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

TLDR

WHO/UNICEF estimates of HPV vaccination coverage from 2010 to 2019 are examined in light of the 2030 target of 90 % coverage set by the global cervical cancer elimination strategy. In the post‑COVID era, the study urges maintaining introduction momentum, prioritizing the most populous countries, and improving global program performance. As of June 2020, 107 of 194 WHO Member States had introduced HPV vaccination, with the Americas and Europe leading, a record 2019 uptake mainly in LMICs, but average first‑dose coverage of 67 % and final‑dose coverage of 53 % (15 % weighted by population), leaving only 6 % of countries above 90 % and indicating a long way to reach the 2030 90 % target.

Abstract

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.