Continuation and expansion of a highly successful postpartum HPV vaccination program

This application is to fund a fourth cycle of the highly successful postpartum HPV vaccination program at the University of Texas Medical Branch (UTMB) conducted in collaboration with the University of Texas Rio Grande Valley (UTRGV). In the next cycle, we will expand our catchment area to 32 counties which span four Public Health Regions (PHR 4/5N, 6/5S, 7, and 11) in east and south Texas. Seven of the counties we will serve are federally recognized medical underserved areas (MUAs) and 18 are MUA/Rural. Many of these women are at higher risk of cervical cancer than the rest of Texas (10.6 cases per 100,000 population in PHR 5/east Texas and 10.4 in PHR 11/Rio Grande Valley as compared to the 8.3 overall rate in Texas). Postpartum women receiving care at these two universities are especially at risk. Over two-thirds of those who deliver an infant at UTMB and 93% at UTRGV are Hispanic or Black, groups at increased risk of cervical cancer morbidity and mortality. Both universities have a steady stream of new patients, most who are unvaccinated or incompletely vaccinated against HPV. In fact, a survey of female patients between 2020-2022 found that only about 40% of those in our target population had received at least one dose in comparison to the Texas average of 55%. Barriers include the prohibitive cost of the vaccine, lack of access to accurate information, lack of a provider recommendation, and inadequate follow-up after the series is initiated. Our postpartum intervention addresses all these barriers by having patient navigators (PNs) educate patients and offer the vaccine at no cost while they are in the hospital after delivery and at postpartum visits. PNs remind patients about follow-up appointments and keep in close contact until all doses are complete. Finally, our team will continue to educate medical and nursing students, residents and community physicians on the importance of counseling all eligible patients on this vaccine and teach them how to administer it.