Human Papillomavirus Vaccines: Opportunities and Challenges – Self Assessment – 2 Points


To access each section, click on the title to expand; to retract, click the title again.

Step 1 - Review ABP Activity Profile

Sponsor(s): American Academy of Pediatrics – Ohio Chapter

Title: 2017 Human Papillomavirus Vaccines: Opportunities and Challenges

Description: The rate of girls and boys in Ohio receiving the series of the HPV vaccine is extremely low. Kristen Feemster, MD, MPH, MSHPR, FAAP will explain current trends in HPV-related disease, the safety and efficacy of the immunization, key barriers to series completion and important strategies to improve rates in boys and girls

Completion Criteria: Once you begin the assessment, you have until the end of the calendar year to complete it, but are not required to complete it in one sitting. Please note: answers may not save when exiting an incomplete assessment; if concerned about ability to return, we recommend that you keep a list of the answers that your provided to enter later should your answers not save. You must answer all of the items AND answer 80% of them correctly in order to receive credit for this assessment.

Credit Assignment Criteria: Upon completion of the activity, you will be required to enter your American Board of Pediatrics (ABP) Diplomate number*, state and birthdate (MM/DD). Your ABP Diplomate number can be found in your ABP online profile. If you are unable to locate this number, you may look it up by clicking here or please contact the American Board of Pediatrics [Telephone: (919) 929-0461, Business Hours: (8:30 am – 5:00 pm ET Monday – Friday), E-mail:].

*Please note that your American Academy of Pediatrics member ID number is not accepted for MOC Part II credit reporting.

Please allow up to 7 business days for MOC Part II and CME credit to be accessible in your ABP Diplomate Profile.

Your credit will be entered into the ACCME’s Program and Activity Reporting System (PARS), this system will transfer your credit into your ABP profile.

Activity Contact: Elizabeth Dawson, Phone Number: 614-846-6258,

MOC Credit Approval Period: August 1, 2017 – July 31, 2018

MOC Type/Value: Part 2 – 1 Point

CME Available: Yes

Speciality: General Pediatrics; Pediatric Infectious Diseases

Step 2 - Review Enduring CME Information

2017 MOC Part II Self-Assessment – HPV Vaccines: Opportunities and Challenges

This course will address a broad range of topics relating to pertussis disease and vaccination.

Target Audience: Health care providers who administer vaccines to adolescents and providers-in-training.

Objectives: Following completion of this educational activity, learners should be able to:

  1. Review current trends in HPV-related disease, HPV vaccine safety and efficacy and HPV vaccine recommendations
  2. Identify key barriers to HPV vaccine series initiation and completion among males and females
  3. Identify strategies to improve implementation of HPV vaccine recommendations among males and females

Needs Assessment/Gap: 

The 2015 National Immunization Survey shows just 37.8% of Ohio girls received all 3 of their HPV vaccinations, and only 21% of Ohio boys. In addition, according to the Cancers Associated with HPV in Ohio report in 2008-1012, approx 1157 cases of cancer were attributed to HPV each year. Studies show providers can change minds, one study shows a large portion of parents changed their minds about delaying vaccination after assurances from their provider.

Accreditation Statement:

The Ohio Chapter, American Academy of Pediatrics (Ohio AAP) is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

The Ohio AAP designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 2 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.

Faculty List:

Kristen A. Feemster, MD, MPH, MSHP, FAAP
Research Director, Vaccine Education Center
The Children’s Hospital of Philadelphia

Disclosure: It is the policy of the Ohio Chapter, American Academy of Pediatrics to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. All conflicts of interest will be resolved prior to an educational activity being delivered to learners through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the individual’s control over CME content about the products or services of the commercial interest, and/or 3) validating the activity content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of drugs or devices. Persons who refuse or fail to disclose are disqualified from participating in the CME activity. This information is used to plan future activities.

The following faculty have no financial relationships other than listed above with commercial interests relevant to the content of this activity:

  • Kristen A. Feemster, MD, MPH, MSHP, FAAP

The CME staff, meeting planners, editorial staff, planning committee, and CME committee reviewers other than listed above do not have any relevant financial relationships to disclose.

Off-label Disclosure: This educational activity does not contain discussion of unlabeled and/or investigational uses of agents that are not approved by the FDA. Please consult the prescribing information for each product.

Medium & Education Instructions for Internet/On-Demand Learning:

Please allow for one hour to review the video and answer the questions.

You must answer all of the items AND answer 80% correctly in order to receive credit for this assessment.

Dates of original release, most recent review or update, and termination date:  

  • Release Date: August 1, 2017
  • Expiration Date: July 31, 2018

Commercial Support Acknowledgement: There is no financial support to acknowledge for this activity.

CME Credit for this activity is available as a member benefit for individuals who are current members of the Ohio AAP. Individuals who are not current Ohio AAP Members will be asked to join the Chapter, or pay a $15 CME Administration Fee. Additional information will be provided on the confirmation page after completing this activity, as well as in the follow-up email that will be sent to you.

Want to become an Ohio AAP Member and receive free CME, along with many other member benefits? Click here! Not sure yet? Click here to learn about all of the benefits enjoyed by members of the Ohio AAP.

Step 3 - Review Self-Assessment Instructions

You will have two chances to correctly answer each question. Please be aware that by clicking on the circle to the left of your desired response, you are submitting that response to be graded by the system. If you are not prepared to have your response to a particular question submitted to the system, do not select any of the answers.

If you fail to answer the question correctly on your first attempt, you will be given the link to the reference where additional information can be found on that particular question. Clicking on the link will open this resource in a new window/tab. When you are ready to provide your second response to the question, please select the “Retry” button, and then proceed to select the answer that you believe is correct.

Following a correct response or your second response to a question, whichever comes first, you will select the “Next” button to advance to the next question. You can review previous questions by selecting the “Previous” button, however you will be unable to modify your answer if you have already provided 2 responses to that particular question.

This activity consists of 10 questions; successful completion will result in earning 2 Points of ABP MOC Part II Credit.

Step 4 - Launch and Complete Assessment

After watching the video, click the button “Start Quiz” to complete the post-quiz.

Please be advised that once you begin the quiz questions, you cannot save your progress. Do not close your browser, as your work will be lost.

If you do not achieve a score of 80% or higher, you have the option to re-test by going back to this page. Please feel free to send any questions/comments/concerns to Elizabeth Dawson.




TIES Regional Seminars

ties speakers

Regional Seminars

The Ohio Chapter, American Academy of Pediatrics and Ohio Department of Health present four regional seminars to educate physicians, nurses and other vaccinators in Ohio on adolescent vaccines.

The seminars will feature nationwide experts on adolescent health and immunizations – including Michael T. Brady, MD, Robert W. Frenck, Jr., MD, and Paula K. Braverman, MD and social media expert Angela KrileLarry Pickering, MD from the Centers for Disease Control and Prevention will be our featured guest speaker at the Columbus TIES Seminar! The talks will feature many subjects Ohio health care workers deal with in their workplace every day, including:

  • parental refusal
  • sexual misconceptions
  • HPV-caused cancers
  • reminder/recall strategies
  • connecting with your adolescent patients on social media

Each person who registers for a TIES Regional Seminar is registered to win an iPad Mini! There will be a drawing at EACH seminar!


  • Featured Speakers: Larry Pickering, MD, Robert W. Frenck, Jr., MD, Paula K. Braverman, MD, and Michael Brady, MD
  • Tuesday, September 23, 2014
  • 8:30am-1:30pm (registration begins at 8am)
  • Location: Holiday Inn Worthington (map)
  • Lunch provided by the American Academy of Pediatrics
  • registration closed
  • CME: This Live activity, Teen Immunization Education Sessions (TIES) Regional Training Columbus, with a beginning date of 09/23/2014, has been reviewed and is acceptable for up to 4.00 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 Credit™ toward the AMA Physician’s Recognition Award.  When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.

Nurses will be provided the same certificate of participation as physicians. Keep your certificate on file, as the Ohio Nurses Association will accept CME toward CNE credit.

Bill Introduced to Mandate Child Care Immunizations

(May 14, 2014) — Two Ohio legislators introduced a bill that would require immunizations for children entering licensed child care or preschool facilities.

2014-05-14 11.12.55

Representatives Nickie Antonio, a Democrat from Lakewood, and Ryan Smith, a Bidwell Republican, introduced House Bill 536 during a press conference at the Ohio State House. They were joined by Ohio AAP Executive Director Melissa Wervey Arnold and Ohio AAP board member Jonathan Thackeray, MD, FAAP.

The bill would require that children enrolled in licensed child care facilities be immunized in accordance with a schedule that is based on the schedule recommended by the Advisory Committee on Immunization Practices (ACIP) of the CDC. The bill includes exemptions for medical and parental reasons.

Ohio is the only state that does not require the immunizations for children entering child care or preschool.

Click here to view the ACIP Birth-18 years-old immunization schedule.

Click here to read House Bill 536.


Ohio AAP Wins Ohio Medicaid VFC Policy Reversal Update

The Ohio Chapter, American Academy of Pediatrics, won a reversal of a policy decision by Ohio Medicaid. Ohio Medicaid issued a policy change in December regarding payment for VFC vaccines. Our members were concerned that they were only being paid for one vaccine administration code – even though multiple vaccines were given.

Ohio AAP worked with our members and put pressure on Ohio Medicaid using information gathered from both our members and our national organization. Ohio Medicaid sent a memo to all plans on April 24 letting them know they could not cap payment for the administration of VFC vaccines per encounter and had to pay the enhanced fee per vaccine administered. In addition, Ohio Medicaid said both plans and ODM must make adjustments to make sure qualifiying physicians get the additional reimbursement they are owed. Ohio Medicaid also thanked Ohio AAP and its members for bringing this to their attention.

You can read the memo Ohio Medicaid sent to all Medicaid Coordinators and Contracted Managed Care plans by clicking here: Payment for Vaccines for Children under the Primary Care Rate Increase

Ohio AAP’s Dr. Bob Frenck Urges Adult Mumps Shot in The Columbus Dispatch

The Columbus Dispatch :: April 24, 2014

If you’re a child of the 1960s, ’70s or ’80s, there’s a decent chance you aren’t fully immunized against mumps, and unless your mom and dad kept meticulous records, it probably makes sense to think about a shot, health officials say.

The central Ohio mumps outbreak is persisting, with 263 people sickened as of yesterday.

As the case count climbs, more adults are worrying over often-foggy vaccine histories. A look at the age breakdown for cases not connected to Ohio State University shows that much of the illness has been in working-age adults.

Those who know or suspect they didn’t get two MMR (measles, mumps and rubella) shots should strongly consider getting the vaccine, said Dr. Julie Mangino, an infectious-disease expert at Ohio State University’s Wexner Medical Center.

Today, children are supposed to get two rounds, the first when they’re a year old and the next between 4 and 6 years old.

But the second dose wasn’t recommended until 1989, after a measles outbreak highlighted the need, said Dr. Robert Frenck, a professor of pediatrics and infectious-disease expert at Cincinnati Children’s Hospital.

About 5 percent of people vaccinated with one round of the MMR vaccine get no benefit from it; the second shot is designed to catch those people and boost immunity for others, said Frenck, who is the medical director for the immunization program for the Ohio chapter of the American Academy of Pediatrics.

There is a blood test that determines whether a person has immunity against mumps (either through natural exposure or a vaccine), but Mangino said it makes sense to just go ahead and get a second dose if you know you didn’t have the second shot.

The vaccine contains a live virus and shouldn’t be given to people with compromised immune systems, including those with cancer or HIV, or to those who are being treated with steroids, she said. It’s also not recommended for women who are looking to become pregnant in the next few months and for those who are breast-feeding.

“It’s not just like getting a flu shot,” Mangino said.

Public-health concerns about MMR under-vaccination go beyond the current mumps outbreak. Several measles outbreaks are underway elsewhere, and that disease more commonly leads to serious complications, including pneumonia, which can be deadly.

In some cases, shots might make sense for older adults who never contracted mumps as children (if you had mumps, you don’t need the vaccine).

In general, it is assumed that those born before 1957 were exposed because mumps was so common, but there are exceptions.

Mabel Freeman, 69, had her first shot recently and will be back for a second next month in light of concerns about mumps at Columbus State Community College, where she is interim vice president for student affairs.

“This is a personal choice on my part,” she said, adding that she wants to make sure she doesn’t carry the illness to family members, including her grandchildren.

“I know I had the measles and the German measles (rubella), but I never had the mumps,” Freeman said. “You don’t forget that you’ve had them.”

Many doctors who care for adults won’t have the MMR vaccine in their office, but it is available at health departments and currently is free at Columbus Public Health. Minute Clinics charge $129.99, according to their website, though most routine vaccinations are covered by insurance.

Some parents are asking about speeding up the vaccine schedule so that their children who are younger than 4 can have a second dose. Pediatricians aren’t encouraging this in general, but in some cases they’re vaccinating early.

Sara Ijams-Dashner’s twin girls, Keira and Ella, will be 4 on May 19. When the Blacklick woman learned that a child in her daughters’ preschool had mumps, she asked their pediatrician about early vaccines.

He didn’t want to do it at first, but he agreed after researching outbreak-specific guidance from the Centers for Disease Control and Prevention, Ijams-Dashner said.

“The preschool is full of half-vaccinated kids,” she said. “I was scared. The mumps can pose very serious health risks.”

She also has been frustrated by some parents’ decisions to forgo vaccines.

“There’s no evidence that vaccines are more harmful than the diseases they prevent,” Ijams-Dashner said. “The fact is those kids aren’t vaccinated and they expose our kids to the disease.”

Letter to the Editor: Mumps Outbreak

Research, record family’s vaccinations

Published in The Columbus Dispatch on Thursday, April 10, 2014

The Dispatch has reported that the lack of vaccinations among students in local schools has helped spread the mumps cases in our community (“Lack of vaccination helps spread mumps,” last Thursday).

With more than 150 cases now reported, there are evidenced-based actions that can be taken to prevent another outbreak.

Pediatricians statewide support parental education about vaccines to help parents make informed decisions and to help them understand the importance of keeping vaccinations up to date through routine well-child visits.

We support mandating vaccinations for entry into child-care settings at all levels, from birth to college. One simply needs to look at how one case of mumps at Ohio State University now is linked to at least 100 cases to understand how important it is for children who are in group care or close living settings to receive these critical vaccinations.

Additionally, attempts by special-interest groups to fracture the medical home in our state can lead to missed vaccinations and lack of parental education about important health topics. That’s why we work hard to ensure that any efforts to improve access to health care for Ohio children maintain the high quality and consistency of care available through a licensed pediatrician.

This is not the time to panic over the spread of preventable diseases like mumps, but it is the time to look at our public policies and utilize evidence-based medical practices that can prevent and eliminate these diseases in our local community.

More information about vaccinations for children of all ages can be found at


Executive director

Ohio Chapter

American Academy of Pediatrics