Table 1.
Summary of policy opportunities to increase HPV vaccination in rural areas.
| Policy Opportunity | Description | Level | Big “P”/Little “p” |
|---|---|---|---|
| Healthcare provider recommendation | HPV vaccination recommendation to patients at each visit, particularly when other vaccines are being administered; decreases missed opportunities. | Provider | Little “p” |
| Reminder and recall systems | Reminders within the electronic medical record, prompting providers to initiate HPV vaccination recommendation; patient reminders to initiate and/or complete the HPV vaccine series. | Clinic | Little “p” |
| State immunization registries | Statewide registries in which all immunization records are entered and maintained. | State | Big “P” |
| Standing orders | Official clinic protocols that give clinical staff authorization to complete immunizations for patients meeting recommended guidelines. | Clinic | Little “p” |
| Provider assessment and feedback evaluations | Routine feedback to providers on patients’ HPV vaccination series initiation and completion rates. | Clinic | Little “p” |
| Participation in VFC Program | Clinic approval and implementation of processes that allow for participation in the VFC Program. | Clinic | Little “p” |
| Vaccination in alternative settings | Providing HPV vaccination programs in schools, pharmacies, mobile clinics, dental practices, and other community-based, non-medical settings. | Clinic, Community | Little “p” |
| Pharmacy-related laws | State-enacted laws allowing pharmacists to provide the HPV vaccine series to youth and young adults. | State | Big “P” |
| School-entry requirements | State-enacted laws that require students to initiate and complete the HPV vaccine series to maintain eligibility to attend school. | State | Big “P” |
| Communication campaigns | Leveraging rural community partnerships and voices of local residents to deliver positive HPV vaccination messaging. | Community | Little “p” |
| Rural HPV vaccination research | Increased funding for interventional rural HPV vaccination research (e.g., randomized controlled trials, quasi-experimental studies, and pragmatic trials). | National | Big “P” |