COVID-19 pandemic has interrupted delivery of key health services for children and adolescents, including HPV vaccination for cancer prevention

Case Comprehensive Cancer Center, a partnership of Case Western Reserve University, University Hospitals and Cleveland Clinic, has joined with 71 other National Cancer Institute (NCI)-designated cancer centers and partner organizations to issue a joint statement urging the nation’s physicians, parents and young adults to get the human papillomavirus (HPV) vaccination back on track.

Dramatic drops in annual well visits and immunizations during the COVID-19 pandemic have caused a significant vaccination gap and lag in vital preventive services among U.S. children and adolescents—especially for the HPV vaccine.

“Without a doubt, vaccination rates and well visits have decreased because of COVID,” said Andrew Hertz, a pediatrician at University Hospitals Rainbow Babies & Children’s Hospital, clinical assistant professor of pediatrics at Case Western Reserve University School of Medicine and longtime steering committee member of the HPV Quality Improvement Collaborative. “HPV vaccination is a highly effective way to prevent several types of common cancers. However, if vaccination rates do not rise, there will be an increase in cancers, health care expenses and patient morbidity and mortality over the next 20, 30, 40 years.”

Nearly 80 million Americans—1 of every 4 people—are infected with HPV, a virus that causes several types of cancers. Of those millions, more than 36,000 will be diagnosed with an HPV-related cancer this year. Despite those staggering figures and the availability of a vaccine to prevent HPV infections, HPV vaccination rates remain significantly lower than other recommended adolescent vaccines in the U.S. Even before the COVID-19 pandemic, HPV vaccination rates lagged far behind other vaccines and other countries’ HPV vaccination rates. According to 2019 data from the Centers for Disease Control (CDC), slightly more than half (54%) of adolescents were up to date on the HPV vaccine. Those numbers have declined dangerously since the pandemic:

  • Early in the pandemic, HPV vaccination rates among adolescents fell by 75%, resulting in a large cohort of unvaccinated children.
  • Since March 2020, an estimated one million doses of HPV vaccine have been missed by adolescents with public insurance—a decline of 21% over pre-pandemic levels.

The U.S. has recommended routine HPV vaccination for females since 2006, and for males since 2011. Current recommendations are for routine vaccination at ages 11 or 12 or starting at age 9. Catch-up HPV vaccination is recommended through age 26.

NCI Cancer Centers strongly encourage parents to vaccinate their adolescents as soon as possible. The CDC recently authorized COVID-19 vaccination for 12-15-year-old children, allowing for missed doses of routinely recommended vaccines, including HPV, to be administered at the same time. NCI Cancer Centers strongly urge action by health care systems and health care providers to identify and contact adolescents due for vaccinations and to use every opportunity to encourage and complete vaccination.

“There is misperception that the HPV vaccine will encourage teens to engage in risk-taking behavior, but studies have proven this is not the case,” said Kimberly Giuliano, chair of primary care pediatrics at Cleveland Clinic Children’s and associate professor of pediatrics at Case Western Reserve School of Medicine. “The HPV vaccine is among the greatest breakthroughs in cancer prevention, but to be effective, kids have to get it. While we have heightened awareness of vaccines due to the COVID-19 pandemic, it is vital to discuss other important vaccines like HPV.”

The Case Comprehensive Cancer Center is mobilizing efforts to improve HPV vaccination rates. It recently reconvened the HPV Quality Improvement Collaborative, pulling together health systems across the region to increase overall HPV vaccination rates.

“We’ve made a huge progress over the last several years in increasing our vaccination rates across the region. COVID has contributed to the drop in well visits this past year, and subsequently a drop in vaccination rates,” said Erika Trapl, associate director for community outreach and engagement at Case Comprehensive Cancer Center and director of the Prevention Research Center for Healthy Neighborhoods at Case Western Reserve School of Medicine. “The HPV vaccine can prevent about 90% of HPV-related cancers. It’s really important for us as parents to get our kids back in for well visits and back on track with their HPV vaccination.” 

More information on HPV is available from the CDC and National HPV Vaccination Roundtable. This is the third time that all NCI-designated cancer centers have come together to issue a national call to action. All 71 cancer centers unanimously share the goal of sending a powerful message to parents, adolescents and health care providers about the importance of HPV vaccination for the elimination of HPV-related cancers.