Wide Open Spaces: Supporting HPV Vaccination in Rural Communities

Mountain West HPV Vaccination Project Helps Shape American Cancer Society National HPV Vaccination Program -  June 2024

graphic depicting mountain west states

In 2020, the American Cancer Society (ACS) launched the Mountain West HPV vaccination project to increase HPV vaccinations in five mountainous and rural states: Idaho, Montana, Nevada, Utah, and Wyoming. The project sought to address geographic and gender gaps in HPV vaccination rates and increase on-time initiation. With 57 million Americans calling rural communities’ home, these individuals experience access barriers and poorer health outcomes, including higher incidence of HPV-related cancers. Historically, rural communities lag 10% behind urban in uptake of the HPV vaccination series, and the COVID-19 pandemic elevated vaccine hesitancy in these communities. To address this gap, ACS applied a health equity lens and partnership model to implement disparity-reducing interventions through a three-pronged strategy including state, system, and individual work.

State work to improve HPV vaccination happened through a regional consortium. ACS convened 235 partners representing 100 organizations for region-wide virtual and in-person state meetings to network, share current work, discuss best practices, and pinpoint future opportunities.

Ashley Lach

Ashley Lach, MHA, CPHQ, is HPV Program Manager American Cancer Society

With a strong history of health system partnerships, ACS recruited 17 partners with 93 clinics, in 2022 and 2023, to provide formal education and technical assistance via a monthly quality improvement (QI) learning collaborative model. Partners aimed to increase HPV vaccination rates among the collective 52,000 active 9-13-year-old adolescents by using QI to identify gaps and implement provider and system level interventions. One partner shared, “as a result of the ACS partnership, we have added electronic health record clinical decision support that cue providers and parents to initiate vaccination at age nine and emphasizes the importance of equal vaccination for boys and girls.” Across both cohorts, more than 65 interventions were implemented, and partners saw between 3-9% increase in both initiation and completion of the series.

Furthermore, ACS partnered with groups to provide professional education to 2,173 traditional and non-traditional vaccinators including clinical staff, students, community health workers, dental professionals, and pharmacists through ECHO (Extension for Community Healthcare Outcomes). ECHO is a learning framework, where professionals share their knowledge, recommendations, and best practices. Session topics included HPV vaccination at age 9, addressing vaccine hesitancy, overcoming health inequities, and highlighting innovation increasing HPV vaccinations. One participant shared, “this was one of my favorite CE [continuing education] credits, I have ever done. I loved the variety of opinions and ideas and I feel like I can take a lot back to my work. I love the confidence this gave me in patient education.” Another revealed, “I gained a wealth of knowledge on how to work with those who experience health inequity and resources to support patients, and myself as a student and future practitioner.”

Despite the project coming to an end, key elements and best practices from this work have shaped ACS’s national HPV program, through state-based initiatives and geographic disparities including the launch of our Rural HPV Vaccination Learning Community.


We invite guest contributors to share information on how they are working to improve HPV vaccination in rural areas. If you are interested in contributing or learning more about our efforts to improve HPV vaccination with rural communities, please email us at: PreventHPV@stjude.org.