State of art of anti- Human Papillomavirus vaccination programs and vaccine coverage levels: comparison between Italy and others European countries. [Comunicazione breve]

Background The persistent infection of the genital tract by a high-risk Human Papillomavirus (HPV) type is the primary cause of cervical cancer, the second most common cancer affecting women aged 15–44 in the European Union (EU). Each year, in the EU there are around 33 000 cases of cervical cancer and 15 000 deaths, in Italy each year new cases are 3500 and deaths 1500. The availability of anti-HPV vaccines, in association with cervical cancer screening programs, is an important tool to reduce the disease rate. This work is aimed at providing a comparison between Italy and others EU countries about implementation of vaccination programs and vaccine coverage rate in the target populations. Methods A literature review was performed by using electronic databases and institutional websites. In particular, for the European data we referred to the reports of the European Centre for Disease Prevention and Control (ECDC) and for the Italian ones we referred to biannual updates of the Italian National Institute of Health. Results Since 2008, HPV vaccination programs have been implemented in most EU countries. By May 2012, 19 out of 29 countries in the EU had implemented routine HPV vaccination programs, and 10 countries had also introduced catch-up programs. In Italy, by the end of 2007, HPV vaccination is free and actively promoted in all Regions for twelve years old girls. In EU countries the highest coverage rate for three doses is shown in Portugal (84%), followed by Denmark (79%), Spain (64%), Norway (63%), Netherlands (58%) and Slovenia (55%). The lowest rate is 17% (Luxembourg). In Italy the coverage rate for three doses is highly variable among Regions, ranging from 25.5 to 84.7% for the 1997 birth cohort, with an average of 68.8%. Conclusions In the EU countries there is great heterogeneity in vaccine policies, regarding target age group, catch-up programs, system of financing and delivery of the vaccines and coordination about countries is lacking. Moreover, despite the efforts made by single States, coverage rates are lower than expected in many EU countries. Several public health strategies to increase coverage vaccination levels could be implemented, such as the empowerment of the population through specific training and education programs. Key message This work highlights the need to implement policies to promote anti-HPV vaccination in the EU countries in order to increase coverage rates and reduce cervical cancer cases.