Learning Objectives for this Presentation:
After the presentation the participants will be able to:
• Discuss the pros and cons of the mass HPV immunization campaign conducted in the CNMI.
• Identify successful components of the HPV media campaign
• Apply lesson learnt for a successful community coalition

Background:
Cervical cancer death rate in the CNMI is 6 times higher than the USA national average.
Of cancer in females (1991-2001), 20 % were cervical cancer. The HPV vaccine will now be provided to sixth grade students. This two-year project targets those girls still eligible for VFC vaccine but passed the sixth grade.

Setting:
The CNMI is a US territory (15 islands, only three inhabited) directly north of Guam.

Population:
The fourteen targeted high schools, on three islands, have a combined female enrollment of 1,756

Project Description:
An active community coalition was formed to introduce HPV vaccine to the CNMI. A media campaign targeted teenage girls and their parents with information on cervical cancer and HPV vaccine. The campaign theme was “ So What Are You Going to Do” which stressed personal responsibility for health. The HPV vaccine was provided in high schools throughout the territory. To further promote cervical cancer awareness, the girls were given teal blue charm bracelets with the intention of adding a representative charm after each dose. Following the second shot, the girls also received black and teal t-shirts that broadly state "Let's fight cervical cancer!"

Results/Lessons Learned:
The first round resulted in 73% of the enrolled girls receiving the first dose (1,269 students). The preconceived fear of community rejection of HPV vaccine because of sexual issues never materialized. Simplification of parental consent forms is advised for future campaigns.