"Because of the low uptake, we are unnecessarily placing an entire generation of young people at risk for cancer later in their lives. We'll have a lost generation who will be unnecessarily placed at risk for cancer," said Dr. Noel Brewer, a professor of health behavior at UNC Gillings School of Global Public Health, who has worked on expanding HPV vaccinations.
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About 80 million Americans have HPV, and 31,000 people will be diagnosed with an HPV-related cancer this year. Doctors acknowledge there is a stigma associated with the virus, as it' is sexually-transmitted.
"We talk about kids getting HPV vaccine before they become sexually active. That's not really what we mean. We mean well before they're sexually active. We need to do it about a year or two. Get their body, immune systems all in order - we can't time this," Brewer said.
Doctors know it can be difficult for parents to think about their children becoming sexually active.
"They don't want to think about their adolescent or child in that way. And the way a lot of us try to present the HPV vaccine and other vaccines, is for the HPV vaccine -- it helps prevent cancer. And some of these cancers can be deadly. So when you bring it to that, you're trying to prevent disease, that's the most important thing," added Dr. David Tayloe, a pediatrician at Coastal Children's Clinic in New Bern.
The American Academy of Pediatrics encourages HPV vaccinations beginning at age 9.
Tayloe said that after a drop in appointments early in the pandemic, patients have largely returned to normal scheduling at his clinic by this point.
The pandemic has affected vaccination rates, with more than 1 million doses of the HPV vaccine missed by adolescents with public insurance since March 2020, equaling a decline of 21% compared to pre-pandemic levels for publicly-funded doses and 12% for privately insured individuals.
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"HPV vaccination is cancer prevention. It prevents six cancers in men and women," Brewer said.
It's also important to remain on-schedule with other vaccinations, something Rolesville mother Mary Hilbert makes sure her children do.
"My daughter actually had to get the meningitis vaccine, which our doctor's office did not give out itself. So we had to find that and went to the pharmacy," Hilbert said.
With capacity limits removed and COVID-19 metrics improving, it's likely families will be traveling and children and adolescents be gathering in large groups again.
"More than ever it's important to keep all of that stuff up. Because how crazy horrible would it be if (in the midst of) COVID, kids didn't get sick with that, but then you got tuberculosis because you forgot to get your booster," Hilbert said.
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The family's proactive attitude extends to the COVID-19 vaccine.
"It's definitely so much better. I finally got to see my friend who I hadn't seen since March of last year," her son Samuel, a high school sophomore, said of getting his COVID-19 shot.
Outside of physical diseases and viruses, the pandemic also impacted mental health capabilities.
"We have fewer people seeking mental health support, and at the same time experiencing more mental health challenges. So that is definitely a concern. We need to make sure people have access to mental health services," Brewer said.
The Centers for Medicare and Medicaid Services found mental health services in children dropped by 34% between March and October 2020 compared to the same time period in 2019.