OBJECTIVES: Due to the high HPV vaccination coverage reduction caused by the COVID-19 pandemic in Greece, a catch-up initiative was designed to run until 12/2023. However, our latest analysis (Gountas et al. EPSID 2023) highlighted that despite the ongoing catch-up, the HPV vaccination dose deficit had been increasing, reaching at the end of 2022, 4.7-7.0 months of vaccination of 2019 (e.g., 40-58.3% of the 2019 vaccination doses). This study aims to update the HPV vaccination deficit estimation and assess the progress of the running catch-up.

METHODS: A published calculator (Saxena et al. CMRO 2021) was populated with local HPV vaccine sales data. Until 04/2022, when the Greek National Immunization Committee introduced gender-neutral HPV vaccination, only girls were eligible for HPV vaccination, hence, the dose deficit was only attributed to girls. To exclude boys’ vaccination after 04/2022, three scenarios were examined: 35%, 50%, and 65% of the observed HPV sales data were assumed to be attributed to girls. The accumulated deficit was expressed as a function of months of the last pre-pandemic year (e.g., 2019).

RESULTS: The estimated accumulated deficit at 03/2023 ranges between 4.6-6.5 months. To clear the HPV deficit by the end of 2024, yearly administered doses should be increased by 110% compared to 2023. Compared to a scenario with a catch-up program ending in 2024, expanding the catch-up program until 2025 would reduce the annual number of doses by 18%.

CONCLUSIONS: Although the existence of some early signs of recovery, our estimates showed that a substantial increase in the number of HPV vaccine doses is required to clear the dose deficit by the end of 2024. Expanding the catch-up program until the end of 2025 along with interventions to increase catch-up effectiveness is required to make HPV vaccine deficit elimination a more realistic target and prevent future HPV-related morbidity and mortality.