Introduction:
The COVID-19 pandemic has impacted the human papillomavirus (HPV) vaccination in many countries, causing disruptions to routine immunization and delaying the introduction of new vaccines. However, although developing a vaccine for coronavirus has increased the knowledge among populations about the disease and hopes of returning life to normal, some negative views of the vaccine remain. Cervical cancer caused by persistent infection of HPV is the leading cause of death from cancer among women worldwide. However, studies have shown that awareness of the importance and safety of vaccination has positively affected the acceptance of HPV and other vaccines.
What Is The HPV Vaccine?
HPV is a common sexually transmitted infection causing genital warts and certain cancers like cervical, vaginal, vulvar, penile, anal, and throat cancer. HPV vaccines are vaccines against the Human papillomavirus (HPV) that prevent and reduce cervical cancer risk. In addition, this vaccine is effective against vulvar, vaginal, anal, head, and neck cancers in women and men. The vaccine is given to children or adolescents above nine years of age through 26 years. HPV vaccine is usually administered in a series of shots to provide optimal protection.
How Did Covid-19 Affect The HPV Vaccine?
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High Vaccine Costs:
One of the significant barriers to the HPV vaccine is its high cost and vaccine program costs, particularly among low and lower-middle-income countries. The COVID-19 pandemic has caused restricted access to vaccines in various countries. The impact of COVID-19 led to an economic recession leading to reduced national incomes and health budgets, increased public and private debt, and reduced access to vaccines and vaccine delivery services. As a result, access to HPV vaccines is more challenging than before due to their cost.
Also, government support and advocacy are crucial in providing PPE, diagnostics, training and communication campaigns, and immunization services during a COVID-19 pandemic. One of the major concerns was providing immunization services, including HPV vaccines, and implementing vaccine programs in the poorest and remote communities due to the current pandemic and future outbreaks safely and effectively. Evidence suggests that a single dose of the HPV vaccine is effective and sufficient for protection against HPV infection and its associated diseases. Since the vaccine is highly cost-effective, interventions are required to provide access to vaccine recipients.
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HPV Vaccine Supply:
The COVID-19 pandemic has also affected vaccine production to meet the global demand for HPV vaccines. In addition, many adolescents have missed the vaccination due to the lockdown and restricted healthcare access and services. Due to the pandemic, the restrictions related to transportation have also increased the supply-demand of the HPV vaccine.
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School Closure:
During the COVID-19 pandemic, school closures have disrupted routine immunizations, including HPV, diphtheria, tetanus, and pertussis, that are given at school. School closures have also impacted healthcare workers and services required to care for children and adolescents.
What Is The Response Of HPV Vaccine Uptake Post COVID-19?
The COVID-19 pandemic has disrupted livelihoods and threatened progress in health, education, and life opportunities for children and adolescents worldwide. In addition, the pandemic has caused an economic downturn resulting in poverty which may lead to early marriage and early sexual activity in low-income countries. It may also result in food scarcity and starvation, leading to migration and vulnerability of girls increasing the risk for sexually transmitted diseases and HPV before the vaccine is made available.
Few measures can be taken to address the major barriers to HPV vaccination:
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Increasing the funding for HPV vaccines to address high vaccine and program costs.
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HPV vaccination schedules and recommendations should be adjusted to address the supply of vaccines.
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Education and awareness about the HPV vaccine through marketing to address unawareness and unfavorable attitudes towards the vaccine.
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Making schools the primary platform to deliver HPV vaccines because school vaccination programs provide universal coverage.
Post-COVID-19, the perception of the importance and safety of vaccination positively affects the acceptance of vaccines, including the HPV vaccine. In addition, studies have shown that many people have better understood the importance of HPV vaccines and their pharmacodynamics after the COVID-19 pandemic.
Is There Any Long-term Impact Due To Missed Vaccination?
The long-term impact of missing the HPV vaccination possibly increases the risk of cervical cancers and genital warts cases in the upcoming years. During the COVID-19 pandemic, the vaccine coverage rate was reduced to 23 % in the United States in 2020. This dropped vaccination resulted in cases of HPV infection, such as genital warts, CIN 1, and CIN 2 or 3 were reported. Many more patients will be reported over the next 50 years. Thus, a catch-up program should be implemented to look for the girls who missed or had incomplete vaccine dosages during the pandemic and provide HPV immunization.
What Is Meant by a Catchup Program?
Because of the disruption of the HPV vaccination program by the COVID-19 pandemic, a catch-up program is needed to close the large gaps created by the pandemic. This program helps vaccinate adolescents who missed their vaccination during the COVID-19 Through a catch-up program, the incidence of cervical cancers can be reduced and avoided for over 100 years, and a significant reduction in HPV infection.
Before implementing this program, parents' and recipients' perceptions are considered, such as the importance of the HPV vaccine, its effect and safety, their queries, etc., to avoid vaccine hesitancy. Schools also play an important role in administering the HPV vaccine through a catch-up program. They need to assess and arrange the number of students that require vaccination and adherence to the regulations recommended for the COVID-19 pandemic. The catch-up program may become an opportunity to bring community awareness about the HPV vaccine. In addition, the catch-up program is important to achieve zero HPV-related diseases in the future.
Conclusion:
The COVID-19 pandemic has impacted the HPV vaccine program and schedules due to multiple lockdowns, school closures, restricted healthcare services, and anxiety about catching up with coronavirus infection. The HPV vaccine is known to prevent cervical cancers among women and is not taken up by low-income communities due to its high cost. However, the post COVID-19 studies have reported increased knowledge and awareness about the importance of vaccines.
