1. HPV Vaccination Activities Elizabeth Sobczyk, MSW, MPH Manager, Immunization Initiatives American Academy of Pediatrics

2. AAP Mission The mission of the AAP is to attain optimal physical, mental and social health and well-being for ALL infants, children, adolescents and young adults. To accomplish this mission, the Academy shall support the professional needs of its members.

3. HPV Recommendations Published in February 2012 Align with CDC recommendations

4. Implementation of Recommendations Implementation Guidance Periodic Survey of Fellows Increasing Adolescent Immunization through Pediatric Partnerships Building Capacity of the Public Health System to Improve Population Health through National Non-profit Organizations (HPV focus) –Also known as the HPV umbrella agreement

5. Implementation Guidance Accompanies the policy statement Addresses –Supply –Liability and Risk Communication –Risk Management –Payment –Coding –Patient Education http://www2.aap.org/immunization/illnesses/hpv/HPVImple mentationGuidance.pdf

6. Periodic Survey of Fellows PS#84 was an eight-page self-administered questionnaire sent to 1622 nonretired U.S. members of the AAP from October 2012 to March 2013. Analysis is limited to those pediatricians who provide patient care and offer age appropriate immunizations to all or some patients in their practice (627 pediatricians). Parental refusal was reported as a major barrier to delivering HPV vaccine.* Lack of adolescent well visits was also a barrier. *Pediatricians say that parents are the barrier, parents say that pediatricians are the barrier.

7. Increasing Adolescent Immunization Through Pediatric Partnerships Cooperative agreement with the CDC September 1, 2012 – August 30, 2015 Consultants: Humiston, Rand, Schaffer, Szilagyi Objectives 1.Educate pediatricians about the need for a strong recommendation to parents for on-time adolescent immunizations (AI) to increase AI rates. 2.Implement quality improvement (QI) activities to reduce missed opportunities to vaccinate adolescents in the office setting. 3.Raise parental awareness of adolescent vaccines in order to increase visits to the medical home and opportunities for AI. 4.Increase use of tools available to create practice changes in AI.

8. Increasing Adolescent Immunization Through Pediatric Partnerships CME: Creating online courses through Pedialink, one on giving a strong provider recommendation using CDC materials, one on office strategies for increasing rates (go live July 2014) QI: EQIPP module that counts for Part IV Maintenance of Certification, added adolescent and HPV-specific content, being piloted but is available Residents: Video contests, risk communication curriculum/case studies Office materials: training guide, talking to your teens, talking to your parents

9. Increasing Adolescent Immunization Through Pediatric Partnerships http://www2.aap.org/immunization/pediatricians/adolesce nts.html

10. HPV Umbrella Agreement: Background Cooperative agreement with the CDC September 23, 2013 – June 30, 2014 Consultant: Humiston Goal: Work in collaboration with the CDC to build the capacity of pediatricians to increase coverage of HPV vaccination and to improve quality, availability, and accessibility of public health education materials, training, and evaluation tools and resources related to HPV vaccination.

11. HPV Umbrella Agreement: Objectives 1 and 2 Support AAP Chapter “HPV Action Plans” In November 2013, a call for proposals was issued to AAP Chapters, requesting participation in a variety of HPV vaccination activities. Thus far, 47 chapters in 43 states have submitted applications. Disseminate Existing HPV Vaccination Promotion Materials Discussions have focused on what materials exist and what is needed. A continuing medical education course will be available in February from the CDC. Videos and print materials are already available, though state- specific videos may be created. A flip chart to aid practice-level discussions will be developed.

12. -IZ Congress-Train the trainer -Host a speaker-Webinar -QI Activity-Materials -CDC funding -No application HPV rate is % vaccinated with > 1 dose for females 39.7 56.1 54.3 41.2 65 61.4 CT-57.6 DE- 67.2 DC- 57.8 MD- 42.7 39.4 52.3 64.6 51.3 41.2 48.4 57.5 42.7 51.2 62.1 61.7 48.1 59.4 46.6 51.6 55.1 67.5 62.5 51.1 56.0 53.3 60.3 56.4 55.1 58.5 57.4 41.9 51.0 54.3 51.2 44.350.9 64.5 45.2 50.5 53.9 MA- 69.3 NH- 52.2 NJ- 54.6 RI- 73.7 VT- 66.4

13. HPV Umbrella Agreement Objective 3 Use of Social Media to Promote HPV Vaccination to Pediatricians and Parents. Planned for Spring 2014

14. HPV Umbrella Agreement: Objective 4 Use the AAP Healthy Children Expo (2014) to Promote HPV Vaccination to Parents. Program staff plan to exhibit at the Expo, which is the AAP’s first direct in-person education of parents. The conference aims to attract 5,000 families in the Chicago- land area and be repeated in other regions in future years. Booth space was requested and an exhibit is being designed with CDC materials. In addition, staff are working with the presenter of a session on adolescent immunization to include CDC messages on HPV vaccine.

15. AAP Chapters Chapters are independently incorporated from the AAP; however, we do provide guidance and funding on many issues. Chapter Executive Director contact information can be found at http://www2.aap.org/member/chapters/chaplist.cfm. http://www2.aap.org/member/chapters/chaplist.cfm Or contact me at esobczyk@aap.org to find out more about what is happening in your area.esobczyk@aap.org

16. Questions? esobczyk@aap.org or 847/434-4271esobczyk@aap.org