After a Sharp Decline in HPV Vaccine Rates From 87% to 50%, Irish Health Experts, Politicians and NGOs Joined Forces To Turn The Tide, Helping to Increase Vaccination by 11%. This Is How We Did It

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Background and context: Just three years ago, in 2015, HPV vaccination uptake in Ireland was running at 87%. The school-based program was going well, and thousands of girls had completed a two-dose vaccination course which will significantly reduce their risk of cervical cancer and other HPV-related diseases. This was achieved with limited public health messaging. Then an online campaign to undermine the vaccine began to gather momentum. A small number of stories surfaced on social media claiming links between the timing of the vaccination campaigns and the subsequent development of illnesses. The campaign against the vaccine went viral on social media, local radio - and, in November 2015, on a commercial television station - fear began to trump science. In the summer of 2016, when preliminary figures showed uptake had hit 50%, the Irish Cancer Society commenced a campaign to take decisive action. Aim: To reverse the decline in HPV vaccine and restore uptake to previous levels above 80%. Strategy/Tactics: For health campaigners, such as the Irish Cancer Society, the problem of falling HPV vaccine uptake was a perplexing one. The society had pushed hard for the introduction of the HPV vaccine which commenced in 2011. To address the problem the Irish Cancer Society developed an advocacy campaign which eventually led to the establishment of the HPV Vaccination Alliance, a large group of leading health, children and women's groups, with the aim of ensuring that the public saw a broad coalition standing up for the vaccine. The Alliance has simple and consistent messages - including the fact that 40 women will die each year as a result of parents opting out of the vaccination program. Work was done to ensure that politicians were strongly supportive of the vaccine including political briefings with politicians who had previously sought to question its effectiveness. Young women with cervical cancer endorsed the campaign. The Minister for Health strongly endorsed the vaccine. The credibility of support groups for those with reported side effects of the vaccine was undermined by highlighting their links with national and international antivaccine activists as well as highlighting their repeated refusal to answer questions about where they spent money raised from the general public. Outcomes: Figures show uptake of the vaccine has increased to 61% in 2017 - up from 50% in 2016. What was learned: Not enough was done to support the initial implementation of the vaccine which created an information vacuum and under informed vaccination teams. The answer was a classic example of good public health advocacy in action demonstrating the power of alliances delivering consistent, clear and simple messaging.