Targeting Human Papillomavirus (HPV) Vaccination in International College Students

Background:  HPV vaccine coverage at this large Midwestern university typically mirrors the National Immunization Survey (NIS-Teen) coverage among 17 year-olds, an age cohort similar to entering freshmen.  International students though have much lower HPV vaccine coverage – 18.8% of female international students report receipt of one dose and 12.5% report three doses; 7% of male international students report receipt of one dose and 2.7% report three doses. HPV vaccine is often not available in many of the countries international students arrive from. We initiated a community-based, peer-to-peer outreach effort to promote HPV vaccination among international students aged 18-26 years who were seeking influenza vaccine during the fall 2015 semester.

Methods:  Students were targeted during a fall flu shot campaign to raise their awareness of HPV and the need for vaccination. The intervention engaged members of three student organizations to approach students in line for flu shots to complete a survey, which served as an entree to have a conversation about HPV vaccine. HPV vaccine was available onsite and administered to interested, insurance-eligible students. Students also had the option to get vaccinated at the health center clinic at a later time.

Results:  Total HPV vaccinations administered by health center staff increased for the months of September and October 2015 by 41% compared with the prior year, and students from China accounted for the largest proportion of vaccinated students (70.1% of doses). Survey results revealed high self-efficacy (90.1%) to obtain the HPV vaccine among students in this age group.

Conclusions: These results suggest that: 1) direct peer-to-peer outreach and education can improve vaccination rates; 2) international college students are interested in HPV vaccination; 3) young college students, if not yet fully vaccinated, have high self-efficacy to seek HPV vaccination; and 4) flu shot clinics are conducive settings to promote other vaccine initiatives.