April 3, 2023

Dear Connecticut Health Providers,

Nationally, the Human Papillomavirus (HPV) is estimated to cause about 37,300 new cases of cancer each year.

We have an opportunity to eradicate HPV-associated cancers, and yet too many people are not getting this safe and effective vaccine that prevents six different cancers associated with HPV which include oropharyngeal cancers and approximately 91% of cervical cancers. In Connecticut oral- pharyngeal cancer incidence has been trending up since 2005 for males and females of all races. It is now the 8th most diagnosed cancer in CT males and 11th for females.

A nine-valent HPV vaccine (HPV9) is available to protect against multiple strains, including HPV 16, 18, 31, and 33, the types that cause most cervical and other anogenital cancers, as well as some oropharyngeal cancers. The HPV vaccine is approved for ages 9 years through 45 years for ALL GENDERS. The American Cancer Society (ACS) and American Academy of Pediatrics (AAP) recommend vaccination at age 9, and many of Connecticut’s vaccine advocates are leading this charge, including the Connecticut Chapter of the AAP.

In Connecticut, only 66.4% of adolescents aged 13-17 are fully vaccinated for HPV- associated cancers. Nationally, approximately 27% of men and 53.6% of women between the ages of 18–26 are vaccinated. In rural communities, HPV vaccination rates are low, yet incidence and mortality rates of HPV-associated cancers are high. The HPV vaccination rate for Connecticut adolescents living in non-urban geographic locations is 66.4%% compared to the 97.3% rate for ≥ 1 dose meningococcal vaccine.

We need to address the public health issue and the burden of cancers related to the low HPV vaccination rates of Connecticut adolescents and adults. Provider recommendation for the HPV vaccine is considered the most effective determinant of vaccine uptake compared to other interventions such as parent education.

Connecticut is partnering with NH, VT, VA, WV, DC, PA, OH, MD, and DE, in a multi-state Call to Action to increase HPV vaccination through strong and consistent provider recommendations and initiation of HPV vaccination starting at age 9. HPV vaccination is cancer prevention!



➢ Set your electronic health record notifications from age 9 years through 45 years for men and women. Initiating the HPV vaccination at age 9 has been shown to increase vaccine completion by 22 times.

➢ Make a strong recommendation for HPV vaccines for all patients ages 9 years through 26 years. Data shows that your recommendation may improve vaccinations by up to 5 times.

➢ For adults aged 27 years through 45 years, engage in shared decision-making to help determine the benefits of vaccination.

➢ Vaccination recommendations should be made in all healthcare settings including acute, non-acute, GYN, and dental locations.

➢ Encourage same-day vaccination in your facility.

➢ Review your patients who have not completed their 2 or 3-dose series and proactively recall patients to your facility.

➢ Review vaccination status at every visit- not just well checks.

➢ 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 (immunize.org).

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



The Connecticut Partnership
HPV Vaccination Workgroup