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Genital human papillomavirus (HPV) is the most common sexually transmitted virus in the USThere are about 40 types of HPV 20 million people are infected in the US 6.2 million new infections annuallySpread through sexual contact 10,000 women get cervical cancer in the US3,700 die annually2nd
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2. Genital human papillomavirus (HPV) is the most common sexually transmitted virus in the US
There are about 40 types of HPV
+ 20 million people are infected in the US
+ 6.2 million new infections annually
Spread through sexual contact
+10,000 women get cervical cancer in the US
3,700 die annually
2nd leading cause of cancer deaths among women around the world
Human Papillomavirus (HPV)
3. Gardasil (Merck) is the first HPV vaccine licensed in the US (3 dose series)
Protects against 4 major types of HPV
Can prevent most genital warts and most cases of cervical cancer
Licensed by the FDA: 6/8/2006
Added to the Federal VFC Program: 6/26/2006
But not funded until 12/2006
Added to the Texas VFC Program: 2/1/2007
ACIP Recommendations published in MMWR: 3/23/2007
HPV Vaccine Timeline
4. Gardasil (Merck)
Licensed for women 9 -26 years of age
3 dose series (est. $120/dose)
Dose 1: Now
Dose 2: 2 months after dose 1
Dose 3: 6 months after dose 1 (at least 12 weeks after the second dose)
Not recommended for use in pregnancy
If the vaccine series is interrupted, the series does not need to be restarted
Can prevent most genital warts and most cases of cervical cancer HPV Vaccine
5. Eligible Groups in Texas for Public Vaccines
Texas Vaccines For Children (TVFC) eligible females 9-18 years of age
Texas HPV vaccine estimates
Total females 9-18 years of age: 1.7 million
Total TVFC eligible females: 52%
HPV Vaccination in Texas
6. Federally funded vaccine supply program
Distributes free vaccines to private and public providers for defined populations
Serves children birth to 18 years of age who are
Enrolled in Medicaid
Uninsured
Native American/Alaska Native
Have health insurance, but it does not cover immunizations (underinsured). In these cases, these children must go to a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) for immunizations.
What is VFC?
7. Resources CDC website for HPV Vaccine:
http://www.cdc.gov/nip/vaccine/hpv/default.htm
Merck's website for HPV:
https://www.merckvaccines.com/gardasilProductPage_frmst.html
8. Hepatitis B Vaccination in HIV and STD Clinic Settings
9. Purpose To determine whether providing hepatitis B vaccine was feasible in the STD setting
To offer vaccine to high-risk adult population in Texas
10. Timeline Pilot: December 2002 May 2006
Immunization Division purchased 39,000 doses
18 sites volunteered to participate
Eligibility: Persons 19 and older seeking testing, treatment, or counseling services
Continuation: April 06 to Present
One-time funds available from CDC
Imm Branch, HIV/STD, and IDCU collaboration
Two-year project
Expanded to include HIV prevention services clinics in addition to STD clinics
34 STD clinics (24 lhds)
10 HIV clinics (8 agencies)
11. Methods Doses recorded by age and dose number
Temperature log
Inventory monitored on a monthly basis (reports due on 7th of each month)
Vaccine is replenished as needed
14. List of Pilot Sites Abilene Taylor County Health Dept
City of Amarillo Public HD
Austin-Travis county HHSD
Brazos County HD
Corpus Christi-Nueces County HD
Dallas County HHS
El Paso County HD
McAllen Clinic Hidalgo County HD
City of Lubbock
City of Houston
Medical Center
Lyons
West End
Milam County HD
San Antonio Metro HD
Northeast Texas Public HD (Smith County)
Texarkana Bowie
Victoria City-County HD
Wichita Falls-Wichita County Public HD
15. Doses Administered by Dose Number Pilot7/03-5/06
16. Age Distribution of ClientsPilot, 7/03-5/06
17. Hepatitis B Vaccine Uptake Pilot, 7/03-5/06
18. On this map, the shaded areas indicate sites participating in the project. The blue dots identify the major cities in the state for a point of reference and not indicating participating sites. On this map, the shaded areas indicate sites participating in the project. The blue dots identify the major cities in the state for a point of reference and not indicating participating sites.
19. List of Participating STD Sites City of Amarillo Public HD
Angelina County & Cities Health District
Austin-Travis county HHSD
Beaumont Public Health District
Brazos County HD
Cherokee County
Collin County Health Dept
Corpus Christi-Nueces County HD
Dallas County HHS
El Paso County HD
Grayson HD
Gregg HD
Hays County HD
Hidalgo County HD McAllen Clinic
City of Houston
Laredo HD
City of Lubbock
Milam County HD
Northeast Texas Public HD
San Antonio Metro HD
Victoria City-County HD
Wichita Falls-Wichita County Public HD
Williamson County HD
20. On this map, the shaded areas indicate sites participating in the project. The blue dots identify the major cities in the state for a point of reference and not indicating participating sites.On this map, the shaded areas indicate sites participating in the project. The blue dots identify the major cities in the state for a point of reference and not indicating participating sites.
21. List of Participating HIV Sites AIDS Arms Peabody Health Center
AIDS services of North Texas
Denton
Plano
AIDS Resources of Rural Texas
Weatherford
Abilene Permian Basin Community Centers- Basin Asst Services
Health Horizons - Nacogdoches Clinic
Legacy Houston
Nelson-Tebedo Health Resource Center
Valley AIDS Council
22. Doses Administered by Dose Number, 7/06-4/07*
23. Age Distribution of Clients7/06-4/07*
24. Uptake Estimates STD sites
16 sites submitted data on number offered first dose
85% vaccinated with 1st dose
31% received the 2nd dose
HIV sites
7 sites submitted data on number offered first dose
80% vaccinated with 1st dose
47% received the 2nd dose
25. Resources Interpretation of Hepatitis Markers:
http://www.cdc.gov/ncidod/diseases/hepatitis/serology/index.htm
Hepatitis B Vaccination Recommendations
for Adults:
http://www.cdc.gov/ncidod/diseases/hepatitis/recs/index.htm
26. Contact Information Mark Ritter, MHA
mark.ritter@dshs.state.tx.us
Ph. (512) 458-7111 ext. 6432
Rita Espinoza, MPH
rita.espinoza@dshs.state.tx.us
Ph. (512) 458-7111 ext. 6335
Fax (512) 458-7616