The HPV vaccine will save lives by reducing the risk of cancer in our community. We have to work together to help protect our children and this study gives us some direction where to start.
Ilana Cass, MDA newly published paper by two Dartmouth Health physicians at Dartmouth Hitchcock Medical Center (DHMC) and one graduate student in the Quantitative Biomedical Sciences Program at Dartmouth’s Geisel School of Medicine outlines research that shows an association between declining human papilloma virus (HPV) vaccination rates and the release of the COVID-19 vaccine. It also compares vaccination rate fluctuations for tetanus, diphtheria, and pertussis (Tdap).
“Changes in HPV vaccine uptake following the COVID vaccine”—co-authored by Stephanie A. Harlow, MD, chief obstetrics and gynecology resident at DHMC, Ilana Cass, MD, DHMC’s OBGYN chair and professor of obstetrics and gynecology at Geisel, and Elizabeth C. Anderson, PhD, a Dartmouth Health research biostatistician—was published in the Journal of Pediatric and Adolescent Gynecology.
The paper by Harlow, Cass, and Anderson addressed existing hesitancy surrounding the HPV vaccine. The rollout of the COVID-19 vaccine coincided with a rise in vaccine skepticism.
“We investigated whether introducing the COVID-19 vaccine correlated with changes in HPV vaccine initiation compared to Tdap within Dartmouth Health, a large New England health system,” Harlow, Cass and Anderson write.
The researchers looked at vaccination records for 15,696 adolescents within the Dartmouth Health system in New Hampshire and Vermont, with ages ranging from 9 to 18, over the course of four years. The study was broken down into three periods: before the COVID-19 pandemic (March 2019 to February 2020), during the COVID-19 pandemic (March 2020 to May 2021), and after the COVID-19 vaccine became available (May 2021 to May 2023). A second analysis was performed to account for the time of year.
In each analysis, Harlow, Cass and Anderson tracked how many adolescents started the HPV vaccine and how many got the Tdap vaccine. They also tracked differences in sex and whether the patients lived in rural or urban areas.
Their research showed that during the pandemic, HPV vaccination rates didn’t really change.
After the COVID-19 vaccine was introduced, fewer adolescents started the HPV vaccine compared to pre-pandemic. The drop was most significant among boys, as well as adolescents in urban areas in the Dartmouth Health catchment area in New Hampshire and Vermont.
Tdap vaccination rates stayed steady during the pandemic and actually increased post-pandemic.
To summarize, Harlow, Cass, and Anderson report that after the COVID-19 vaccine rollout, fewer adolescents, especially boys in urban areas, started the HPV vaccine series. Other routine vaccines like Tdap did not decline.
The findings of this paper suggest that the broader vaccine hesitancy that grew during the pandemic may have specifically impacted HPV vaccination. The researchers suggest the decline in vaccination will result in an increase of cases of cervical cancer in women and mouth cancers in men in our region.
“Approximately 5% of all cancers are due to HPV infection. Cervical cancer is the most common cancer caused by HPV infection in women and oropharyngeal cancer is the most common HPV-associated cancer in men,” said Cass. “HPV vaccination has been shown to dramatically reduce the risk of these cancers. This study highlights the need to explore the root causes of this trend of HPV-specific vaccine hesitancy and devise better education campaigns for healthcare providers and patients. The HPV vaccine will save lives by reducing the risk of cancer in our community. We have to work together to help protect our children and this study gives us some direction where to start.”
To read the study, visit go.d-h.org/mf28am. Dartmouth Health has more information about vaccines available at go.d-h.org/kf6zvb.
About Dartmouth Health
Dartmouth Health, New Hampshire’s only academic health system and largest private employer, serves patients across New England. Dartmouth Health provides access to more than 2,300 providers in nearly every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH. Its network of hospitals, outpatient centers, clinics and home care facilities, spans a broad geographical area. Year after year, DHMC is named the #1 hospital in New Hampshire by U.S. News & World Report, and is consistently recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, northern New England’s only National Cancer Institute-designated Comprehensive Cancer Centers and one of less than than 60 total nationally; Dartmouth Health Children’s, which includes the state’s only children’s hospital (Children’s Hospital at DHMC/CHaD) and more than 20 locations around the region; eight member hospitals in Lebanon, Keene, Claremont, Hampstead, and New London, NH, and Windsor and Bennington, VT; Dartmouth Health Home Care; Dartmouth Health Connected Care Center for Telehealth, serving patients as far away as Texas; and more than 30 primary and multi-specialty clinics across New Hampshire and Vermont. Through its partnership with Dartmouth College, Dartmouth’s Geisel School of Medicine and the White River Junction VA Medical Center, Dartmouth Health trains nearly 400 medical residents and fellows annually and performs cutting-edge research and clinical trials with international impact. Dartmouth Health and its more than 16,000 employees are committed to serving the healthcare needs of everyone in the communities it serves and to providing every patient with exceptional, state-of-the-art, personalized care. Learn more at dartmouth-health.org.
About the Geisel School of Medicine at Dartmouth
The Geisel School of Medicine at Dartmouth, founded in 1797, strives to improve the lives of the communities we serve through excellence in learning, discovery, and healing. The nation's fourth-oldest medical school, the Geisel School of Medicine has been home to many firsts in medical education, research and practice, including the discovery of the mechanism for how light resets biological clocks, creating the first multispecialty intensive care unit, the first comprehensive examination of U.S. health care cost variations (The Dartmouth Atlas), and the first Center for Health Care Delivery Science, which launched in 2010. As one of America's top medical schools, Dartmouth's Geisel School of Medicine is committed to training new generations of physician leaders who will help solve our most vexing challenges in health care.