Introduction of HPV vaccines in European Union countries – an update

ECDC publishes an update to its 2008 Guidance on human papillomavirus (HPV) vaccines in Europe. The update follows the introduction of vaccination programmes in 19 European countries and new evidence from research studies over the past four years. The Guidance recommends that public health initiatives should continue to focus on vaccinating girls. Routine HPV vaccination should target girls between ages 10-14 before the onset of sexual activity and to be administered in three doses within six months. The Guidance reports that in spite of the benefits of the vaccination, current economic models show that including boys in the current HPV vaccination programmes is unlikely to be cost-effective. However, this issue could be re-assessed when more data is available and especially if vaccination costs are significantly reduced. HPV vaccines have a good safety profile and demonstrated efficacy against cervical cancer precursors. In spite of this, vaccination rates in European countries are lower than expected, ranging from 17% to 84%. Among the deterring factors are the high cost of vaccines and the regime of three doses in six months. Increased parental acceptance would help improve vaccination rates. The Guidance stresses the importance of cervical cancer screening; HPV vaccination should complement, not replace, screening programmes. Cervical cancer is the second most common cancer after breast cancer to affect women aged 15–44 years in the European Union (EU). Each year, there are around 33 000 cases of cervical cancer in the EU and 15 000 deaths. More than 70% of   cervical cancer cases in Europe are due to persistent infection of the genital tract by a high-risk HPV types – 16 and 18