HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010–2019

• Published in: Preventive medicine Vol. 144; p. 106399
• Main Authors: Bruni, Laia, Saura-Lázaro, Anna, Montoliu, Alexandra, Brotons, Maria, Alemany, Laia, Diallo, Mamadou Saliou, Afsar, Oya Zeren, LaMontagne, D. Scott, Mosina, Liudmila, Contreras, Marcela, Velandia-González, Martha, Pastore, Roberta, Gacic-Dobo, Marta, Bloem, Paul
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2021
• Subjects: COVID-19; Europe; Female; Humans; Immunization Programs; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; SARS-CoV-2; United Nations; Uterine Cervical Neoplasms - prevention & control; Vaccination; Vaccination Coverage; World Health Organization; Europe
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2020.106399

WHO/UNICEF estimates for HPV vaccination coverage from 2010 to 2019 are analyzed against the backdrop of the 90% coverage target for HPV vaccination by 2030 set in the recently approved global strategy for cervical cancer elimination as a public health problem. As of June 2020, 107 (55%) of the 194 WHO Member States have introduced HPV vaccination. The Americas and Europe are by far the WHO regions with the most introductions, 85% and 77% of their countries having already introduced respectively. A record number of introductions was observed in 2019, most of which in low- and middle- income countries (LMIC) where access has been limited. Programs had an average performance coverage of around 67% for the first dose and 53% for the final dose of HPV. LMICs performed on average better than high- income countries for the first dose, but worse for the last dose due to higher dropout. Only 5 (6%) countries achieved coverages with the final dose of more than 90%, 22 countries (21%) achieved coverages of 75% or higher while 35 (40%) had a final dose coverage of 50% or less. When expressed as world population coverage (i.e., weighted by population size), global coverage of the final HPV dose for 2019 is estimated at 15%. There is a long way to go to meet the 2030 elimination target of 90%. In the post-COVID era attention should be paid to maintain the pace of introductions, specially ensuring the most populous countries introduce, and further improving program performance globally. •Determining comparable HPV vaccine coverage estimates requires a dedicated methodology.•Globally only 15% of girls in the target age for HPV vaccination are fully protected.•While girls in LMIC lack HPV vaccines, most girls and progressively more boys in HICs, where burden is lower, get vaccinated.•Average HPV programs performance - 53% for final dose – lags behind childhood vaccine coverages.•Reaching the 90% elimination target is challenging but both HIC and LMIC countries have shown this is feasible.