High HPV Vaccine Uptake Among Alaska Native Teens

Background: Alaska Native women experience higher rates of cervical cancer than other US women.  In 2006, Alaskan public health personnel and clinicians formed a task force to plan how best to promote the use of human papilloma virus (HPV) vaccine among Alaska Native adolescent females. In-depth interviews with Alaska Native adolescents revealed  low levels of HPV knowledge; a preference to learn about health information from television, internet, brochures and posters; and identification of medical staff, mothers and friends as health information resources.

Objectives: To evaluate HPV vaccine coverage rates in Alaska Native adolescents.

Methods: As part of the HPV vaccination campaign, Alaska Native-specific brochure, poster, and story videos were developed and distributed to over 250 tribal clinics and hospitals. Additionally, HPV information was presented to health care personnel and tribal leaders at grand rounds, conferences and tribal board meetings. The vaccine was provided by the State Immunization Program in June 2007.  All tribal facility clinics and public health nursing offered HPV vaccine.  Vaccine coverage rates were evaluated through computer-based records system for 13-17 year old girls who had 2 visits within 3 years at a tribal facility.  

Results: Vaccination rates for ≥1 dose of HPV among Alaska Native teen girls aged 13-17 years increased from 26% on 3/31/08 to 61% on 12/31/08 to 71% on 9/30/09 while vaccination rates for 3 doses of HPV increased from 2% to 15% to 32% in the same time period. 

Conclusions: The 12/31/08 HPV vaccination rate for ≥1 HPV dose in Alaska Native 13-17 year old girls (61%) was significantly higher than the 2008 estimate for US 13-17 year old girls from the National Immunization Survey (37.2%; 95% CI 35.2-39.3).   Feedback from qualitative research was critical in determining the focus of HPV messages with an emphasis on family-involvement in decision-making.