Dear Connecticut Health Providers,

Nationally, the Human Papillomavirus (HPV) is estimated to cause 36,000 new cases of cancer each year.
We have an opportunity to eradicate HPV-associated cancers, and yet too many people are not getting the safe and effective vaccine that prevents six different cancers associated with the human papillomavirus (HPV) including oral pharyngeal and cervical cancer. The HPV vaccine is approved for ages 9 years through 45 years for ALL GENDERS.

The American Cancer Society and American Academy of Pediatrics (AAP) recommend vaccination at age 9, and some of Connecticut’s biggest advocates are leading this charge, including the Connecticut chapter of the American Academy of Pediatrics (AAP), The Connecticut HPV Vaccination Workgroup, the Connecticut Cancer Partnership and the Connecticut Department of Health.

In Connecticut, 71.9% of adolescents aged 13-17 are fully vaccinated against HPV-associated cancers. In Connecticut’s rural communities, HPV vaccination rates are even lower with 49.9% of adolescents up to date with HPV vaccination yet incidence and mortality rates of HPV-associated cancers are high.

Nationally, approximately 27% of men and 53.6% of women between the ages of 18–26 are vaccinated.

We are reaching out to you to address the public health issue of vaccination of Connecticut’s children, adolescents, and adults against HPV. Connecticut has partnered with Delaware, Maryland, Ohio, Washington D.C., and West Virginia in a multi-state Call-to-Action campaign to increase HPV vaccination through strong and consistent provider recommendations and initiation of the HPV vaccination at age 9.

The Connecticut Vaccines for Children Program provides free HPV vaccines for all kids enrolled in Connecticut Medicaid or who have no insurance. The HPV vaccine is a covered benefit through age 26. Over 95% of insurances cover ages 26 years through 45 years with shared decision-making which can be documented with an e-prescription/prescription.

Please review the resources and links at the end of the letter. If you have any questions or would like to join the Connecticut Cancer Partnership’s HPV Vaccination Workgroup, please email [email protected].

Thank you for all that you do to improve the health of your patients and for your participation in this important effort to prevent cancer by increasing the uptake of the HPV vaccination in Connecticut.

Mitchell Clark

Mitchell Clark, MD, MPH, FRCSC

Chair, The Connecticut Cancer Partnership HPV Vaccination Workgroup
Assistant Professor, Division of Gynecologic Oncology
Dept. of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine


  • Set your electronic health record and pharmacy notifications from age 9 years through 45 years for men and women. Starting at age 9 has been shown to increase vaccine completion by 22 times.
  • Make a strong recommendation for HPV vaccines for all patients age 9 years through 45 years. Data shows that your recommendation may improve vaccinations by up to 5 times. For adults age 26 years through 45 years, engage in shared decision-making to help determine the benefits of vaccination. Vaccination recommendation should be made in all healthcare settings including acute, non-acute, GYN, dental and pharmacy locations.
  • Encourage same-day vaccination in your facility.
  • Leverage your local pharmacy especially in ADULTS to deliver vaccinations. If you are not able to stock vaccine at your facility, e-prescribe/prescribe to the pharmacy. The prescription will activate pharmacy reminder systems which will improve compliance.
  • Review your patients who have not completed their 2 or 3-dose series and proactively recall patients to your facility or e-prescribe to your local pharmacy to complete the series.
  • Check adult patients through age 45 to ensure they have completed their HPV series.
  • Identify an immunization champion at your facility.
  • Implement standing orders which can be found at Vaccine Standing Orders for Healthcare Providers (


HPV Vaccination Resources

American Academy of Pediatrics Resources

National HPV Roundtable Clinical and Health System Action Guides

Clinical Guides

  • Physicians, Physician Assistants & Nurse Practitioners

  • Nurses & Medical Assistants

  • Dentists & Hygienists

  • Office Administrative Staff Teams

Systems Guides

  • Small Private Practices

  • Large Health Systems


[1] National Cancer Institute. HPV and Cancer.
[1] Brandt HM, Vanderpool RC, Pilar M, Zubizarreta M, Stradtman LR. A narrative review of HPV vaccination interventions in rural U.S. communities. Prev Med. 2021 Apr;145:106407. doi: 10.1016/j.ypmed.2020.106407. Epub 2021 Jan 1. PMID: 33388323.
[1] McElfish PA, Narcisse MR, Felix HC, Cascante DC, Nagarsheth N, Teeter B, Faramawi MF. Race, Nativity, and Sex Disparities in Human Papillomavirus Vaccination among Young Adults in the USA. J Racial Ethn Health Disparities. 2021 Oct;8(5):1260-1266. doi: 10.1007/s40615-020-00886-5. Epub 2020 Oct 8. PMID: 33033889; PMCID: PMC9753349.
[1] O’Leary ST. Why the American Academy of Pediatrics recommends initiating HPV vaccine at age 9. Hum Vaccin Immunother. 2022 Nov 30;18(6):2146434. doi: 10.1080/21645515.2022.2146434. Epub 2022 Nov 20. PMID: 36404635; PMCID: PMC9746363.
[1] Ylitalo KR, Lee H, Mehta NK. Health care provider recommendation, human papillomavirus vaccination, and race/ethnicity in the US National Immunization Survey. Am J Public Health. 2013 Jan;103(1):164-9. doi: 10.2105/AJPH.2011.300600. Epub 2012 Jun 14. PMID: 22698055; PMCID: PMC3518336.