Category Archives: AFIX

Raising HPV Vaccination Rates: What Works?

Mikaela Kramer, Oregon State University

Oregon Immunization Program HPV Intern

Figuring out how to increase human papilloma virus (HPV) vaccination rates doesn’t have to be different for every clinic. The barriers to vaccination typically fall into one of three categories: 1) misinformation (e.g. my child isn’t at risk for HPV, vaccination promotes sex, etc.); 2) communication (e.g. staff and/or parents discomfort discussing sex); or 3) timing (e.g. getting patients to initiate and complete the series). We spoke with a couple of local clinics that are succeeding in getting teens vaccinated with HPV vaccine. We wanted to know what works and what strategies other clinics could adopt.

Yellowhawk Tribal Health Clinic

Debbie Barry, the VFC Immunization Coordinator at Yellowhawk Tribal Health Clinic in Pendleton, credits their high HPV immunization rates with teamwork.  Instead of having one HPV vaccination champion in the clinic, Debbie makes sure each staff member is proactive and confident when communicating about HPV prevention. She educates staff about the human papilloma virus, HPV vaccine and about strategies for communication with patients and their parents.

Being straightforward with patients and their parents about HPV and the vaccine promotes open communication. When parents raise concerns that vaccination will promote sexual activity, Debbie keeps her answer simple – HPV provides protection from cancers and warts that the patient may be exposed to in the future by their partners. She encourages patients and their parents to educate themselves about the disease. To encourage completion of the series, Yellowhawk sends reminder letters to patient’s monthly showing which vaccines are due and providing contact information for making appointments or finding out more information.

Debbie Berry

Debbie Berry, VFC  Immunization Coordinator and her team (left to right) Shana Alexander, RN-Supervisor; Heather Brown-Lowry, CMA;  Debbie Berry, CMA; Sharman Sams, CMA; Molly Jim, RN; the two in front with their heads together are Rena Cochran, CMA and Bobi Tallman, RN BSN.

Yakima Valley Farm Worker (YVFW) Clinics

Not every strategy works perfectly without some refinement. Regional Nursing Supervisor for Western Oregon, Christine Wysock, emphasizes that trial and error is necessary for finding out what works. In her clinics, Christine has found that highlighting the new two-dose schedule and that the vaccine prevents cancer is persuasive, as well as reminding parents that the vaccine can prevent infections years from now. She also recommends talking with patients and their parents about getting the HPV vaccine done that day. Christine was also able to take advantage of educational materials and tracking tools provided by the vaccine’s manufacturer, saving the time and cost of developing her own materials. Christine also stresses that teamwork is essential. Her staff all receive continuing education about vaccination strategies, ensuring that everyone is giving the same messages.

Christine Wysock

Christine Wysock, Regional Nursing Supervisor -Western Oregon , Yakima Valley Farm Workers Clinic

Several of these strategies could be replicated in any size practice in a short time frame. Educating your staff and encouraging them to promote HPV at every patient encounter can make a measurable difference in your HPV immunization rates. If you want to institute reminder letters in your practice, ALERT Immunization Information System (IIS) can easily generate a custom letter. Educational materials are available from a variety of sources, including the Centers for Disease Control and Prevention and the Children’s Hospital of Philadelphia. If you need help implementing these strategies, please contact the Oregon Immunization Program. Let’s educate and vaccinate against HPV.

If you have any questions about your clinic’s immunization rates, please feel free to reach out to the Oregon Immunization Program’s Vaccines For Children Help Desk at 971-673-4832 or



Comments Off on Raising HPV Vaccination Rates: What Works?

Filed under AFIX, Education, Oregon Immunization, Private Clinics, Public Clinics

Saluting Salud Medical Center: Improving rates by improving processes

Salud Medical Center in Woodburn is a large community and migrant health center, part of the Yakima Valley Farm Workers (YVFW) organization. Several years ago, YVFW leadership chose childhood immunization rates as a target for process improvement.

They placed protocols in every YVFW clinic that empowered licensed nurses and medical assistants to vaccinate all patients—at any visit—with all needed immunizations.


The responsibility for improving childhood immunization rates falls directly on the nursing supervisor at each clinic. They use CoCasa (CDC software available for free download) to run monthly rates and progress reports, which are then shared with the other clinics and upper management. The clinics have turned this process into a friendly competition with each vying to be number one in the organization. Their efforts are clearly paying off with a phenomenal jump in coverage rates from 43 percent in 2010 to 96 percent in 2012.



Salud’s single vaccine rates also show impressive improvements with every measured vaccine rate exceeding Healthy People 2020 goals.

 When asked about their immunization success, Salud’s Christine Wystock, RN, CSN, said it is important to designate a vaccine “champion” willing to live and breathe vaccines. Other keys to higher rates include integrating regular vaccine updates into staff meetings; requiring RNs, LPNs and MAs take an annual vaccine quiz; and pre-visit immunization forecasting for every child, from birth to age 18. Alert IIS is also used regularly to check patients with spotty or missing forecasts.

 Christine says that the reward for all this hard work is less about the rates (as nice as they are) and more about the real-world protection that vaccines offer the children and families in their community.


Comments Off on Saluting Salud Medical Center: Improving rates by improving processes

Filed under AFIX, All Posts, VFC