Improving HPV Vaccination Rates in Rural West Virginia through the HPV Dental Integration Pilot Project

By Lauren Wright, DSL, MPH

West Virginia has one of the highest rates of HPV cancers in the United States (U.S.), usually falling either first or second on the incidence rate list each year. Additionally, West Virginia has one of the lowest rates of HPV vaccination series completion in the nation, most recently ranked 43^rd according to the National Immunization Survey—Teen 2024. West Virginia faces several barriers to health care, with most of the state being considered a medically underserved area. As the only state entirely encompassed within Appalachia, West Virginia is mostly rural with a total population of less than two million—significantly smaller than most large U.S. cities. West Virginians face barriers to health care, including poverty, low health literacy levels, transportation, and a low health care provider-to-patient ratio. The state is also not immune to the increasing amount of vaccine misinformation being spread across the country, making conversations with parents and patients even more difficult for pediatric and primary care providers. Together, these barriers affecting both patients and providers called for a unique project.

Mountains of Hope is West Virginia’s statewide cancer coalition, an organization built on strong, collaborative partnerships over the past 25 years. HPV is one of Mountains of Hope’s top priority cancer prevention focus areas, so when a coalition member and community partner requested that Mountains of Hope assist in the creation of an HPV project with oral health providers, Mountains of Hope got to work. Mountains of Hope partnered with the West Virginia Oral Health Coalition, the West Virginia Dental Hygienists’ Association, and a local federally qualified health center, Community Care of West Virginia, to create and implement the HPV Dental Integration Pilot Project.

Oral health providers are not traditionally taught about HPV in detail throughout their schooling, as oropharyngeal cancers were not added to the HPV vaccination prescribing information for Gardasil 9 list until June 2020. However, oral health providers typically spend more uninterrupted time with a patient during a dental cleaning than most pediatric and primary care providers during a well visit, making them an important touch point for HPV-related education. Mountains of Hope representatives created educational presentations about HPV and its impact on oral health and oral cancer rates across the state and presented these to both the West Virginia Oral Health Coalition and the West Virginia Dental Hygienists’ Association to improve HPV knowledge and to increase HPV awareness among dental professionals.

Additionally, Mountains of Hope worked closely with West Virginia Dental Hygienists’ Association and Community Care of West Virginia to create a workflow integrating HPV cancer prevention into dental offices. This workflow included an oral health-focused HPV rack card created by partners of Mountains of Hope; a memorandum of understanding approved and signed by both Mountains of Hope and Community Care of West Virginia ; and a warm handoff process between the dental clinic and medical clinic so that patients and/or parents who are interested in being vaccinated could be referred easily to the medical clinic.

Community Care of West Virginia ’s dental clinic implemented the HPV Dental Integration Pilot Project in September 2025 and has educated 34 age-eligible, unvaccinated dental hygiene patients between September 2025 and March 2026. Of those 34 patients, 10 agreed to begin their HPV vaccination series. The hygienist at Community Care of West Virginia  has shared that all patients have been receptive to the education she provides during their visit, which indicates that this project is feasible and acceptable in this population. Project expansion is planned to begin taking place in 2026 and 2027.

Additionally, as a result of these partnerships and this project’s success, Mountains of Hope, West Virginia Oral Health Coalition, and West Virginia Dental Hygienists’ Association have begun working on a policy change effort that would allow dental providers to vaccinate against HPV within their dental clinics—a change that, if implemented, would remove an additional barrier to HPV vaccination series initiation and completion.