FQHC fosters dental-medical collaboration to boost HPV vaccination rates

Dover, N.J. — A federally qualified health center in New Jersey integrated dental and medical teams to successfully increase the rate of human papillomavirus (HPV) vaccinations in their younger patient population, according to a research article published in the peer-reviewed journal Oral Health & Dental Science.

The program’s goal, Zufall Health Center Chief Dental Officer Dr. Sam Wakim told the ADA News, was to improve their immunization rate by 10% in a cohort of medical and dental patients by Jan. 1, 2020, in an effort to stem oral cancers.

 Dr. Sam Wakim
Dr. Sam Wakim
But by using eight ADA-trained community dental health coordinators (CDHQs) that teamed up with the centers’ physicians and dentists, the health center was able to exceed its expectations by boosting the immunization rate from 12% to more than 30%.

HPV is the most common sexually transmitted infection in the U.S., with more than 70 million Americans infected, according to the Centers for Disease Control and Prevention.

70% of oropharyngeal cancers are associated with HPV infection; oropharyngeal cancers are among the top 10 new cancer diagnosed in men and women; and are among the top-10 cancer deaths in men and women.

The CDC Advisory Committee on Immunization Practices as well as the American Academy of Pediatrics recommend that boys and girls receive the HPV vaccine during adolescence.

The Zufall program, which began in April 2019, tracked about 900 patients ages nine to 18, primarily from its northwest and central New Jersey populations comprising uninsured and underinsured patients including the homeless, working poor, public housing residents and farm workers.

Integration of staff, systems, training and communications was vital to the project’s success, Dr. Wakim said. He said there is a perceived tendency in health centers and health care organizations to contain silos, but health care providers cannot provide excellent care without fully understanding the whole patient.

“We successfully unified medical and dental staff’s understanding of patients’ overall health; created a continuous process improvement program as a benchmark; streamlined and integrated electronic data and records systems for easier and smarter access; and aligned training and messaging so staff could confidently and effectively interact with patients and families.”

The CDHCs were crucial to the success of the programs by being advocates for vaccinations and dental interventions, Dr. Wakim said.
“The CDHCs, with their unique skill set, service orientation, and dental expertise, were the right champions to propel this unique dental intervention project forward,” he said. “The CDHCs assured patients and families that the HPV vaccine was safe, knowledgeably guided patients through the vaccination process from start to finish and reminded them of the impact of the immunization on the young patients' current and future good medical and oral health.”

Although the program was conducted at a FQHC, Dr. Wakim said the results showed that education about cancer prevention through HPV vaccines can start in the dental chair inside anyone’s office.

“Dentists can rest assured that by talking about it with their patients in their offices that it’s making a difference,” Dr. Wakim said. “I hope the results are useful to everyone, regardless of their practice setting.”

In 2018, the ADA adopted a policy that urges dentists to support the use and administration of the HPV vaccine.