Photovoice Project Promotes HPV Vaccination Awareness Among Michigan Teens

By: Melanie Perry

Photo of a young woman touching the play button on the screen.

Michigan’s District Health Department #10 (DHD#10) created an HPV vaccination awareness campaign based on the Photovoice concept.


Michigan’s District Health Department #10 (DHD#10) used an innovative Photovoice project created by area high school students to increase awareness of the human papillomavirus (HPV) vaccination. Students contributed their photographs, images, and messages to educate their peers and parents about the cancer prevention benefits of HPV vaccination and to initiate conversations about why the vaccination is important for adolescent boys and girls.


HPV causes about 42,700 cancers annually in the United States, according to the Centers for Disease Control and Prevention (CDC). However, HPV vaccination can prevent most of these cancers (about 33,700) from ever developing. In 2014, about 72% of Michigan adolescent boys and girls were up-to-date on their Tdap vaccine, which is administered at age 11. In contrast, only about 19% were up-to-date on the recommended doses of HPV vaccine, according to a December 2014 Michigan Care Improvement Registry (MCIR) report card.

DHD#10 (Michigan’s largest public health department) is working to improve HPV vaccination rates. However, parents report not vaccinating their children because of safety concerns, their lack of knowledge of the vaccine’s benefits, and not receiving a recommendation from their health care provider.

At the start of this project, the DHD#10 region’s adolescent vaccination rates were slightly better than average for Michigan. However, the rates were less than the Healthy People 2020 goal of 80% coverage of boys and girls aged 13 to 15 who receive two or three doses of HPV vaccine as recommended. In the DHD#10 region, about 78.1% of adolescents in this age group received at least one dose of the HPV vaccine. However, only 27.2% of adolescents were up-to-date on all doses of the HPV vaccine.


DHD#10 created an HPV vaccination awareness campaign based on the Photovoice concept. They partnered with The Oceana Prevention Partnership for Change (TOPPC), a nonprofit organization that trains local high school students to become peer educators. TOPPC’s Youth Board created the Photovoice project using messages and images from their peers to explain the importance of completing the HPV vaccination series.

Visit the HPV Vaccination Photovoice Project for more information.


MCIR data for the DHD#10 region showed that the HPV vaccination completion rates for males and females combined increased from about 27% to 33% from December 2014 to December 2015. Completion rates for all Michigan adolescents during the same period increased from about 19.1% to 24.6%. Although it is difficult to determine how much the Photovoice project contributed to this improvement, DHD#10 believes the increased awareness, education, youths’ concern for their own health, and statewide communication efforts helped to increase understanding of how to promote and recommend the HPV vaccine for cancer prevention.

“DHD#10 is committed to increasing HPV vaccination rates through partnerships with health care providers, addressing immunization misconceptions, and promoting the benefits of HPV vaccination through innovative projects, like the Photovoice project.”

Melanie Perry, MPH, CHES
District Health Department #10

What’s Next?

Although this HPV vaccination awareness campaign and the Photovoice component were completed, more work is being done on a statewide basis to improve HPV vaccination rates in Michigan. DHD#10 continues to implement and evaluate evidence-based interventions, including the use of client reminder and recall systems to increase community demand for vaccines. Michigan’s statewide goal is to increase the percent of males and females aged 13 to 17 years who have completed the HPV vaccination series from 48.80% to 53.68% by June 2022.

The findings and conclusions in this success story are those of the author(s) and do not necessarily represent the official position of the funding agencies of the Centers for Disease Control and Prevention (CDC).