With support from the Solutions Journalism Network, Taunya English reported on Chicago’s success boosting human papillomavirus vaccine coverage. Her story, “How Chicago is improving HPV vaccination rates,” aired on the health-science show “The Pulse” in Philadelphia on August 3, 2015.
How I found this story:
I’ve been covering health and the healthcare system since before the human papillomavirus vaccine was approved in the United States in 2006. I saw the initial excitement among public health experts, who were pleased to have a tool to prevent, not just a sexually transmitted disease, but cancer later in life.
It’s been fascinating to follow the vaccine conversation ever since. Fights erupted over efforts to make the vaccine mandatory. Parents and politicians raised concerns about safety. The vaccine was originally approved only for girls and young women. Then, in 2009 as more research on HPV-related cancers emerged, the U.S. Food and Drug Administration also cleared the vaccine for boys and young men. Vaccine rates remained stubbornly low. In recent years, the Centers for Disease Control and Prevention began using grant money and other levers of influence to nudge state and city health departments to increase coverage.
Along the way, I covered local iterations of the story from my home base—first in Baltimore, then Philadelphia. This year, nearly a decade after the vaccine was first approved in the U.S., it was a great time to check in on the story again.
Searching for Positive Deviants:
Early in my reporting, it was clear that a city or state would be a major character in any solutions approach to the story—but which one?
Because early debates over the HPV vaccine were often tussles between liberals and conservatives, I suspected that public health departments with a reputation as “progressive” might have the highest coverage rates. Other reporters assumed that cities with large public-health budgets are inching fastest toward the CDC’s Healthy People goals.
To cast the right character, I needed information—and a bit of time away from the grind of daily reporting—to dig into those numbers. The data team at the Solutions Journalism Network offered me both. The analysts pointed me to data sources I wasn’t aware of before and helped me synthesize the information. With their help I was able to shoot down some theories and back up others.
Houston, Delaware and Washington, D.C., all had strong vaccine coverage rates and became contenders as a focus for my story. But with more analysis, it became clear that Chicago was doing something different.
Chicago somehow boosted its vaccine levels significantly from 2011 to 2013. The city posted a near 23 percent increase during a time when the rest of the state had an average 6 percent decrease. In public health change rarely happens so fast.
To find out more, I booked my flight to Chicago’s Midway—and start making calls to map out my reporting trip.
The pattern doesn’t hold everywhere, but in some parts of the country, HPV vaccine coverage levels are particularly low among low-income families and racial minorities. HPV infection can lead to cervical cancer. And that cancer disproportionately affects African American and Latina women. Those two insights helped focus my search for solutions: What works to increase HPV vaccine rates especially among poor black and Latino adolescents?
In Chicago, I asked that question in my interview with the health commissioner. I also spent half a day shadowing a pediatrician whose practice includes many Latino families in the Medicaid program.
The CDC awarded Philadelphia and Chicago hundreds of thousands of dollars to boost vaccine rates, but many communities will never receive such a large infusion of money to work on the problem. I wanted my reporting to be useful for them too. So I made sure to highlight low-cost initiatives in Chicago that could be duplicated.
That’s a solutions approach to journalism that I’ll carry with me into my future reporting.
Chicago health planners are still sorting out which strategies have been most effective. But, the health commissioner said even before her city received a grant, she began to recognize and hold up as role models the physicians and other clinicians who have higher vaccine coverage levels.