Human Papilloma Virus Vaccination: Focus on the Italian Situation

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.

Factors affecting children’s HPV vaccination in Austria: Evidence from a parent survey

“…HPV vaccine uptake may have particularly suffered following the cancelation of school-based vaccinations as part of the measures put in place to contain the COVID-19 pandemic in 2020–2021, which required parents to be proactive in initiating vaccination at alternative vaccination sites. 41 A reliable system for monitoring and documenting vaccination uptake has also become mandatory. Owing to the novel implementation of electronic health records (i.e., ELGA) in Austria, including electronic vaccination documentation, the surveillance of national vaccination rates is expected to be facilitated in the coming years.…”

Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap?

“…The prevalence of HPV+ OPSCC was previously reported to decrease with increasing age, and historically most HPV+ OPSCCs occur in men. [30][31]. HPV+ OPSCC incidence has greatly increased over the last two decades in some European countries [30; 32-33], while in lower middle-income South Asia and sub-Saharan Africa epidemiological reports are scarce, so it is consequently unclear whether similar upward trends are absent or simply undetected in these regions [34].…”

Accuracy of Cervical Intraepithelial Lesion Diagnosis by Visual Cervical Examination with Acetic Acid

“…There are 15-20years time gap between the peak HPV infection and the peak of cancer incidence but could happen faster & earlier (5-10years) in those with HIV/AIDS. HPV vaccine for girls at age of 9-14 years, screening women starting at 30years with early treatment of the precancer would prevent the invasive cancer 4 .…”

“…Even if the world figures show low number, in a single report in Ethiopia squamous cell carcinoma of the cervix was 90% of all cases and adenocarcinoma account only for 3.85% of cases 5 . Cervical cancer is diagnosed histologically; surgery, chemotherapy and radiotherapy are the possible modes of treatment based on stage of the disease, patient status, & availability of the modalities 4 .…”