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Vaccines
Special Issues
Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies
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Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Human Papillomavirus Vaccines".

Deadline for manuscript submissions: 28 February 2026 | Viewed by 7932

Special Issue Editor

Dr. Irena Ilic

E-Mail Website
Guest Editor
Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Interests: epidemiology; cervical cancer; prevention; vaccines; vaccination coverage; vaccination schedule; burden of disease; risk factors; cancers; infectious disease; evidence-based medicine; meta-analysis

Special Issue Information

Dear Colleagues,

Globally, cervical cancer ranks as the fourth most common cancer and fourth leading cause of cancer death in women. According to the International Agency for Research on Cancer, Human papillomavirus (HPV) is considered carcinogenic to humans, particularly for cervix uteri.

The first HPV vaccine was approved in 2006, and the latest data show a significant overall reduction in cervical cancer incidence in the cohort of vaccinated adolescents worldwide. Countries are reporting a 65–97% reduction in the occurrence of cervical cancer in the population of vaccinated women.

But disparities in cervical cancer burden will likely widen with differences in HPV vaccination coverage. According to the latest WHO data, globally in 2022 the HPV vaccination program coverage in females was 21% with the first dose and 15% with the last dose, while in males the coverage was 6% and 5%, respectively, with coverage varying more than 20-fold between WHO regions. In response to this, WHO updated recommendations for the HPV vaccination schedule.

Improving HPV vaccination coverage is essential in reducing the burden of HPV-related cancers and health inequities. The COVID-19 pandemic has significantly disrupted HPV vaccination worldwide. This Special Issue is focused on current issues, future prospects and strategies aimed at improving HPV vaccination coverage.

Dr. Irena Ilic
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • HPV vaccine
  • HPV-related cancers
  • vaccination
  • vaccine coverage
  • vaccine acceptance
  • vaccine hesitancy
  • vaccines knowledge, attitudes and practice
  • immunity
  • prevention

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Published Papers (5 papers)

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21 pages, 1081 KiB  
Article
HPV Knowledge, Vaccination Uptake, and Salivary Diagnostics Among Dental Students in Romania
by Sergiu Baranga, Doina Chioran, Octavia Balean, Ramona Dumitrescu, Roxana Popescu, Daniela Jumanca, Roxana Oancea, Ruxandra Sava-Rosianu, Vanessa Bolchis and Atena Galuscan
Vaccines 2025, 13(6), 658; https://doi.org/10.3390/vaccines13060658 - 19 Jun 2025
Abstract
Background: Human papillomavirus (HPV) is a key cause of cervical and oropharyngeal cancers. Despite available vaccines, uptake remains low in Romania due to limited awareness and hesitancy. This study assessed HPV knowledge, vaccination status, and the presence of high-risk strains (16 and 18) [...] Read more.
Background: Human papillomavirus (HPV) is a key cause of cervical and oropharyngeal cancers. Despite available vaccines, uptake remains low in Romania due to limited awareness and hesitancy. This study assessed HPV knowledge, vaccination status, and the presence of high-risk strains (16 and 18) in the saliva of dental students from Victor Babeș University in Timișoara. Methods: A cross-sectional study was conducted between February and March 2024, enrolling 199 dental students. Participants completed a 15-item questionnaire addressing HPV-related knowledge, vaccination status, lifestyle factors, and health history. Saliva samples were collected and analyzed using real-time PCR for the detection of HPV types 16 and 18. Logistic regression analysis was employed to identify predictors of vaccination uptake. Results: Only 10.6% of participants had received the HPV vaccine, although 96.9% acknowledged its safety and efficacy. Awareness was higher among females (88.1%) than males (84.3%), and vaccination rates were significantly greater among students under 25 years old (p = 0.0312). A total of 16.6% reported the presence of papillomas or warts. HPV DNA was detected in 10% of saliva samples. Conclusions: Although awareness of HPV was high, vaccination rates remained low, revealing a gap between knowledge and preventive action. Saliva-based screening shows promise as a non-invasive diagnostic tool, and integrating targeted education and advocacy into dental curricula may enhance public health outcomes in Romania. Full article
(This article belongs to the Special Issue Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies)
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23 pages, 2542 KiB  
Article
HPV Infection Prevalence, Vaccination-Related Knowledge, Attitudes, and Barriers Among Women Aged 30–64 in Shenzhen, China: A Cross-Sectional Study
by Zhongai Ouyang, Minting Zhu, Zhijian Chen, Weigui Ni, Lijuan Lai, Bingyi Lin, Long Jiang, Yi Jing and Jingjie Fan
Vaccines 2025, 13(6), 561; https://doi.org/10.3390/vaccines13060561 - 25 May 2025
Viewed by 471
Abstract
Background: the distribution of human papillomavirus (HPV) infection, vaccination rates, and awareness levels varies across China. Methods: this study examined HPV infection prevalence, vaccine uptake, and barriers among 2440 women aged 30–64 in Shenzhen, China, using partial least squares structural equation [...] Read more.
Background: the distribution of human papillomavirus (HPV) infection, vaccination rates, and awareness levels varies across China. Methods: this study examined HPV infection prevalence, vaccine uptake, and barriers among 2440 women aged 30–64 in Shenzhen, China, using partial least squares structural equation modeling (PLS-SEM) to analyze associated factors. Results: The overall HPV prevalence was 14.2% (347/2440), with HPV52 being the most common type, followed by HPV58 and HPV53. Factors significantly associated with HPV infection included more sexual partners, genital tract infections, manual labor, and single marital status (p < 0.05), whereas higher education demonstrated a protective association (p < 0.05). The HPV vaccination rate was 41.8% in ages 30–45. There were direct effect indicators of younger age, fewer pregnancies, and premenopausal status (p < 0.05) on HPV vaccine uptake, whereas inversely associated factors included divorce/widowed, lower household income, irregular menstruation, more deliveries, no contraception, and lack of HPV knowledge. Among 828 unvaccinated individuals, 47.9% of those aged 46–64 were willing if the age restrictions were expanded, with the main barrier being a lack of vaccine knowledge (40.7%). Willingness was significantly associated with younger age and healthcare occupation (p < 0.05), but negatively with eastern Shenzhen residence, lower household income, no HPV disease awareness, abnormal leucorrhea, lack of HPV knowledge, and belief against post-vaccination screening (p < 0.05). Conclusions: Socioeconomic disparities in HPV infection and vaccination rates in Shenzhen highlight intervention priorities. The impact of HPV knowledge underscores the need for effective health communication. The vaccination willingness and infection status among women aged 45+ provide supporting evidence for expanding HPV vaccination to older age groups. Full article
(This article belongs to the Special Issue Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies)
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10 pages, 202 KiB  
Article
Perceptions of a State-Level HPV Vaccine Mandate and Exemption Option in Rural Virginia: A Qualitative Study
by E. Marshall Brooks, Kendall Fugate-Laus, Ben Webel and Shillpa Naavaal
Vaccines 2024, 12(4), 401; https://doi.org/10.3390/vaccines12040401 - 10 Apr 2024
Cited by 2 | Viewed by 2106
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination [...] Read more.
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination rates among children and youth and reduce the burden of HPV-related cancer. This study investigated community perceptions of an HPV vaccine school-entry mandate in Virginia and the consequences of a low threshold exemption option included in the legislation. We conducted 40 interviews with community members including 15 interviews with parents, 19 with healthcare providers, and 6 with community leaders. Interviews asked about knowledge, beliefs, and attitudes concerning the HPV vaccine and mandate. Interviews were recorded, transcribed, and thematically analyzed. Despite healthcare provider support for the mandate, there was widespread confusion over the school-entry policy and concern that the exemption option undermined vaccination efforts. Understanding variations in community-level perceptions and response to school-based vaccination mandates is crucial for designing effective public health strategies. Findings suggest statewide vaccination initiatives should preemptively identify low uptake areas and provide targeted information to communities. Future mandates should avoid the use of ambiguous and contradictory language in vaccine-related legislation. Full article
(This article belongs to the Special Issue Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies)

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14 pages, 1400 KiB  
Systematic Review
Clinician Communication Training to Increase Human Papillomavirus Vaccination Uptake: A Systematic Review and Meta-Analysis
by Nutthaporn Chandeying and Therdpong Thongseiratch
Vaccines 2024, 12(6), 611; https://doi.org/10.3390/vaccines12060611 - 3 Jun 2024
Cited by 3 | Viewed by 1491
Abstract
The battle against Human Papillomavirus (HPV)-related cancers is hindered by suboptimal vaccination rates, despite the proven efficacy and availability of vaccines. This systematic review and meta-analysis addressed this issue by evaluating the impact of clinician communication training on increasing HPV vaccination uptake among [...] Read more.
The battle against Human Papillomavirus (HPV)-related cancers is hindered by suboptimal vaccination rates, despite the proven efficacy and availability of vaccines. This systematic review and meta-analysis addressed this issue by evaluating the impact of clinician communication training on increasing HPV vaccination uptake among adolescents. From an initial pool of 3213 records, six randomized controlled trials involving 245,195 participants across the United States were rigorously selected and analyzed. Our findings indicated that clinician communication training could enhance vaccination uptake rates by an average of 5.2%. Specifically, presumptive communication strategies, which proactively assume a patient’s acceptance of vaccination, achieved a significant 9.1% increase in uptake, markedly outperforming the 2.3% increase observed with more passive conversational techniques. Moreover, interventions that incorporated audit and feedback processes were particularly impactful, boosting vaccination rates by 9.4%. The most striking results emerged from combining presumptive communication with audit and feedback, which propelled the effectiveness to an 11.4% increase in vaccination rates. These outcomes highlight the pivotal role of deliberate, targeted clinician–patient communication in improving health interventions. This study offers actionable insights for healthcare providers and policymakers to refine communication strategies, thus potentially maximizing HPV vaccination rates and mitigating the spread of HPV-related conditions. Full article
(This article belongs to the Special Issue Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies)
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23 pages, 4494 KiB  
Systematic Review
Vaccine Hesitancy among European Parents—Psychological and Social Factors Influencing the Decision to Vaccinate against HPV: A Systematic Review and Meta-Analysis
by Teodora Achimaș-Cadariu, Andrei Pașca, Nicoleta-Monica Jiboc, Aida Puia and Dan Lucian Dumitrașcu
Vaccines 2024, 12(2), 127; https://doi.org/10.3390/vaccines12020127 - 26 Jan 2024
Cited by 8 | Viewed by 2932
Abstract
Background: Due to low adherence to HPV vaccination programs, the European region struggles with vaccination rates lower than 30% among the targeted population. The present report investigated various socio-demographic and psychological factors influencing European parents’ hesitancy towards vaccinating their children. Methods: As of [...] Read more.
Background: Due to low adherence to HPV vaccination programs, the European region struggles with vaccination rates lower than 30% among the targeted population. The present report investigated various socio-demographic and psychological factors influencing European parents’ hesitancy towards vaccinating their children. Methods: As of September 2023, four databases were searched. After applying inclusion criteria, all articles comparing psychological and socio-demographic factors in parents who vaccinate or do not vaccinate their children were included. Results: Twenty-five primary publications met the criteria, totaling 385,460 responders, of which 311,803 want to or have already vaccinated their child, and 73,555 do not wish to do so. Immigrant and employment status, religion, age of parents and the child’s gender seemed to influence their decision to vaccinate their child. Previous experience with vaccines, perceived safety and efficacy and the mother’s previous abnormal CCS results also impacted their decision. The caregivers’ education, gender, civil status, number of children, family history of neoplasia or mother’s CCS attendance did not influence their hesitancy to vaccine. Conclusion: Multiple demographic, social, economic and psychological barriers involved in the parents’ hesitancy to vaccinate their children against the HPV virus were highlighted. Specific at-risk categories that need to be targeted with information, education and vaccination campaigns were identified. Full article
(This article belongs to the Special Issue Improving HPV Vaccination Coverage: Current Issues, Future Prospects and Strategies)
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