No improvement in HPV vaccination rates among young adults during COVID-19; LGBTQ+ young adults most likely to be vaccinated against HPV

HPV vaccination rates for young adults didn’t improve between 2019 and 2022, researchers at MUSC Hollings Cancer Center found.

Adults ages 18 to 26 are a key target group for vaccination against the human papillomavirus (HPV), which can cause six types of cancer. Yet the researchers found that the vaccination rate has stagnated at about 47%. Their results are published this week in JAMA Network Open.

One subgroup, however, stood out in a positive way. People from the LGBTQ+ community were far more likely to have received at least one dose of the HPV vaccine than their heterosexual counterparts.

"Stagnation of HPV vaccination rates in the U.S. is a major public health problem, and, if not addressed soon, it could result in an escalation in cancer incidence in the future."

Kalyani Sonawane, Ph.D.

The Hollings researchers studied whether the COVID-19 pandemic affected vaccination rates. They looked at responses to a national health survey conducted in 2018, 2019 and 2022 and analyzed the data according to race, insurance status, educational level, geographic region and sexual orientation.

“Until 2019, there was an improvement. But since 2019, we saw absolutely no change in vaccine rates,” said Hollings researcher Kalyani Sonawane, Ph.D., the lead author on the paper. “Stagnation of HPV vaccination rates in the U.S. is a major public health problem, and, if not addressed soon, it could result in an escalation in cancer incidence in the future.”

Ashish Deshmukh, Ph.D., co-leader of the Cancer Control Research Program at Hollings and senior author on the paper, said the stagnation in vaccination rates could indicate that fewer teens were vaccinated against HPV during the COVID-19 pandemic.

“Rapid recovery in HPV vaccination rates to achieve the 80% vaccination goal of Healthy People 2030 is crucial to ensure that we eliminate these cancers,” he said.

The HPV vaccine can be given to people between the ages of 9 and 26.

The vaccine is important for both males and females because HPV can cause multiple types of cancer, including head and neck, cervical and anal cancer. The U.S. Centers for Disease Control and Prevention estimates that about 37,000 cancer diagnoses each year are caused by HPV infection.

Although the plateau in vaccination rates is concerning, the relatively high levels of vaccination among the LGBTQ+ population were a bright spot.

“Relatively higher vaccination rates among sexual minorities are reassuring as they are at a much greater risk of developing cancers caused by HPV and unlikely to benefit from herd immunity,” Deshmukh said.

Among other subgroups, people without insurance were only half as likely to have the vaccine.

“If you don't have insurance, this vaccine is one of the most expensive on the market,” Sonawane said. “Once you become a young adult, you no longer qualify for Medicaid, so you no longer qualify for free vaccines, so that's a significant barrier for uninsured young adults in getting the HPV vaccine.”

They also observed that vaccination rates were lower among people with a high school diploma or less, compared with those with associate’s or bachelor’s degrees.

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