Recovery from HPV vaccination deficits caused by the COVID-19 pandemic in Germany: a modeling study of catch-up HPV vaccination among adolescent girls

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Health care disruptions associated with the COVID-19 pandemic have caused persistent decreases in human papillomavirus (HPV) vaccination uptake in Germany. The objective of this study was to estimate the cumulative deficit in first doses of the HPV vaccine administered to girls in Germany since the beginning of the pandemic and the projected time to recover from this deficit at different catch-up vaccination uptake levels, focusing on girls 9–14 years of age. This study used a published HPV vaccination modeling tool. Retrospective vaccination data from 2019 were used to calculate the baseline vaccination rate, while data from 1 January 2020 to 31 December 2023 were used to estimate the size and duration of the HPV vaccination deficit accrued since the beginning of the COVID-19 pandemic. We modeled scenarios in which the rate of monthly vaccinations increased from the 2023 average to 5%, 10%, or 15% above the baseline 2019 level. The average monthly number of first doses of HPV vaccine administered to girls 9–14 years of age was 7.4% below the 2019 baseline level in 2020, 21.2% below baseline in 2021, 21.0% below baseline in 2022, and 19.5% below baseline in 2023. At a catch-up vaccination uptake of 5–15% above the 2019 baseline, there would be an estimated accumulated deficit of 267,052–285,798 first doses by 31 December 2024 that would clear between October 2029–April 2040. A catch-up vaccination uptake of 12.3% (11.9–12.7%) every month above baseline would be needed to clear the accumulated deficit by the end of 2030. Conclusions: Significant HPV vaccination deficits have accrued in Germany since the beginning of the COVID-19 pandemic. Sustained efforts to vaccinate the affected cohorts are now needed to mitigate the long-term impacts of the vaccination deficit.What is known:• Health care disruptions associated with the COVID-19 pandemic have caused persistent decreases in human papillomavirus (HPV) vaccination uptake in Germany.What is new:• Our model projected that the HPV vaccination deficit would be cleared between October 2029 (15% above the 2019 baseline level) and April 2040 (5% above the 2019 baseline level).• A catch-up rate of 12.3% (11.9–12.7%) above the 2019 baseline level would be needed to clear the HPV vaccination deficit by 31 December 2030.• Sustained efforts to vaccinate the affected cohorts are now needed to mitigate the long-term impacts of the accrued vaccination deficit on mortality, morbidity, and health care costs from HPV-associated diseases.