Abstract 6200: Context-specific strategies for enhancing HPV vaccination: insights from the US and territories in the post-COVID-19 era
Authors: Erika Escabí-Wojna, Mariola Acosta-Rullán, Natalie Álamo-Rodríguez, Grace Vélez-Crespo, Vivian Colón-López
Journal: Cancer Research (2025)

Introduction: Over 42 million people in the United States (US) are affected by Human Papillomavirus (HPV), which causes over 90% of cervical cancer cases. Despite there being an FDA-approved HPV vaccine for cancer prevention, vaccination completion rates significantly vary by state, ranging from 38.5% to 85.2% among adolescents, leaving many vulnerable to this infection and contributing to cancer health disparities. Objective: This qualitative study aimed to identify effective HPV vaccination strategies and context-specific factors, including the impact of the COVID-19 pandemic, that influence policy adoption and vaccination uptake across the US and its territories, that will offer insights into effective methods for addressing this public health challenge. Methods: To date, we have purposely sampled key informants, including immunization program managers, health department personnel, and others, from the following states and territories: (1) Puerto Rico, (2) Virginia, (3) D.C., (4) New York, (5) Rhode Island, and (6) California. Inclusion criteria required participants to have expertise in an area related to health or public policy focused on vaccination, at least three years of experience, and knowledge of HPV vaccination policies or strategies. Eligible key informants (n=9) participated in virtual, audio-recorded semi-structured interviews via Microsoft Teams, lasting 45 to 90 minutes. Preliminary analyses were conducted using Dedoose. Results: Several effective strategies were identified for promoting HPV vaccination, including provider education, the implementation of school vaccination policies, and the use of cancer prevention messaging. Barriers included the spread of vaccine misinformation by anti-vaccine groups, which hindered organizational efforts and complicated the implementation of HPV vaccination strategies. Collaboration with health departments, schools, and immunization programs, emerged as a key facilitator in overcoming these challenges and promoting HPV vaccination uptake. Participants noted that the introduction of the COVID-19 vaccine negatively influenced parents’ perceptions of vaccinations, increasing resistance and opposition to HPV vaccination efforts. Conclusions: Our preliminary results suggest that educating healthcare providers, implementing school vaccination policies, and shifting HPV messaging to focus on cancer prevention are effective strategies for improving vaccination rates. Collaboration between health departments and educational institutions is also crucial. Our analysis highlights the need to address vaccine misinformation and improve perceptions, especially post-COVID-19 vaccine rollout. Future efforts will include expanding participant recruitment to include other states, conducting interviews, and applying thematic analysis to our data. Funding: NCI grant R01CA232743. Citation Format: Erika Escabí-Wojna, Mariola Acosta-Rullán, Natalie Álamo-Rodríguez, Grace Vélez-Crespo, Vivian Colón-López. Context-specific strategies for enhancing HPV vaccination: insights from the US and territories in the post-COVID-19 era [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6200.