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Kosrae HPV Campaign

Cervical cancer is the second most common cancer in Kosrae, Federated States of Micronesia. The Kosrae Comprehensive Cancer Control Partnership (KCCCP) developed Goal 1 of the Kosrae Comprehensive Cancer Control Plan [PDF-1MB] to “reduce the cancer burden through promotion of healthier lifestyle choices.” The human papillomavirus (HPV) vaccine was not licensed when the Kosrae Cancer Plan was developed, so the original objective related to conducting a feasibility study (on implementation of HPV vaccine) by 2012. KCCCP changed the objective in 2008 to implementation of an HPV campaign, since the vaccine was made available to FSM through CDC’s expanded Vaccines for Children program.

Planning for the Kosrae HPV Campaign got underway during the later part of 2008. Its goal was to vaccinate 90% of females aged 9–18 in Kosrae by August 2009. Partners in this project included the Department of Education, Kosrae Parents and Teachers Association, FSM Telecommunication Corporation, Kosrae V6AJ Radio, FSM Immunization Program, CDC, Kosrae Immunization Program, and KCCCP. Partners provided funding, helped coordinate the parents’ awareness material and consent form, provided transportation and chaperone services, and made in-kind donations including 25,000 pre-paid telephone cards imprinted with a message encouraging girls to get the HPV vaccine and free airtime for an HPV radio talk show.

The major barrier identified was parents’ refusal to consent to the HPV vaccine, for several reasons: it is new, they were concerned with side effects, and the implied approval of sexual activity. They overcame this barrier through parent-focused awareness, the school incentive program, and advocacy from the Kosrae First Lady and medical doctors.

During the campaign kickoff in February 2009, 642 girls were vaccinated within 2 hours and 30 minutes. The second dose was administered during late May and early June, and the the third dose was given in August.

Overall, 93% of eligible girls received the second dose of the vaccine through the Kosrae HPV Campaign, 3% above target. They hope to maintain this coverage rate to reduce the cervical cancer burden in Kosrae in the years to come.