Protect Her Wings Campaign

Instead of focusing on mortality (from cervical cancer), the campaign celebrated women's femininity and "apparent frailty" during "the fight against a 'silent' menace that inflicts pain". Rogalski Damaschin elaborates on the strategy, continuing: "the campaign aimed to empower women to overcome the burden of cervical cancer by using their own weaknesses and transform[ing] them into powerful arguments, such as delicacy, femininity and sensibility." Even though the topic of discussion was a serious cause of concern, the campaign concept focused on creating a unitary and positive call to action. Instead of scaring away audiences, key messages and visuals focused on inviting women, mothers, doctors, and other key opinion leaders (KOLs) to plan ahead and protect their own femininity.

To address the perceived need to mobilise women to get screened for, and to take action to prevent, cervical cancer without risking controversy and alienation from the KOLs on the topic, the campaign was structured in 2 phases: raising awareness on cervical cancer and its cause, HPV infection (phase 1), and educating the public about HPV vaccination (phase 2).

Step by step, Rogalski Damaschin worked to establish a national conversation about the burden of cervical cancer and its prevention methods by implementing the following activities:

• A public event on cervical cancer meant to raise the interest of a wide range of stakeholders, including the Ministry of Health. One-to-one briefings were held with key health journalists about the disease, its prevention methods, and HPV vaccination to support them in writing well-documented articles about these topics.
• During World Immunization Week, a video-mapping projection was displayed on National Military Circle, a landmark building in Bucharest - an action meant to remind Romanian women of the fundamental role of vaccination in preventing cervical cancer.
• The "Protect Her Wings!" roadshow traveled to 9 cities in Romania: Cluj Napoca, Tg. Mureș, Timișoara, Oradea, Iași, Bacău, Constanța, Pitești, and Craiova. Organisers established direct communication with close to 15,000 women of all ages, who were instructed on how to prevent cervical cancer and where they can go for a free Pap test. In addition, events were dedicated to local public authorities and the media, during which relevant local information was distributed that was meant to be shared: the number of women diagnosed with cervical cancer in each city, the number of women getting a Pap test, etc.
• Around the time that Gardasil 9 was launched in Romania (March 2018), Rogalski Damaschin sought to create awareness around it and the topic of HPV vaccination in general through "HPV IQ" test, a digital quiz addressed to women of all ages. Rogalski Damaschin invited key influential bloggers on health- and parenting-related topics (Paula Rusu, Oana Botezatu, Vasi Radulescu, Alina Serea) to promote this test on their blogs, while also launching conversations in social media about the need to vaccinate.
• Rogalski Damaschin intensified their public awareness communication efforts by discussing HPV and cervical cancer with key policy stakeholders (deputies and senators) and representatives from non-governmental organisations (NGOs) with a role in sexual education and vaccination policies. As a result, 16 Ministers of Parliament (MPs) from all political parties sent public interpellations to the Health Minister, asking about the future of anti-HPV vaccination. Some MPs organised public debates with members from their political parties, while others responded to call-to-action videos (see an example, below) by talking to the media about this unaddressed issue. In June 2018, 7 NGOs specialising in patients' rights sent an open letter to the Romanian government and Health Minister, calling for funds for HPV vaccination in Romania.

Immunisation and Vaccines, Women

Context: According to Rogalski Damaschin, cervical cancer in Romania is both an unaddressed burden and a "taboo" subject: In 2017, 2 out of 3 women were not getting tested against cervical cancer, and 3 out 4 had never heard of the HPV vaccine. These numbers contributed to a critical context: Information Centre on HPV and Cancer (HPV Information Centre) data (PDF published December 2018) indicate that cervical cancer ranks as the second-leading cause of female cancer in Romania. In 2008, the Romanian Ministry of Health rolled out a school-based immunisation campaign providing free HPV vaccines for 10- to 11-year-old girls. Coverage statistics revealed that only 2.57% of eligible girls received vaccination. Rogalski Damaschin explains that "refusal to vaccinate and mistrust from both parents and doctors caused the most catastrophic immunization campaign."

Protect Her Wings campaign results:

• Over 500 news items were broadcast on national and local TV stations, radio, print, and online media during the campaign, with a total reach of almost 27 million people.
• Rogalski Damaschin claims that their campaign has changed Romanian women's perception and behaviour on cervical cancer and HPV vaccination, pointing to improvement in national health statistics. They write: "in May 2018, an IMAS study revealed that half of the Romanian women have been tested in the past 3 years (from only a mere 27% in September 2016) and awareness on anti-HPV vaccination have increased from 25% to almost 61%, registering an increase of almost 36 percentage."
• The organisation points to their having "obtained open public commitment from key stakeholders: for the first time in 10 years, a political consensus was established on the issue of 'cervical cancer, a matter of national health problem', with members of the most important political parties signing a letter of commitment in which they showed their public support for the importance of developing a coherent and complete vaccination program against HPV related diseases."