ArticleBMC public health2025
Human papillomavirus vaccination patterns among youth aged 16-26 in the context of publicly-funded eligibility changes: a retrospective cross-sectional study from Alberta, Canada.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHuman papillomavirus (HPV) vaccination programs in Canada primarily target school-aged adolescents (≤ 15 years) through publicly-funded, school-based delivery. In the province of Alberta, publicly-funded HPV vaccination for older youth (age ≤ 26) began with a risk-based program (i.e. availability limited to those at elevated risk for HPV infection and/or progression to disease) in 2018, expanding to an age-based program (i.e. available to all individuals within funded age groups) in July 2020. This study explores HPV vaccination patterns among 16-26-year-olds during this time period, in the context of the COVID-19 pandemic.
methodsWe conducted a retrospective cross-sectional study using population-wide administrative health data (February 2018-December 2023). Rates of HPV vaccination per 10,000 individuals were calculated by sex and age group, comparing the quarterly absolute and percent difference between the pre-pandemic risk-based period and the pandemic age-based period. We also calculated the quarterly proportion of doses delivered by sex (stratified by age group), delivery site, and individual residence (metro/urban/rural, age of arrival to province).
resultsHPV vaccine administration rates were higher among females than male throughout the study period (84-224 doses/10,000 compared to 40-135 doses/10,000). Rates dropped sharply after pandemic onset (March 2020), with the largest and most sustained drops among 16-17-year-olds (156 doses/10,000). Rates for 18-21 and 22-26-year-olds, who were newly eligible under the age-based program, returned to or exceeded pre-pandemic levels by 2022. Delivery site distribution shifted, with increased vaccination at post-secondary and STI health centres. Dose delivery remained consistently highest among metro residents, and individuals who entered Alberta after age 16.
conclusionsExpansion to an age-based HPV vaccination program may have mitigated pandemic-related declines in vaccination rates among older youth, though overall administration remained low. Results highlight persistent inequities by sex and geography, and underscore the importance of targeted promotion, improved service delivery, and expanded provider engagement to optimize HPV vaccine uptake outside school-based settings.
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