Some health experts say there’s a ‘concerning decline’ in HPV vaccination rates since pandemic began

‘‘Our biggest issue is not just getting one of the shots, but the whole three-shot series,’' said a spokesperson for Planned Parenthood Southern New England.

Gardasil-9 is an FDA-approved vaccine series to prevent against HPV.YURI CORTEZ/AFP via Getty Images

Planned Parenthood of Southern New England is seeing a “concerning decline” in vaccination rates for human papillomavirus, or HPV, with vaccinations down roughly 40 percent over the past few years, according to health experts from the organization.

The reason? Primarily the pandemic, experts say, after people put off in-person doctor appointments, and as a result, certain preventative health measures, like getting the HPV vaccine.

Children, teens, and young adults ages 9 to 45 are eligible for the HPV vaccine, with people younger than 15 getting two doses, six to 12 months apart; and people 15 to 45 getting the three doses, also known as Gardasil 9, over six months, according to the Centers for Disease Control and Prevention.

HPV is spread by sexual activity, and some strains can lead to cervical cancer, as well as cancers in the throat, mouth, head, and neck. Getting vaccinated against HPV helps prevent cancer in men and women. The ideal age for vaccination is before a person is sexually active, according to Mayo Clinic.

“Our biggest issue is not just getting one of the shots, but the whole three-shot series,” a spokesperson for Planned Parenthood Southern New England said in a statement. “Studies showed that Latinx and immigrants and people without insurance generally had low rates of vaccination.”

A CDC report published in August also found that new HPV vaccinations in teens stalled for the first time in 10 years.

Jennifer Love, one of the lead clinicians at Planned Parenthood’s Manchester, Conn., location,, explained how HPV vaccination recommendations “dropped off our typical counseling” during the pandemic, as clinicians weren’t typically seeing patients in-person. Now, she and other providers are trying to “get back to normal.”

“It’s taken some effort from us to readjust the script, now that we have the patient in front of us,” Love said. “Patients often have many outstanding preventative health needs. There is extremely limited time in each visit to try and address them all. It is very difficult and overwhelming for providers.”

Dr. Ayiti Maharaj-Best, medical director of Planned Parenthood of Southern New England, said with the pause on in-person school in 2020, “many kids missed their annual school physicals, which serves as an important checkpoint for keeping adolescents up to date on their vaccines.”

“We are still trying to get them all caught up,” Maharaj-Best said.

Dr. Elizabeth Lange, a pediatrician at Coastal Medical in East Providence, said she has noticed parents “asking more questions about vaccines that are recommended for their children.”

“Many times, it’s because the parent would like to talk to the other parent about the information they learned in the exam room,” Lange said. “They’d like to do a little bit more research on their own.”

Lange added that the HPV vaccine, even pre-pandemic, has given some parents pause “as to what it protects against and why.”

“This vaccine, in particular, has often caused more discussions than the vaccines against whooping cough and meningitis,” Lange said. “But in most cases, with an educated discussion, parents do choose to protect their children against cancer.”

Love said her patients often decline the vaccine due to a lack of knowledge about HPV.

“People think they aren’t eligible because they are older, or have already had HPV in the past,” Love said. “They may also think they don’t need it because they aren’t currently sexually active, or do not have a cervix, etcetera.”

Finances can also be a barrier. The vaccine is covered by most private insurance companies, but not all. In some cases, Planned Parenthood can offer financial assistance.

When Love encounters vaccine hesitancy, which she notes has been around forever “but kind of came to the surface with COVID,” she has a conversation with the individual to address concerns.

Political ideologies can also creep into conversations about vaccines. A study published last month in the American Journal of Managed Care found that political ideology is linked to awareness of HPV and HPV vaccines.

“Understanding the association between political ideology and HPV awareness is important for tailoring public health interventions to different political groups to increase vaccine uptake,” the authors of the study wrote. “Such interventions may help to address the suboptimal HPV vaccination rates in the US and ultimately reduce the burden of HPV-associated cancers.”

Love reiterated that when it comes to targeted intervention, she keeps the focus on concerns of the individual.

“Even though there is that political correlation, it is a medical intervention,” she said. “The conversation in the clinic is just about the patient’s own individual experience, so I try to focus on that. Treating them as the person not the overarching political trend.”

Planned Parenthood of Southern New England has put some “real focus” over the last eight months on getting all of their patients caught up on preventative health care.

“I think we’re going to start seeing an increase,” Love said. “I think everyone is getting caught up in different types of health care neglected during COVID.”

Rhode Island has also paid particular attention to vaccination rates in children since the start of the pandemic.

“Our Department of Health and our state government have been very purposeful in making sure all children have access to vaccines, and we’ve actually minimized the dip in our state because of this partnership and the hard work of all pediatric offices,” said Lange, of Coastal Medical. “So we are not seeing in Rhode Island the same decline in pediatric vaccination rates that might be seen in other parts of the country because of the pandemic.”

In the CDC report published last month, HPV vaccination rates varied widely by jurisdiction, with Rhode Island teens ages 13 to 17 having the highest HPV vaccination rates in the country, with 85.2 percent up to date, and 94.6 percent having gotten at least one dose. Mississippi had the lowest HPV vaccine rates in the country, with 38.5 percent up to date, and 61 percent having gotten at least one dose.