The Alaska Immunization Program

Partners and Programs in the Spotlight

In March 2008, the Alaska Native Tribal Health Consortium identified that only 26 percent of adolescent Alaska Native girls had received one or more doses of HPV vaccine. In a span of only 18 months, this number climbed to 71 percent. Alaska's current HPV vaccination coverage rate for adolescent Alaska Native girls with one or more doses of HPV vaccine is 84 percent, well above the national coverage rate of 57 percent.

How was this increase achieved?

Through a combination of best practices involving provider education and outreach, parent education, reminder/recall, and working with key partners and stakeholders.

In its early efforts, a statewide multi-agency HPV evaluation workgroup focused on educating clinicians and parents about the importance of adolescents getting HPV vaccine. While conducting focus groups with Alaska Native parents, the workgroup quickly realized that the decision to get the HPV vaccine was a multigenerational decision. They discovered the influence that parents and grandparents have on the decision-making process and crafted promotional and educational materials based on this finding.

The Alaska Immunization Program works closely with its state American Academy of Pediatrics (AAP) Chapter as well as community organizations, tribal leaders, and the Centers for Disease Control and Prevention (CDC) to increase HPV vaccination rates. AAP serves as a credible partner to reach and engage with healthcare professionals, tribal leaders, and community groups.

As first-dose rates climbed, they found it important to implement reminder-recall systems to increase second and third dose rates. Based on data from VacTrAK, the state immunization information system, notices were sent to parents of adolescents who were due for vaccines to remind them to get their shots. Hundreds of electronic HPV reminder magnets were also distributed to healthcare professionals to help remind parents and/or teens when the next HPV vaccine appointment is due.

One practice that implemented the use of electronic reminder magnets has now achieved a 95 percent coverage rate for two doses of HPV vaccine. In addition, one tribal organization that sent reminder-recall notices to parents has now achieved a series completion rate of 41 percent in March 2014 for boys, nearly twice the series completion rate for all adolescent Alaska Native boys at 23 percent.

With AAP funding the Alaska Immunization Program was able to co-sponsor and provide multiple trainings for healthcare professionals to educate them on how to communicate with parents about HPV vaccine and how to give an effective, bundled recommendation for routinely recommended adolescent vaccines.

Moving forward, the Alaska Immunization Program in collaboration with a key stakeholder joint initiative workgroup plans to implement a three-fold communication campaign targeting providers, parents with children and the general public. In addition the Alaska Immunization Program plans to promote use of reminder-recall systems for vaccination series completion, continue to educate healthcare professionals, and provide incentives to practices with high HPV vaccination rates with an overarching goal of increasing coverage rates in Alaska.

"We've been able to raise our rates significantly over the past few years, but it's not enough," said Dr. Rosalyn Singleton, a pediatrician for the Alaska Native Tribal Health Consortium. "We still have a long way to go in protecting our preteens and teens from the devastating cancers caused by HPV."

**All data based upon the Alaska Native Tribal Health Consortium electronic health record system.

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