O-39 Improving protection against and our understanding of Human Papillomavirus infection in the Cayman Islands using a multi-faceted approach

Methods: The Cayman Islands introduced an adolescent school-based HPV immunization programme in 2012, offering Gardasil 4 for females in two high schools. In 2023, the HPV immunization programme was evaluated and recommendations made to improve accessibility and uptake. Improvements were implemented over two years to provide universal vaccination to males and females, transition to the nonavalent from the quadrivalent vaccine, enhance communications and use electronic consent forms. Descriptive analysis of the immunization coverage, was conducted for the Year 7 students in 2023–2024 and 2024–2025, by school and by sex. Analysis was focused only on the target population of year 7 students and older students who were administered the vaccine as catch-up efforts were excluded from analysis. High risk HPV surveillance was implemented through PCR testing, and samples were analyzed between January and November 2025.

Results: The results found vaccination accessibility was improved by expanding the programme to all schools, and including both males and females. Overall vaccine uptake increased to 32% in 2023–24 year 7 students, and declined to 17% in 2024–25 year 7 students. Uptake was similar in both females and males indicating the change to universal programme was well received. The hrHPV positivity rate was 16.8% overall (N=1,503 individuals), and highest for genotypes 31/39/56 at 5.5%.

Conclusion: This analysis demonstrates the implementation of surveillance, improved availability and equality to HPV immunization, and improved protection for the population from the nonavalent vaccine. Further analysis is needed to assess uptake for those under 15 years for a more comprehensive vaccine coverage indicator.