The COVID-19 pandemic has interrupted delivery of key health services for children and adolescents, including HPV vaccination for cancer prevention.
Credit: National Cancer Institute
Today, doctors and scientists across America at National Cancer Institute (NCI)-designated cancer centers and other organizations issued a joint statement urging the nation’s health care systems, physicians, parents and children, 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. The pandemic also has exacerbated health disparities, leaving Black, Indigenous and other people of color; rural; and sexual minority adolescents at even greater risk for missed doses of this cancer prevention vaccine.
Nearly 80 million Americans – 1 out of every 4 people – are infected with HPV, a virus that causes six types of cancers. Of those millions, nearly 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 routinely recommended vaccines and other countries’ HPV vaccination rates. According to 2019 data from the Centers for Disease Control and Prevention (CDC), just 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.
Adolescents with private insurance may be missing hundreds of thousands of doses of HPV vaccine.
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. Adults aged 27 through 45 should talk with their health care providers about HPV vaccination because some people who have not been vaccinated might benefit. The HPV vaccine series is two doses for children who get the first dose at ages 9 through 14 and three doses for those who get the first dose at ages 15 and older and for immunocompromised people.
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 providers to identify and contact adolescents due for vaccinations and to use every opportunity to encourage and complete vaccination.
More information on HPV is available from the CDC and National HPV Vaccination Roundtable. This is the fourth 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 health care systems, physicians, parents and children, and young adults about the importance of HPV vaccination for the elimination of HPV-related cancers. Organizations endorsing this statement include the Association of American Cancer Institutes; American Association for Cancer Research; American Cancer Society; American Society of Clinical Oncology; American Society of Pediatric Hematology/Oncology; American Society of Preventive Oncology; the Prevent Cancer Foundation; Cleveland Clinic Taussig Cancer Institute; and Cleveland Clinic Children’s.
NCI-Designated Cancer Centers Call for Urgent Action to Get HPV Vaccination Back on Track
Cancers caused by human papillomavirus (HPV) are a significant public health problem in the United States (U.S.). But these cancers are preventable with HPV vaccination. The National Cancer Institute (NCI)-designated cancer centers fully endorse the goal of eliminating cancers caused by HPV through gender-neutral HPV vaccination and evidence-based cancer screening. The COVID-19 pandemic has profoundly interrupted delivery of key preventive services, resulting in many U.S. adolescents missing routine HPV vaccine doses. Even before the pandemic, HPV vaccination uptake in the U.S. lagged far behind several high-income countries and remains well below the Healthy People 2030 goal of vaccinating 80% of boys and girls aged 13-15. To protect adolescents from cancers caused by HPV, it is urgent to act now to get HPV vaccination back on track.
NCI Cancer Centers strongly encourage parents to vaccinate their adolescents as soon as possible. The COVID-19 vaccination presents an opportunity for parents to protect their children by catching up on missed or due routinely recommended vaccines. 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. The guidelines recommend that adults ages 27 to 45 talk with a health care provider because some people who have not been vaccinated might benefit. According to the Centers for Disease Control and Prevention (CDC), 54% of boys and girls ages 13-17 completed the HPV vaccination series in 2019, compared to 42% in 2015, with variability by geographic region. The COVID-19 pandemic has jeopardized these modest but positive gains. In spite of more than 15 years of safety and monitoring data and strong evidence showing reduction of HPV vaccine-type infection and cancers, HPV vaccination uptake still isn’t meeting our national goal.
The U.S. is facing a significant vaccination gap, especially for adolescents, due to the pandemic. Well-child visits are down. Usual “back to school” vaccination activity for adolescents has been limited by virtual and hybrid learning. Early in the pandemic, HPV vaccination rates among adolescents fell by 75%, resulting in large numbers of unvaccinated children. It is crucial that the nation gets back on track with adolescent vaccination to ensure protected children and safer communities.
The CDC’s Advisory Committee on Immunization Practices (ACIP) has endorsed the safety and effectiveness of the Pfizer-BioNTech COVID-19 vaccine and its use in 12-15-year-old adolescents. CDC recommends that this vaccine be used among this population, and health care providers may begin vaccinating them right away. In addition, COVID-19 vaccines and other vaccines may now be administered at the same visit. Protecting your child from COVID-19 by getting them vaccinated is an easy opportunity to catch up on other vaccines like the HPV vaccine.
HPV vaccination is cancer prevention. Now is the time to catch up on missed doses of HPV vaccine to prevent future cancers. Contact your local health department or health care provider to schedule an appointment for missed vaccinations today.
More information on HPV is available from the CDC and National HPV Vaccination Roundtable.
This statement is supported by the American Cancer Society (ACS), the American Association for Cancer Research (AACR), the American Society of Clinical Oncology (ASCO), the Prevent Cancer Foundation, the American Society of Preventive Oncology (ASPO), Association of American Cancer Institutes (AACI), American Society of Pediatric Hematology/Oncology (ASPHO), Cleveland Clinic Taussig Cancer Institute, and Cleveland Clinic Children’s.
FULL LIST OF SIGNATURES
Abramson Cancer Center of the University of Pennsylvania
Albert Einstein Cancer Center
Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
Barbara Ann Karmanos Cancer Institute
Case Comprehensive Cancer Center
City of Hope
Cold Spring Harbor Laboratory Cancer Center
Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine
Dana-Farber / Harvard Cancer Center
Dartmouth and Dartmouth-Hitchock’s Norris Cotton Cancer Center
Duke Cancer Institute
Fox Chase Cancer Center, a part of the Temple University Health System
Fred & Pamela Buffett Cancer Center
Fred Hutchinson Cancer Research Center
Georgetown Lombardi Comprehensive Cancer Center
Harold C. Simmons Comprehensive Cancer Center
Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Irving Medical Center
Huntsman Cancer Institute at the University of Utah
Indiana University Melvin and Bren Simon Comprehensive Cancer Center
Koch Institute for Integrative Cancer Research at MIT
Masonic Cancer Center, University of Minnesota
Mayo Clinic Cancer Center
Mays Cancer Center, home to UT Health San Antonio MD Anderson
Memorial Sloan Kettering Cancer Center
Moffitt Cancer Center
MUSC Hollings Cancer Center
O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham
OHSU Knight Cancer Institute
OU Health Stephenson Cancer Center
Perlmutter Cancer Center at NYU Langone
Purdue University Center for Cancer Research
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Roswell Park Comprehensive Cancer Center
Rutgers Cancer Institute of New Jersey
Salk Institute Cancer Center
Sanford Burnham Prebys Cancer Center
Sidney Kimmel Cancer Center – Jefferson Health
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
St. Jude Comprehensive Cancer Center
Stanford Cancer Institute
Sylvester Comprehensive Cancer Center
The Jackson Laboratory Cancer Center
The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute
The Tisch Cancer Institute at Mount Sinai
The University of Kansas Cancer Center
The University of New Mexico Comprehensive Cancer Center
The University of Texas MD Anderson Cancer Center
The Wistar Institute Cancer Center
UC San Diego Moores Cancer Center
UCI Chao Family Comprehensive Cancer Center
UCLA Health Jonsson Comprehensive Cancer Center
UCSF Helen Diller Family Comprehensive Cancer Center
UNC Lineberger Comprehensive Cancer Center
University of Arizona Caner Center
University of California Davis Comprehensive Cancer Center
University of Chicago Medicine Comprehensive Cancer Center
University of Colorado Cancer Center
University of Hawaii Cancer Center
University of Iowa Holden Comprehensive Cancer Center
University of Kentucky, Markey Cancer Center
University of Maryland Greenebaum Comprehensive Cancer Center
University of Michigan Rogel Cancer Center
University of Virginia (UVA) Cancer Center
University of Wisconsin Carbone Cancer Center
UPMC Hillman Cancer Center
USC Norris Comprehensive Cancer Center
Vanderbilt-Ingram Cancer Center
VCU Massey Cancer Center
Wake Forest Baptist Health Comprehensive Cancer Center
Winship Cancer Institute of Emory University
Yale Cancer Center
American Association for Cancer Research
American Cancer Society
American Society of Clinical Oncology
American Society of Pediatric Hematology/Oncology
American Society of Preventive Oncology
Association of American Cancer Institutes
Cleveland Clinic Children’s
Cleveland Clinic Taussig Cancer Institute
Prevent Cancer Foundation