Progress on HPV vaccine is too important to lose

HPV vaccinations among teens in the US dropped precipitously during the early pandemic, a disappointing reversal for shots that can prevent more than 33,000 cases of cancer each year. Worse, efforts to get vaccinations back on track could be stymied by legal challenges.
We can’t let a decade worth of slow and steady progress in HPV vaccinations be lost.
Getting the US public to accept the HPV vaccine as a safe and effective part of routine health care has been a decade-long slog. That effort involved allaying (unfounded) beliefs that these shots, by preventing HPV, could encourage sexual activity among teens. That’s because the virus excels at spreading through skin-to-skin contact — so much so that nearly everyone is exposed, perhaps more than once, during their lifetime. And while the immune system can get rid of the infection most of the time, certain strains can stick around for years, kicking off a process that morphs otherwise healthy cells into cancerous ones.
So there’s no doubt about the benefit of these shots: The HPV vaccine can nearly eliminate cases of cervical cancer, and have a profound impact on many others, including anal, penile, vaginal, vulvar and certain head and neck cancers.
These vaccines also save the health-care system money. A recent study commissioned by St. Jude’s Children’s Research Hospital found that preventing cancers by increasing the rate of completed HPV vaccinations could lower national direct health-care spending by more than $26 million. Those are among the reasons HPV vaccination is now the norm for adolescents in many parts of the US. From 2016 to 2021, the percentage of teens receiving their first shot in the vaccine series leaped from roughly 60% to nearly 77%. And the gap between vaccination rates among girls, the initial targets of these shots in 2006, and boys, for whom it was recommended by Centers for Disease Control and Prevention in 2011, is finally starting to close.
The pandemic has threatened to upend that progress. Disruptions to routine doctor visits and shifting priorities during appointments meant that about 1 million doses were missed in 2020. Data from CDC’s annual survey of teen vaccinations suggests at least a partial recovery in 2021, but we won’t have complete data until next year.
The missed doses also coincide with an increasingly hostile climate for preventive health-care services that fall under the broad umbrella of reproductive or sexual health. That politicization of routine health care could erode access to — and acceptance of — HPV vaccines.
In the wake of the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, which resulted in the overturning of the landmark abortion decision Roe v. Wade, access to many other therapies and preventive services, including HPV vaccination, could be at risk.
Reproductive health experts worry that states with the most draconian laws around abortion might next try to limit access to FDA-approved medicines or vaccines that have long been viewed by conservative groups as controversial. For example, Texas lawmakers earlier this year tried to ban gender-affirming care for teens, and more states are trying to make it harder to access hormonal therapies. And even if individual states don’t take up such causes, private insurers might. That risk to the HPV vaccine was made clear earlier this month by a decision in a lawsuit brought against the US government by a Christian employer, Braidwood Management.
—Bloomberg