A modelled analysis of the impact of COVID-19-related disruptions to HPV vaccination

COVID- 19 disrupted school attendance in many countries, delaying routine adolescent vaccination against human papillomavirus (HPV) in some settings. We used Policy1-Cervix, a dynamic model simulating HPV transmission, natural history, vaccination, cervical screening, and diagnosis of HPV-related cancers, to estimate the impact on HPV-related cancers from disruptions to HPV vaccination in a high-income setting. A baseline scenario of no disruption to HPV vaccination was modelled, which assumed uptake of the nonavalent vaccine at the age of 12 by 82.4% of females and 75.5% of males, as is the coverage in Australia. Additional lifetime HPV-related cancer cases were calculated for three disruption scenarios affecting one birth cohort (2008; aged 12 in 2020) compared to the baseline scenario: (1) 1 -year delay (no doses missed); (2) 1-to 7 -year delay (slow catch -up); (3) no catch -up (herd effects only). A fourth scenario assumed no catch -up HPV vaccination for two birth cohorts, that is all individuals born in 2008 and in 2009 missed vaccination (worst -case scenario). Compared to 1532 HPV-related cancer cases estimated for the baseline no disruption scenario, we found a 1 -year delay could result in <= 0.3% more HPV-related cancers (n = 4) but the increase would be greater if catch -up was slower (5%; n = 70), and especially if there was no catch-up (49%; n = 750). Additional cancers for a single missed cohort were most commonly cervical (23% of the additional cases) and anal cancers (16%) in females and oropharyngeal cancers in males (20%). In the worst -case scenario of two birth cohorts missing vaccination, <= 62% more HPV-related cancers would be diagnosed (n = 1892). In conclusion, providing catch -up of missed HPV vaccines is conducted, short -term delays in vaccinating adolescents are unlikely to have substantial long -term effects on cancer.