HPV Vaccine Rates in Alberta: Impact of the Pandemic and Program Changes

We studied HPV vaccination data across alberta to understand how rates changed before and after the COVID-19 pandemic, focusing on people vaccinated outside of school programs. Our research suggests that making the vaccine available to more people based on age, rather than risk factors, may have helped lessen the negative effects of disruptions caused by the pandemic.

Vaccination rates for those aged 18-21 and 22-26, who were directly affected by the new age-based program, didn’t drop much during the first part of the pandemic (2020, 2021). Actually, rates were similar or even higher in the following years (2022, 2023). however, the 16-17 age group, who didn’t have changes to vaccine funding, experienced the biggest and longest declines in vaccination rates.

A study in the US showed larger drops in adult vaccinations during the pandemic (not just HPV), with rates falling by as much as 70% and staying low in 2022 [22]. We saw smaller changes, likely as of the shift to an age-based program. We also noticed a significant increase in vaccinations given at college and university health centers after the pandemic was declared and the age-based program started. This suggests a greater focus on vaccinating people 18 and older.

Throughout our study, we found that fewer males were vaccinated compared to females.This was surprising because, during the earlier risk-based program, males had better access to free vaccines. also,more unvaccinated people were male during our study period,as they weren’t included in school-based programs until 2014,six years after the program started for females.

Though, this finding aligns with generally lower vaccination rates among males. As of 2023,about 46.9% of Canadian males aged 18-26 were vaccinated against HPV, compared to 77.3% of females [23].Several factors contribute to this difference. Healthcare providers may encourage vaccination more often for females, possibly because they know less about the importance of male vaccination [24] or because they can combine vaccination discussions with routine cancer screenings for women [25].The previous risk-based program required people to share their sexual orientation to get a free vaccine, which likely discouraged some from getting vaccinated. A Canadian study found that only 26-56% of men eligible for free vaccination reported disclosing their sexual behavior to their doctor [13].It’s vital to find out if the males getting vaccinated now, under the age-based program, have similar risk factors as those vaccinated during the risk-based program.

We also found that people who moved to Alberta after age 16, when school-based programs were already in place, made up a large portion of those vaccinated during the risk-based program. This number increased during the age-based program.

References:

• [22] Source for US vaccination rate decline.
• [23] Source for Canadian HPV vaccination coverage rates.
• [13] Source for Canadian study on disclosure of sexual behavior.
• [24] Source for provider knowledge of male HPV vaccination.
• [25] Source for synergy with female cancer screening.