The HPV vaccine helps prevent infections that can lead to cancer, but efforts to raise vaccination rates among young people have slowed.
According to the Centers for Disease Control and Prevention, from 2022 to 2024, the share of teens who received at least one dose held steady at about 78 percent, while about 63 percent completed the full series.
That slowdown is part of a larger trend: Childhood vaccination rates for other diseases have fallen too. In the 2024-2025 school year, fewer kindergarteners received the MMR vaccine to protect against measles, mumps, and rubella.
In Texas, MMR vaccination rates among young children dropped from nearly 97 percent in 2019 to about 93 percent today.
At the same time, more families are requesting exemptions, and reduced funding for vaccination programs is making it harder for health workers to reach kids and their families.
To learn how one community is adapting its HPV vaccination strategy, PGN spoke with Dr. Erika Thompson, a professor at the University of Texas School of Public Health in San Antonio and leader of All for Them Bexar County.
She shared how her team is partnering with community groups and mobile clinics to offer vaccines to teens in more flexible, accessible ways.
Here’s more of what she had to say.
[Editor’s note: The contents of this interview have been edited for length and clarity.]
PGN: Can you tell us more about your work and the All for Them initiative in San Antonio?
Dr. Erika Thompson: My career has focused predominantly on HPV-related cancer prevention, so preventing those six types of cancer, including cervical cancer, but also oral, pharyngeal, and other anogenital cancers. That’s mainly through HPV vaccination but also cervical cancer screening.
I lead a project called All for Them Bexar County. It’s based on a program that’s been going on for several years in other parts of Texas, initially with three main components: providing comprehensive vaccine clinics in schools, social marketing to provide education to families and school staff, and school nurse capacity building around immunization records and promoting vaccination.
When I came to San Antonio two years ago, we wanted to adapt that model knowing it’s getting a little more challenging to get into schools.
So we kept those principles of health education and social marketing but started working more with providers who aren’t necessarily physicians. We are working with community health workers and hosting mobile vaccine clinics at community events, where we offer all adolescent vaccines but bundle in HPV vaccination.
This work is also part of a broader initiative across Texas. We are in the process of developing the cervical cancer elimination plan for our state, and one of the key pillars for that work is HPV vaccination.
PGN: What are you hearing from community partners about vaccination in the communities they serve?
E.T.: I’m also fortunate to chair our Texas HPV Coalition, and so I’ve spent some time going around the state and talking with different communities.
At the grassroots level, what I continue to hear from community organizations that we partner with is that vaccines are still very much in need. Their communities are wanting those services in a way that’s accessible to them.
We do have that level of vaccine hesitancy that’s kind of expected, but reflecting on the San Antonio community specifically, I would say that the underserved populations that we predominantly serve don’t have the same level of hesitancy and mistrust that maybe other white middle-class communities have.
In some ways there’s this detachment of vaccine confidence where we have communities who are willing to get vaccinated but just don’t have access, and then we have communities who have the access but have another level of vaccine hesitancy related to misinformation or mistrust.
So we tend to focus more on the access piece and making that accessible to folks, and bundling it with other vaccines or meeting the whole health needs of a child.
PGN: How do community partnerships shape the way your team approaches vaccination outreach?
E.T.: Oh my gosh, it’s critical. I work at an academic university where I’m newer to San Antonio, and I will say moving here has been a breath of fresh air because the community organizations and partners are very willing to collaborate.
These organizations are trusted in the community. They are situated in the neighborhoods and zip codes where the most need is, and they are already providing services that meet basic needs like health care, child care, or youth development.
By working with these organizations we’re coming in and saying, how can we supplement and provide these health services as well?
We’re trying to figure out where families already go for services so it can just be one more thing available to them.
PGN: You mentioned making some adjustments to how your team presents vaccine information. What prompted those changes?
E.T.: When the project started we adapted materials from our Houston team, and even though the program was called All for Them, most of the fact sheets were about HPV.
But as we started doing community events, I realized we were kind of ‘othering’ this vaccine to start with.
That’s when we developed materials about all the vaccines adolescents need and what they prevent.
We still have the HPV one available if someone has more questions, but we try to be all-vaccines forward rather than HPV-forward.
PGN: What kinds of conversations tend to come up with families about the HPV vaccine?
E.T.: A lot of the families we serve come to us because a school nurse told them they’re missing required vaccines.
So we’re having that conversation of, yes, your school nurse told you you need these two, but there’s also a vaccine that prevents cancer.
And then the question becomes: Why isn’t this required?
Because HPV isn’t a school entry requirement in Texas, that policy sets it up to be a different conversation.
One of the most common concerns we hear is infertility. Our message back to that is actually we’re preserving fertility because if you get this vaccine to prevent cervical cancer, that’s preserving your child’s future fertility.
PGN: For health workers who may not specialize in vaccines but work with teens and their families, what feels important for them to know about HPV prevention?
E.T.: The most important thing to know is that there is a vaccine that prevents six types of cancer.
The reason we give it to adolescents is because we know their bodies work better in building that immune system.
So when we think about the full adolescent…you know, healthy mind, healthy body, healthy well being… a vaccine that can prevent catastrophic outcomes in the future is such a simple intervention right? Like, compared to all the other health behaviors that exist, like, eating nutritious food, being physically active, staying off social media.
The more that community health workers who reach teens reflect on things like how could we partner with a mobile vaccine clinic to do on site delivery? Because once teens age into, like, 19 and up, it becomes much more complicated. So the sooner, the better.