Vaccination against HPV: boosting coverage and tackling misinformation

Abstract

The availability of human papillomavirus (HPV) vaccines and screening tests has raised the possibility of globally eliminating cervical cancer, which is caused by HPV. Cervical cancer is a very common malignancy worldwide, especially among deprived women. High vaccination coverage is key to the containment and eventual elimination of the infection. Public HPV vaccination programmes in Italy and Denmark were swiftly established and are among the most successful worldwide. Still, in both countries, it has been challenging to achieve and maintain the recommended coverage of > 80% in girls. In a well-studied Italian region, vaccination coverage in girls at age 15 years (World Health Organization's gold standard) reached 76% in 2015 but decreased to 69% in 2018, likely due to work overload in public immunization centres. In Denmark, doubts about safety and efficacy of the HPV vaccine generated a decline in coverage among girls age 12-17, from 80% in 2013 down to 37% in 2015, when remedial actions made it rise again. Insights from these two countries are shared to illustrate the importance of monitoring coverage in a digital vaccine registry and promptly reacting to misinformation about vaccination.

Keywords: HPV; cervical cancer; coverage; misinformation; social media; vaccination.

Fig. 1

HPV coverage estimates available for 75 member states (Figure reproduced from UNICEF/WHO [13]).

Fig. 2

Number of girls and boys aged 11–18 receiving ≥ 1 dose each year, FVG Region, North‐Eastern Italy, 2008–2018 (Figure modified from [8]).

Fig. 3

Number of young women aged 12–17 who initiate HPV vaccination per month, June 2012 to December 2017 (Figure reproduced from Statens Serum Institut [30]).