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

It’s a New Year. We have new urgency to prevent HPV cancers tomorrow by ensuring all children are vaccinated on-time today. While we continue to monitor the effects of the COVID-19 pandemic on routinely recommended vaccinations, we must continue acting today. Recent articles have shown growing vaccination hesitancy leading to measles and chickenpox resurgence, declining vaccination confidence, and outright vaccination rejection in the United States. Yet we have a safe, effective vaccination that prevents multiple types of cancer that many children are receiving but with disparities by geographic location and rurality, as two examples. There is new urgency to fuel our efforts. January is the perfect time for renewed efforts during Cervical Health Awareness Month.

I recently had the opportunity to sit down with Joslyn Paguio with Cervivor, Inc. to talk about HPV cancer prevention as part of the recently launched Cervivor Podcast. The people, purpose, and passion behind Cervivor, Inc. inspire me and offer rich resources for survivors. You can access the podcast episode here.

We want to take a moment to acknowledge the profound and impactful legacy of Henrietta Lacks. A statue of Lacks will be built in her hometown of Roanoke, Virginia. May more efforts be undertaken to honor and celebrate her.

Our monthly newsletters generally include updates on our program’s and partner’s activities with useful information and resources. This month, we have sad news to share. The St Jude HPV Cancer Prevention Program lost a team member, Brooke Morgan, in December. Brooke passed away during the process of bringing a healthy baby girl into the world. Our team is experiencing a tremendous, unexpected loss – and I certainly am still processing how our anticipated joy and celebration of new life befell such tragedy. In this issue, we honor Brooke’s life and contributions to our program.

HPV vaccination is cancer prevention.

Brooke Askew-Morgan is remembered by her St. Jude colleagues as passionate about improving the health of the community with a positive attitude and an exceptional ability to work with organizational and community partners. She is also remembered as an inspiration and a friend to her colleagues. Askew-Morgan passed away December 16, just hours after giving birth to her daughter.

Askew-Morgan joined St. Jude in 2012 and was a program coordinator for the St. Jude HPV Cancer Prevention Program. Prior to that, she was a part of the Infectious Diseases team for over nine years working to “End the HIV Epidemic” through her service as the SMILE–Linkage To Care coordinator. She also served as a disease intervention specialist for the Shelby County Health Department, guided by a passion for helping others in the community.

Heather Brandt, PhD, director of the HPV Cancer Prevention Program, first met Askew-Morgan in early fall 2021 when she volunteered to be connected to the Memphis and Shelby County HPV Cancer Prevention Roundtable that they were forming.

“She was clearly passionate about improving the health of our neighbors and had been doing this work for a long time at St. Jude in Infectious Diseases and prior at the Shelby County Health Department,” Brandt said. “Brooke started working in the HPV Cancer Prevention Program in early 2022. I remember when we interviewed Brooke for the position that I was impressed by her confidence in her ability to work with community partners, which would be an essential skill for the position and one in which she excelled. I have to believe Brooke’s influence on us, her colleagues in Infectious Diseases and HIV and at the Shelby County Health Department and beyond will carry on her spirit and continue to honor her.”

Carol Minor, HPV Cancer Prevention Program program coordinator, said Morgan-Askew was very helpful during the planning of the Memphis and Shelby County HPV Cancer Prevention Roundtable Annual Meeting last fall. “I told her and anyone else who would listen that she was invaluable to me. My colleagues teased me, and we even made a video to send to her a couple of days before she passed where I stood at her door and said that I missed her and that she was ‘invaluable.’ No one knew how relevant that would be.”

Portia Knowlton, HPV Cancer Prevention Program program coordinator, said that Askew-Morgan was selfless and always willing to help others.

“Our team formed a bond,” Knowlton said. “I will always cherish our one-on-one conversations.”

Pragya Gautam Poudel, DrPH, postdoctoral research associate in the HPV Cancer Prevention Program, said, “I knew her only for a few months, but there are so many wonderful memories. We used to go for lunch together, and we would talk a lot about her pregnancy, postpartum challenges and daycare for her baby. She was planning and preparing—she was very excited for the next chapter.” 

Askew-Morgan received several honors and awards for outstanding influence in the community and in the field of HIV care. These included the first-place winner in Protecting Patient Privacy; the Memphis Business Journal’s Healthcare Heroes Award for outstanding work in community outreach and development; and the Light of Hope Award, an honor given to an individual for their dedication and support of HIV/AIDS care, education and prevention in Memphis and Shelby County.

Andrea Stubbs, HPV Cancer Prevention Program administrative director, was Askew-Morgan’s manager in Infectious Diseases when she won the Light of Hope Award and had the opportunity to continue to work with Askew-Morgan in her role in the HPV Cancer Prevention Program.

“We were all so excited that Brooke was recognized for her ability to link newly diagnosed HIV-positive youth and young adults into medical care. Brooke was compassionate, kind and resourceful,” Stubbs said. “She was special to her patients and to the Infectious Diseases team and the HPV team. We will miss her deeply.”

The HPV team is coordinating support for her family. For more information, email PreventHPV@stjude.org.

Askew-Morgan is survived by her husband, Marcus Morgan; baby daughter Margo Ava Morgan; bonus daughter, Faith Morgan; her mother, Gwendolyn Suggars; brother, Aaron Askew (Mikita); as well as a host of family and friends.

Cervical Health Awareness Month is a time to talk about preventing, detecting and treating cervical cancer. It’s also an opportunity to take a closer look at who is contracting cervical cancer and what we can do to reduce the incidence in at-risk populations.

Anyone with a cervix is at risk for cervical cancer, and almost all cervical cancers are caused by HPV. Each year, about 13,000 new cases of cervical cancer are diagnosed in the U.S. Hispanic women have the highest rates of new cases of cervical cancer followed by American Indian and Alaska Natives, then non-Hispanic Black women. While HPV vaccination rates among adult Hispanic women and non-Hispanic Black women trail behind those of non-Hispanic white women, HPV vaccination rates among Hispanic youth are higher than those for non-Hispanic Black women and non-Hispanic white women.

Women of all races and ethnicities can reduce their risk by getting screened for cervical cancer. Current recommendations for cervical cancer screening are:

For women ages 21–29: screening every three years with a Pap test alone.
For women ages 30–65: screening every three years with a Pap test alone, every five years with high-risk HPV testing alone or every five years with high-risk HPV testing in combination with a Pap test (called co-testing).

HPV vaccination can prevent almost all cases of cervical cancer and is recommended for everyone ages 9–26 and for some people ages 27–45.

Adolescents can get vaccinated against HPV at health care providers’ offices, state or local health clinics and some pharmacies. Almost every major insurance plan in the U.S. covers HPV vaccination, and the federal Vaccines for Children program may provide coverage at no cost for those who quality.

HPV vaccination today is cancer prevention for the future.

Full-time working mother and wife Kimberly Williams was diagnosed with cervical cancer in 2018 after an abnormal Pap test followed by a biopsy. Initially, Williams felt scared and wondered if her diagnosis was a death sentence. After meeting with her oncologist, she learned her treatment would include a radical hysterectomy followed by chemotherapy and radiation. Although Williams’ friends and family supported her and her and treatment plan, she researched additional information about HPV and cervical cancer to help educate them further. Following a recurrence of cervical cancer in August 2019 that was treated with radiation and chemotherapy, Williams received her first “no evidence of disease” or “NED” in December 2019.

Read more about Kimberly's story.

Please note that Kimberly is not affiliated with and was not treated by St. Jude Children’s Research Hospital. We are grateful for her contributions to promoting HPV cancer prevention and this article.

Access social media resources (like the image below) celebrating Cervical Health Awareness Month on the stjude.org/bright-future website.

Path to a Bright Future campaign partner Cervivor Inc. is a leading global community of patient advocates who inspire and empower those affected by cervical cancer. Cervivor educates and motivates these advocates to use their voices to help end stigma, influence decision-making and change, and end cervical cancer.

In October 2022, the St. Jude HPV Cancer Prevention Program partnered with Cervivor to deliver HPV Cancer Survivors School. This program empowers cervical cancer survivors to use their own experiences to help create positive change for other survivors and for newly diagnosed patients.

We talked with Morgan Newman, community engagement liaison for Cervivor, click here
to learn more about Cervivor and her journey,

Wide Open Spaces is a new series of articles to be included in our program’s monthly newsletter starting this month. These articles will address ways to improve HPV vaccination with rural communities. We invite guest contributors to share information on how they are working to improve HPV vaccination in rural areas. If you are interested in contributing, please email us at PreventHPV@stjude.org.

Casey L. Daniel, PhD, MPH, director of epidemiology and public health and associate professor of family medicine at the University of South Alabama, shares why improving HPV vaccination with rural communities is important.

Despite an estimated 1 in 5 Americans living in a rural area, rural dwellers in the United States experience numerous health disparities compared to their urban dwelling counterparts. This is due, in large part, to many gaps related to social determinants of health. Disparities between rural and urban areas continue to grow, which translates to rural children and adolescents being less likely to receive appropriate health care—including preventive care such as vaccinations.

Many rural areas lack local health care providers such as full-time practicing pediatric or family medicine clinicians. Additionally, high demand, budget constraints, and immense strain on the health care system, which have only increased in the era of COVID-19, have forced many state health departments to reduce their availability in rural areas where their help is most needed for services such as vaccination. In the economically straining times of COVID-19, we have also seen more small, rural practices forced to close due to financial and/or staffing issues, taking away other local options. If there is not a provider locally, parents must travel to a clinician for their child to receive the vaccine—sometimes over 100 miles to the nearest pediatric facility (in parts of rural Alabama, for example). This scenario comes with its own obstacles, such as transportation barriers, employment/working constraints, and lack of social support services. Thus, people with the fewest resources are often those with the most limited options. They also likely lack awareness of the importance of the HPV vaccine when they are told it is “optional” or not highly encouraged to seek it out to begin with.

Even for rural areas where provider access to HPV vaccination exists, access must fit the needs of the population. Given the consistently high rates of Medicaid-enrolled individuals in rural settings, children who receive vaccines through the national Vaccines for Children (VFC) program are required to be vaccinated only by a currently enrolled VFC provider. These children will be turned away from a provider who is not a VFC provider because of regulations involved with enrollment and reimbursement. The number of VFC providers ranges widely by state, from a few dozen to over 1,000. It can be a confusing program for both patients and providers to navigate. However, it could open the door to vaccinating tens of thousands more children and adolescents if these problems can be overcome.

Improving HPV vaccination in rural communities is important because the disparities we see can and must be mitigated. People living in rural areas must not be overlooked because of the challenges in providing them the same opportunities for health care and prevention as anyone else. Preventive services are arguably even more important for those in rural settings, as they are less likely to engage in timely screenings, which translates into higher morbidity and mortality from cancers that could have been prevented. Rural communities need just as much, and likely more, awareness and education about HPV cancers. And these messages must be targeted to the needs of the communities to increase their impact and effectiveness.

The disparities between urban and rural populations have persisted for far too long. We have a responsibility to go where the need is greatest. Ultimately, facing more barriers means that rural communities need and deserve more help to overcome them. It is our role to do just that.

“When increasing access to vaccination providers, thoughtfulness and creativity should abound. We are not limited to pediatricians and family physicians (though we treasure and appreciate them). To increase rural HPV vaccination, we must explore multiple options such as pharmacists (particularly community pharmacists who have established trust and relationships with community members), mobile vaccination units, vaccine clinics, sports physical clinics, and school-based vaccination programs.” – Casey L. Daniel, PhD, MPH, University of South Alabama Mitchell Cancer Institute

Global Initiative Against HPV and Cervical Cancer (GIAHC) and 2023 sponsors, including the St. Jude HPV Cancer Prevention Program, will host Us vs. HPV Prevention Week, a weeklong series of webinars, social media campaigns, local events and more to promote awareness about HPV and HPV-related diseases.

The 2023 webinars, set for January 23–27, will spotlight collaborative efforts to improve health care equity.

January 23: HPV: Prevention Matters!
January 24: Diversifying HPV Efforts to Improve Health Equity
January 25: Innovations, Empowerment and Solutions in the Global Prevention of Cervical Cancer
January 26: HPV Oropharynx Cancer: What You Need to Know in 2023
January 27: It’s Up to Us: Raising Awareness to End HPV-Related Cancers

The St. Jude HPV Cancer Prevention Program is hosting a series of four virtual seminars leading up to International HPV Awareness Day on March 4:

February 27: Addressing HPV Vaccination Gaps in the Southeastern U.S.
February 28: Improving HPV Vaccination Rates Among Childhood Cancer Survivors
March 1: Promoting PRIDE in HPV Vaccination Among LGBTQIA+ Communities
March 3: Wide Open Spaces: Improving HPV Cancer Prevention with Rural Communities

Seminars will be held from 12–2:15 p.m. CST. All seminars will be recorded. Register for one seminar or the entire series.

Information on presenters will be released later this month.

If you have questions, please email PreventHPV@stjude.org.

Arkansas

The Arkansas Cancer Coalition (ACC) hosted its quarterly meeting on December 13 in Little Rock, Arkansas. Following updates from Arkansas Cancer Coalition Executive Director Trena Mitchell, Julia Neely with the St. Jude HPV Cancer Prevention Program shared highlights of key programmatic activities and discussed opportunities to implement best practices to improve HPV vaccination coverage in Arkansas. Meeting participants also had the opportunity to hear from Brittany Rose, a survivor who courageously shared her experience of being diagnosed with and treated for cervical cancer.

California

The Moores Cancer Center at UC San Diego is hosting a 2023 Cervical Cancer Awareness Summit January 19 from 10 a.m. to noon PST. The event will be led by the Community Outreach and Engagement team and highlight the advancements of the Moores Cancer Center Gynecologic Oncology team. The theme is “Eliminating the Cervical Cancer Burden.” The summit is open to all community members to maximize awareness of the highly preventable cancer in the San Diego border region and share the present reality and future possibilities for treatment and prevention. Registration is required.

Louisiana

Denise Linton, DNS leader of the Lafayette Louisiana chapter of the National Cervical Cancer Coalition, is collaborating with the St. Jude HPV Cancer Prevention Program to host a Cervical Health Awareness Month Facebook Live event on January 24 at noon CST. The event will feature public health expert Donna Williams, DrPH, who will enlighten the audience on the importance of cervical health. Viewers will also get the opportunity to hear from a cervical cancer survivor. To request more information, email dlinton@nccc-online.org or portia.knowlton@stjude.org.

Tennessee

The Memphis and Shelby County HPV Cancer Prevention Roundtable is sponsoring “Your Future Your Decision: Cervical Health Awareness” in collaboration with the Tigers Vax Now HPV Student Ambassador Program on January 31 at 6 p.m. CST at the University of Memphis. The evening panel presentation will include discussion about cervical health through the lens of a cervical cancer survivor, an adolescent gynecologist with a focus on cervical health and HPV testing, and a pharmacist who administers adult vaccinations. The final panelist will provide results of a cross-state college initiative with sororities on HPV education and empowerment. If you would like to learn more about the event, email carol.minor@stjude.org or portia.knowlton@stjude.org.

As we enter 2023, many of us are using the New Year to mark a fresh start with resolutions to lose weight, exercise more and eat better. While all of these healthy habits provide long-lasting health benefits and can help reduce our chances of getting cancer, let’s not forget other tools we have to help prevent cancer in ourselves and our children—such as HPV vaccination.

Join us today in resolving to prevent cancer tomorrow by getting your child vaccinated against HPV by their 13th birthday. Encourage others to get their children vaccinated and share the facts: HPV vaccination is safe, effective and can prevent 90% of HPV cancers before they start. HPV vaccination provides long-lasting protection against six types of cancers and is strongly recommended by health care professionals. You can also sign and share our Parent and Caregiver Pledge to ensure a bright future for your child.

Access social media resources (like the image below) celebrating Cervical Health Awareness Month on the stjude.org/bright-future website.

January is a time of new beginnings. The time of year people set new goals of what they want to accomplish for the new year. The St. Jude HPV Cancer Prevention Program team shared what they look forward to accomplishing in the new year.

“In the new year, I am going to train my dog, Otis, to be my kayaking buddy.”– Alison Footman, postdoctoral fellow

“My new year goals are broadly classified into two categories, professional and personal. I plan to keep myself busy doing more HPV vaccination-related research and submit manuscripts for publication, participate in activities that help to increase awareness regarding HPV-related cancers, improve HPV vaccination in diverse groups of populations, and build collaboration and networking skills that support my career goals. My personal goals include drinking more water and exercising regularly.”– Pragya Gautam Poudel, postdoctoral fellow

"I look forward to stepping more out of my comfort zone and learning new skills that will help me excel within my role. I also look forward to taking more trips with my family.”
– Portia Knowlton, program coordinator

“I am going to work towards a healthier me.” – Ursula Leflore, administrative specialist.

“I look forward to creating a new daily routine that will allow me to practice self-care.”
– Duha Magzoub, program coordinator

“I plan to create more networking opportunities for personal growth activities in and around Memphis.” – Carol Minor, program coordinator

“In the new year, I plan to be more proactive. I juggle many things and I am very guilty of procrastinating. Recent circumstances have shown me how important it is to make the most of every moment. “ – Julia Neely, program manager

"I have set a goal to invest in creating "moments that matter" with and for people I engage with throughout the year. I am looking forward to making many hearts smile this upcoming year."– Andrea Stubbs, administrative director

"I resolve to wake up every day with the intention to make a positive impact in someone’s life because one good deed may not seem like much, but 365 good deeds each year really start to add up." – Heather Brandt, director

The St. Jude HPV Cancer Prevention Program’s Path to a Bright Future campaign spotlights the benefits of on-time HPV vaccination to prevent cancer in children ages 9–12. The campaign also raises awareness of the dangers of HPV pre-cancers and cancers.

Join us:

Get your child vaccinated against HPV by their 13th birthday: If you or your child is in the recommended age range (ages 9–26 and possibly until age 45), get vaccinated.
Encourage others to get their children vaccinated: Normalize HPV vaccination as cancer prevention.
Share the facts: HPV vaccination is safe, effective, and durable. It prevents 6 types of cancer.

Learn more and join the campaign.