Improving HPV vaccine uptake in children, adolescents,and young adults - An umbrella review of interventions

HPV causes about 5% of all cancers worldwide. The most common of these cancers is cervical but the virus is also implicated in cancers of the vagina, vulva, anus, penis, head and neck. A significant proportion of the cancers caused by HPV in Europe are in men. The World Health Organization now has a global strategy for the elimination of cervical cancer. Europe’s Beating Cancer Plan, published by the European Commission in 2021, contains a ‘flagship’ commitment to HPV vaccination. Both strategies share the goal of a 90% vaccination uptake for girls and the Beating Cancer Plan also wants to see an increasing number of boys vaccinated through gender-neutral programmes in every member state. But vaccination rates in Europe, and elsewhere, currently vary widely. Data for the European region shows that only two countries achieved a 90% uptake of girls receiving all their vaccine doses. While several managed over 70% uptake, other countries had coverage rates of below 50% and at least two currently vaccinate fewer than 10% of girls. An important part of the explanation for sub-optimal vaccination rates is low vaccine confidence among parents and carers as well as young people themselves. This can be caused by insufficient information, a lack of trust in health authorities and vaccine manufacturers, and concerns about vaccine safety. But we know that vaccine confidence can be improved, and vaccine uptake increased if the right policies and programmes are put in place. That is why the European Cancer Organisation’s HPV Action Network commissioned this important review of published evidence. Our expert research team took a detailed look at the existing evidence base, by means of an umbrella review (essentially a systematic review of systematic reviews) and identified a range of interventions that have been shown to make a difference in terms of intention to be vaccinated, and uptake rates for HPV vaccination. Compared to many other cancer prevention strategies – such as tobacco control, reducing alcohol consumption, increasing physical activity or tackling obesity – HPV vaccination is easy-todeliver, has an immediate positive health impact and is highly efficacious. In fact, it is probably the single most effective means of cancer prevention in the medical arsenal. We will therefore share these findings widely and encourage HPV vaccination programmes in Europe and beyond to make the best possible use of this evidence. If we can achieve a 90% vaccination rate across Europe, we know we will succeed in eliminating HPV cancers as a public health problem in the region