV and cervical cancer among its residents.