Abstract

Human papilloma virus (HPV) is a viral agent whose transmission occurs mainly by sexual means. It causes different pathological conditions in both males and females, ranging from benign pathologies up to cancers. The introduction of vaccination has certainly had a major impact in terms of reducing the incidence of both HPV infections and diseases but in the European Union and the European Economic Area (EU/EEA) there are still about more than 13,000 deaths due to cervical cancer each year. To date in Europe and in Italy there are three vaccines available (bi-, tetra-, and nonvalent vaccines). The vaccination campaign started irregularly in Europe and Italy in 2007, with pre-adolescent girls as the primary target. Later, other cohorts were introduced such as 12-year-old boys, additional cohorts of >25-year-old women, women who already underwent cervical surgery and other subjects entitled to free vaccination. The COVID-19 pandemic has strongly impacted on public health services, particularly on vaccinations that, especially during the first pandemic phase, have been often delayed and/or canceled. The most affected vaccinations by the pandemic have been the non-mandatory ones, particularly those addressing the adolescent and adult population, such as immunization against papillomavirus. To date the achievement of the coverage target set by the Italian National Immunization Plan (NIP) has not yet been achieved. The aim of this work is to summarize the current situation in Italy and to discuss the strategies that have been implemented to increase overall vaccination coverage rates.

Highlights

  • Human papilloma virus (HPV) is an extremely widespread viral agent throughout the world; it includes more than 200 distinct genotypes and its human-to-human transmission occurs mainly by sexual means [1]

  • In Italy, vaccination against HPV started in 2007 and over the years there has been an increase in vaccination coverage even if the target indicated in the 2017–2019 National Immunization Plan (NIP) has not yet been reached [4]

  • 2020, does not reach the 95% target set by the 2017–2019 NIP, both in male and female cohorts

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Summary

Introduction

Human papilloma virus (HPV) is an extremely widespread viral agent throughout the world; it includes more than 200 distinct genotypes and its human-to-human transmission occurs mainly by sexual means [1]. Approximately 70% of cervical cancers and HPV-associated precancerous lesions are caused by the serotypes 16 and 18. Considering that this type of cancer is currently the fourth leading cause of death in the female world population, HPV is responsible for an important burden of disease [1]. In Italy, vaccination against HPV started in 2007 and over the years there has been an increase in vaccination coverage even if the target indicated in the 2017–2019 National Immunization Plan (NIP) has not yet been reached [4]. In Italy the COVID-19 pandemic has caused a sharp slowdown in immunization activities, for vaccinations not included among the mandatory ones. The aim of this work is to summarize the current situation in Italy and to discuss the strategies that have been implemented to increase overall vaccination coverage rates as well as to allow catch-up interventions

HPV Epidemiology in Europe and in Italy
Multicohort Strategy
Current Vaccination Coverage Rates
Impact of COVID on Coverage and Intervention Strategies
Findings
Conclusions
Full Text
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