On the Path to Prevention from the St. Jude HPV Cancer Prevention Program, May 2021

At the end of April, the HPV Cancer Prevention Program hosted a virtual seminar to describe the current policy landscape for HPV vaccination and explore opportunities for action. The analysis covered four states – Arkansas, Missouri, Mississippi, and Tennessee – and results released in a report. However, we know the recommendations may be applicable to other states with low uptake. Part of our discussion of policy included the current landscape related to legislation being introduced due to the advent of COVID-19 vaccines. We have witnessed great progress in uptake of COVID-19 vaccinations that has waned as supply has increased in some parts of the country. “Vaccine hesitancy” has been identified as a major factor in the slow uptake as of late. The need to build vaccine confidence is something on which we have been working for several years related to HPV vaccination. Building vaccine confidence includes building trust in the processes leading to the availability of and recommendations for vaccination, empowering healthcare and public health professionals, and actively and meaningfully engaging with communities, especially working with trusted messengers. We have provided a few resources in this email that may be useful for those of you who also are working on building vaccine confidence. We all play a role in building vaccine confidence – for all vaccines, including COVID-19 vaccination and HPV vaccination.

Each month, our program will send an email like this. We hope you will share it with others who may be interested and ask them to subscribe, too. We also want to hear from you if you have opportunities and information we can share. You also can email PreventHPV@stjude.org with any questions.

HPV vaccination is cancer prevention.

The HPV Cancer Prevention Program of St. Jude Children’s Research Hospital hosted a virtual seminar April 27 titled “HPV Vaccination: A Look at State Policy and a Path Forward.”
Over 200 participants joined the virtual seminar to learn about HPV vaccination and broader vaccination policy landscape in four states (Arkansas, Missouri, Mississippi, and Tennessee). The discussion also has implications for other states in which HPV vaccination uptake has been low.

Rob Clark, chief government affairs Officer at St. Jude provided an overview of the institution’s interest in the policy space, the importance of monitoring policy change, and being proactive in supporting policies to aid in the hospital’s mission.

Seth Palmer, director of strategic communications at NP Strategy, a strategic communications consultancy, presented on his team’s analysis of the state-level policy and regulations enacted over the past decade. He provided the following recommendations for action:

Recommendation No. 1: Introduce legislation modeled on the Missouri education statute in other target states.
Recommendation No. 2: Conduct targeted legislative efforts in opposition to vaccination exemptions on non-medical grounds.
Recommendation No. 3: Engage directly with state regulatory authorities to enact administrative procedures and/or rules to effectuate change to the information disseminated regarding HPV vaccination as cancer prevention.
Recommendation No. 4: Coordinate legislative educational efforts.
Recommendation No. 5: Promote coordinated public service messaging in target states, facilitated by requisite health authorities.

Following presentations by Clark and Palmer, they joined a moderated discussion led by Heather Brandt, PhD, with Kimberly Hughes, American Cancer Society Cancer Action Network; ShaRhonda Love, executive director, Arkansas Minority Health Commission; Sarah Moreland-Russell, PhD, Washington University, St. Louis; and Lisa Piercey, MD, commissioner, Tennessee Department of Health.

Access the report, HPV Vaccination: A Look at State Policy and a Path Forward, here. Access recording of the virtual seminar here.

The World Health Organization (WHO) recently identified “vaccine hesitancy,” as one of the Top 10 threats to global health. Vaccine hesitancy is the reluctance or refusal to vaccinate despite vaccine availability.

The reasons behind vaccine hesitancy are complicated and may include complacency, difficulty in obtaining vaccines, and lack of certainty. Those of us involved in HPV vaccination promotion efforts are quite familiar with vaccine hesitancy. Currently, the focus regarding vaccine hesitancy has shifted.

In the United States (U.S.), we have seen a surge in vaccine hesitancy among many Americans who have not yet obtained COVID-19 vaccinations despite ample supply. The COVID-19 pandemic has resulted in more than 3 million deaths worldwide: people whose lives mattered, and the pandemic will almost certainly impact health in the future. COVID-19 vaccination is essential to slowing and ending the current pandemic. This was a particular focus of World Immunization Week from April 26–30, 2021.

World Immunization Week—celebrated every year in April—aims to promote the use of vaccines to protect people of all ages against disease. Using the theme “vaccines bring us closer,” World Immunization Week 2021 urged greater engagement around immunization to promote the importance of vaccination in bringing people together, and improving the health and well-being of everyone, everywhere throughout life. As part of last month’s celebration, WHO, partners and individuals around the world united to build trust and confidence in vaccines to maintain or increase vaccine acceptance.

Please check out the following resources to learn more about building vaccine confidence:

The Association of Immunization Managers (AIM): Vaccine Confidence Toolkit and Media Materials website contains templates that you can download and customize with your program's information.

The Guidance for HPV Vaccination document contains the latest American Cancer Society recommendations for HPV vaccination, information on why vaccination is important, and information on how to manage and promote HPV vaccination during the COVID-19 pandemic.

Strong confidence in vaccines within communities leads to more people getting vaccinated, which leads to fewer illnesses, hospitalizations, and deaths. The CDC has several resources that can help.

The National HPV Vaccination Roundtable created this page to help our disease prevention partners access resources to help remind parents of the vital need to protect their children against serious vaccine-preventable diseases, even as the COVID-19 pandemic continues.

UNITY Consortium recently launched the “Don’t Wait. Vaccinate.” campaign. Adolescents need routine vaccinations now so that they can safely go back to school at the end of the summer. Learn more about their toolkit.

April 25 was National DNA Day, which is honored by the National Human Genome Research Institute. National DNA Day is a unique day when students, teachers, and the public can learn more about genetics and genomics.

To celebrate, the Cancer Education and Outreach Program of the St. Jude Comprehensive Cancer Center mailed a DNA Day edition of our St. Jude Cancer Education Home Kit to over 300 fourth-grade students in the Shelby County, Tennessee, and Springfield, Missouri, school districts.

Each kit contained an activity booklet, materials, and instructions needed to complete a DNA extraction activity, and a DNA modeling activity. The activity booklet introduced DNA’s role in cancer, provided resources to learn more about cancer prevention, and highlighted prevention measures, including HPV vaccination. Learn more.

“Motherhood comes in many forms.”

Tamika Felder is a women’s health advocate, educator, mobilizer, author, and the chief visionary at Cervivor, a nonprofit dedicated to cervical cancer advocacy and support. At the age of 25, Tamika was diagnosed with cervical cancer and underwent surgery, chemotherapy and radiation. She lost her uterus, her cervix, and as a result, her fertility. The HPV Cancer Prevention Program team was able to spend an hour with Tamika earlier this spring. We are continuously inspired by her story, energy and passion. She shares her thoughts on the bittersweet holiday.

“Mother's Day. This is a day that brings about a lot of mixed feelings for so many people. For me, it's two fold – the first is that I lost my mom and I miss her terribly. She was my everything. The one who encouraged and praised me, but also the one who kept it real with me. I had her for 33 incredible years, and it was a blessing. But as a woman who lost her fertility because of cervical cancer, I understand just how hard this day can be on women who will never experience motherhood. Eight years ago, I married my best friend. With that marriage came a little girl, and I became a stepmom. I am grateful for the love of Zakiya. Motherhood comes in many different forms. My legacy will not be the lives that I bring into this world, but the lives that I save.”

Connect with the Cervivor community.

“Making the decision to have a child is momentous. It is to decide forever to have your heart go walking around outside your body.” --Elizabeth Stone.

We can help reduce the likelihood of cancer in our children by making sure they get the HPV vaccination on time, and by helping them make a lifetime of good choices.

We asked members of the HPV Cancer Prevention Program team to answer this question: “What advice did your mom give you that helped support your healthy growth?”

“My mom offered subtle advice, and it wasn't always in the form of words. What I appreciate most is how she made healthy options available to me. Our family always had access to healthy food options. She taught me my love for fruits and veggies. If we needed medical care or dental care, she made it happen.”

– Julia Neely, program coordinator

“Watch or read something funny before going to bed. Your heart and mind will rest better and be renewed while you sleep.”

– Andrea Stubbs, administrative director

“You only get one smile- so use it, while you still have teeth. And never skip your dental appointments!”

– Katie Midgley, program coordinator

“My mother quit smoking when I was in middle school. She never told us not to smoke, but her quitting sent a strong message about why we shouldn't.”

– Carol Minor, program coordinator

“My mom is loving, kind and patient- and she taught me from an early age to always share because I always have something to give to others.”

– Heather Brandt, PhD, director

Children are not just born from our bodies; they are also born from our hearts. Whether you've never had a child, wanted more children, worried about if you will be able to have children or if you have lost a mom, we are thinking of you on this day. You are not alone. We want to wish all mothers, including stepmothers, foster mothers, grandmothers and mother figures, a very happy and safe Mother’s Day weekend.

Did You Know (DYK): HPV Vaccination declines during COVID-19 pandemic

Early in the pandemic, HPV vaccination rates among adolescents had fallen by 75%. Rates have since recovered somewhat but resulted in a large cohort of unvaccinated children.

Since March 2020, an estimated 1 million doses of HPV vaccine have been missed by adolescents with public insurance. This reflects a decline of 21% over pre-pandemic levels in the public sector. In addition, adolescents with private insurance may be missing hundreds of thousands of doses.

Adolescents with public insurance may be experiencing the pandemic very differently as compared to adolescents with private insurance. Adolescents with public insurance previously had higher HPV vaccination initiation rates but are now part of a widening public-private gap leaving these adolescents with public insurance.

Learn more about getting adolescent vaccination back on track from the CDC and National HPV Vaccination Roundtable.

National and Global Health Observances

We have assembled May 2021 national and global health observances relevant to the HPV Prevention Program that may be of interest. We hope you will join us in promoting these health observances with your networks to advocate for a healthier future.

Remember: HPV Vaccination is Cancer Prevention.

May is National Cancer Research Month. The American Association for Cancer Research (AACR) initiated and supports National Cancer Research Month to highlight the importance of lifesaving research to the millions of people around the world affected by the collection of devastating diseases we call cancer. The AACR hopes you will take a moment during this extraordinary time to show your strong support of pioneering cancer research that is saving lives every day. Learn more.

National Women’s Health Week is from May 9–15 and starts each year on Mother’s Day (May 9, 2021) to encourage women and girls to make their health a priority. The St. Jude HPV Cancer Prevention Program is proud to be a 2021 NWHW partner. We recognize that women have been resilient during the pandemic, often working and serving as caregivers while also taking care of themselves. The 2021 NWHW observance emphasizes the importance of women protecting themselves from getting COVID-19 and maintaining their physical and mental health. Even during the COVID-19 pandemic, there are safe ways for you to stay healthy and active. Read this article from the CDC, which contains tips on getting recommended cancer screenings and ways for women to make their health, both mental and physical, a priority.