A health department-school partnership to boost HPV vaccination among middle school girls

Background. Uptake of human papillomavirus (HPV) vaccine among 11- to 12-year-old girls remains low, highlighting the need for creative methods for increasing vaccination. School-located vaccination clinics remain an underused approach in the United States. We evaluate a partnership between a health department and its local school system to offer periodic HPV vaccine clinics. Methods. In 2009-2010, health and education officials in Guilford County, NC organized clinics to provide HPV vaccine to middle school girls at six host schools and 15 satellite schools. Schools distributed HPV vaccine information and consent forms to parents, who accompanied daughters to afterschool clinics to receive HPV vaccine free of charge. Participating parents received postcards reminding them to attend subsequent clinics when their daughters were due for the second and third doses of the series. Results. HPV vaccine provision was higher among girls attending host schools than satellite schools (6% vs. 1%, OR=6.56, CI=3.99-10.78). Of those who initiated HPV vaccine, 80% received all three doses. Process evaluation revealed the low participation rate resistance may have been due to the focus on HPV vaccine and that some schools were non-compliant with the project procedures. The cost of most vaccines (87%) was covered by private or public insurance. Conclusions. Lessons learned for creating more effective vaccination clinic partnerships include offering clinics in host but not satellite schools and establishing collaborative relationships with stakeholders early on. Future school-located vaccine clinics should attempt to boost initial participation and target several adolescent vaccines simultaneously.