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Pediatrics

Human Papillomavirus Vaccination Before and During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Network Open

Published Online: September 19, 2022

Research Letter

Article Information and Disclosures

Jenny K. R. Francis, MD, MPH^1,2;

Sitara M. Weerakoon, PhD, MPH^3,4;

Serena L. Lucas, RN, BSN, MBA²;

Matthew S. Mathew, MS^3,4;

Julia C. Durante, MD^1,2;

Nancy Kelly, MD^1,2;

Jasmin A. Tiro, PhD⁵

Author Affiliations

¹Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
²Children’s Health System of Texas, Dallas
³University of Texas Health Science Center School of Public Health, Dallas
⁴Center for Pediatric Population Health, Dallas, Texas
⁵Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas

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Every clinical encounter is an opportunity to vaccinate. The COVID-19 pandemic disrupted in-person encounters, leading to delays in childhood vaccinations across different seasonal patterns.¹^,2 Historically, human papillomavirus (HPV) vaccination has lagged behind other adolescent vaccinations.³ Strategies to catch up by offering vaccines at every encounter starting at age 9 years⁴^,5 and prioritizing population subgroups are needed. We characterized HPV vaccination by age and season from 2019 to 2021 and compared vaccination by encounter before and during the COVID-19 pandemic to identify catch-up priority groups.

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Article Information

Accepted for Publication: August 12, 2022.

Published: September 19, 2022. doi:10.1001/jamanetworkopen.2022.34000

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Francis JKR et al. JAMA Network Open.

Corresponding Author: Jenny K. R. Francis, MD, MPH, Department of Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 (jenny.francis@utsouthwestern.edu).

Author Contributions: Dr Francis had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Francis.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Francis, Weerakoon, Mathew.

Critical revision of the manuscript for important intellectual content: Francis, Weerakoon, Lucas, Durante, Kelly, Tiro.

Statistical analysis: Francis, Weerakoon.

Obtained funding: Francis.

Administrative, technical, or material support: Francis, Lucas, Mathew.

Supervision: Francis, Durante.

Conflict of Interest Disclosures: Dr Lucas reported receiving grants from the American Cancer Society during the conduct of the study. Dr Tiro reported receiving grants from the National Institutes of Health and Cancer Prevention and Research Institute of Texas outside the submitted work. No other disclosures were reported.

Funding/Support: This work was supported by the American Cancer Society HPV Cancer Free Texas and grant K23 HD097291 from the National Institutes of Health (Dr Francis).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank the research team, specifically the clinical staff at Children’s Health System of Texas. Stephanie E. Trenkner, MD, and Sonia Allouch, MD (Department of Pediatrics, University of Texas Southwestern Medical Center and Children’s Health System of Texas), attended meetings and reviewed vaccine data as part of a scholarly project. They were not compensated for their role.

References

Nelson R . COVID-19 disrupts vaccine delivery. Lancet Infect Dis. 2020;20(5):546. doi:10.1016/S1473-3099(20)30304-2 PubMed Google Scholar Crossref

Ackerson BK , Sy LS , Glenn SC , et al. Pediatric vaccination during the COVID-19 pandemic. Pediatrics. 2021;148(1):e2020047092. doi:10.1542/peds.2020-047092 PubMed Google Scholar Crossref

Pingali C , Yankey D , Elam-Evans LD , et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years—United States, 2020. MMWR Morb Mortal Wkly Rep. 2021;70(35):1183-1190. doi:10.15585/mmwr.mm7035a1 PubMed Google Scholar Crossref

O’Leary ST , Nyquist AC . Why AAP recommends initiating HPV vaccination as early as age 9. AAP News. Accessed May 18, 2022. https://publications-aap-org.foyer.swmed.edu/aapnews/news/14942

American Cancer Society. HPV vaccination at 9-12 years of age. Accessed May 18, 2022. https://hpvroundtable.org/wp-content/uploads/2022/04/Evidence-Summary-HPV-Vaccination-Age-9-12-Final.pdf

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.