Lost cohorts in the HPV vaccination due to the covid-19 pandemic and potential effects on future HPV associated cancers

ABSTRACT

Background: Due to covid-19 pandemic, the lock downs and long homeschooling periods children /adolescents and their parents were neither reachable for school personnel nor for healthcare professionals. Therefore, vaccination rates decreased by 14% for girls and 9% for boys (DAK Kinderund Jugendreport 2021). Consequently, children in the target age of 9 to 14 years were lost for the HPV-vaccination. A 2-dose-vaccination-scheme is used for children younger than 15 years. Older kids need 3 vaccinations for a complete immunization. The GKV generally reimburses only the cost for age groups younger than 18 years. We aim to assess the resulting HPV associated treatment cost in the German healthcare system and to develop a proposal on how to get the lost cohorts vaccinated. Method(s) To assess the additional cost related to the decrease in vaccination rates, we plan to use the following approaches Scenarios analysis of the need of the 3-dose-scheme (Vaccine, organization, personnel) and future HPV related treatment costs. We will conduct expert interviews and compare sales figures of Gardasil with data from the KV. Finally, we compare European / international countries, on how do they organize the catch-up for the lost cohorts. Result(s) We expect increasing costs due to a third vaccination regime and the treatment of HPV related cancers based on missing immunizations in the juvenile age. Discussion(s) An increased financial burden will be result in the future, if Germany fails to catch-up the lost children and adolescents based on the HPV vaccination gap due to the pandemic. Mechanisms need to be in place to include adolescents, i.e. through the J1-exami, for the catch-up vaccinations. Alternatively, the age limit for a reimbursement could be raised for a limited period of time to immunize the young adults between 18 and 20 years. In collaboration with the Allianz gegen HPV.