Early in the pandemic, as states issued stay-at-home orders, medical providers grappled with how to engage sick and well patients, schools shifted to remote learning, and parents faced new barriers to getting their children their routine childhood vaccinations. As a result, vaccination coverage rates plummeted, leaving many children vulnerable to preventable diseases. According to a report from the Centers for Disease Control and Prevention (CDC), administration of Human Papilloma Virus (HPV) vaccines to children ages 9-12 years and adolescents aged 13-17 years in 10 jurisdictions declined a median of 63.3 percent and 71.3 percent, respectively, during March-May 2020 compared with the same period in 2018 and 2019. While administration rates have improved, they have not been sufficient to catch up children who missed vaccinations in 2019. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Cancer Society, and the Advisory Committee on Immunization Practices (ACIP), among others, strongly recommend the administration of HPV vaccine in males and females to prevent several types of cancer, as the vaccine is proven safe and extremely effective. Although HPV is responsible for 70-90% of cervical and head and neck cancers in the U.S., vaccination rates remain lower than for other recommended childhood vaccinations.
According to Memorial Sloan Kettering Cancer Center, adolescents with public insurance have missed an estimated one million doses of HPV vaccine since March 2020. This amounts to a nearly 21 percent drop in vaccinations compared to March 2020, a time when vaccine uptake was already well below the Healthy People 2030 goal of getting 80 percent of adolescents aged 13 through 15 years vaccinated. According to America’s Health Rankings for 2020, the U.S. HPV vaccine coverage rate for adolescents aged 13 through 17 years was 54.2%.
Challenges to vaccinating young people against HPV infections include lack of education around the cancer-preventing benefits of the vaccine; false beliefs that males are not at risk for HPV-related cancers; beliefs that only sexually active individuals can get HPV infections or that the vaccine causes children to become sexually active; and most recently, hesitancy to schedule preventive health visits out of fear of being exposed to SARS-CoV-2. Providers are also citing concern that lack of confidence in COVID-19 vaccines is beginning to influence acceptance of routine childhood vaccines.
STATE STRATEGIES TO INCREASE HPV VACCINE UPTAKE
States have developed several best practices for overcoming barriers to vaccination as they work to increase HPV vaccine uptake and improve the health of their residents. The list below includes several examples of such initiatives that state officials and policymakers may consider adopting when working to improve HPV vaccine coverage rates in their states: