Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Robin Vanderpool

Committee Member

Dr. Kathryn Cardarelli

Committee Member

Dr. Mark Swanson


Human Papillomavirus (HPV) is a group of more than 150 virus that can cause genital warts and cancers of the oropharynx, cervix, vagina, vulva, penis, and anus. A preventive vaccine currently exists that protects against seven oncogenic HPV strands and two strands that cause genital warts. Current guidelines for HPV9 vaccination consist of a 2-dose series delivered at 0 and 6 months for males and females ages 9-14, and a 3-dose series delivered at 0, 2, and 6 months for those ages 15-26.

While up-to-date (UTD) vaccination rates have increased across the Unites States, in 2017, only about 52.4% of adolescents in central city areas were vaccinated and those outside of a metropolitan area lagged behind at 42.4%. In Kentucky specifically, the Cumberland Valley Area Development Distract (CVADD) has among the highest incidence rates of both cervical and head and neck cancers compared to the other area development districts in the state. As a result, the Cumberland Valley District Health Department has decided to utilize their existing relationships within Clay, Jackson, and Rockcastle County to implement a School-Based HPV9 Vaccination Clinic in the middle schools in the aforementioned counties.

The school-based clinic will begin with recruitment efforts at back-to-school events within the counties involved. The clinics will be deployed in the schools with the first dose of the series offered in August and September for five days each month, and the second dose will be available in March and April. Retention efforts will include paper and text message reminders as well as incentives for initiating and completing the 2-dose series.

Performance evaluation measures will be collected throughout the project; consent forms will be completed by parents or guardians. A process evaluation will consist of clinic logs and parent and guardian surveys to assess barriers to vaccination and their satisfaction with the vaccine clinics. Primary outcome measures will be vaccination initiation and completion rates. Secondary outcomes will focus on existing knowledge of HPV vaccination and biases associated with the HPV vaccine and other immunizations; these will be assessed through the University of North Carolina National Parent Survey. We hope that a School-Based HPV9 Vaccination Clinic will increase UTD vaccination rates among youth in the CVADD, foster a passion that allows us to expand this program to the remaining counties in the CVADD, and decrease HPV-associated cancer rates in this region of Kentucky.

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