Wartime HPV vaccine introduction in Ukraine: strategy, results and lessons
Abstract
Issue: Cervical cancer is among the top five cancers in women in Ukraine, causing approximately 3,300 cases and over 1,100 deaths annually. Ukraine remains one of the few countries in the European Region that has not yet introduced the HPV vaccine into the national immunization schedule. Introducing HPV vaccination under wartime conditions is critical to reducing the long-term cancer burden and strengthening public trust in the health system more broadly.
Practice: In January 2026, Ukraine introduced single-dose HPV vaccination nationally for girls aged 12–13. The strategy combined evidence-based policy, strong coordination, and integration into routine primary healthcare. Key tools included National Immunization Technical Advisory Group recommendations, health technology assessment, and managed entry agreements for procurement. Implementation was supported by the strong national coordination mechanism, an operational plan covering core program components, and a network for training and supervision centers established during COVID-19, enabling rapid cascade training, microplanning, and crisis-sensitive communication.
Results: HPV vaccination was introduced nationwide despite conflict. Around 401,000 girls were targeted, reaching 13% coverage in the first two months of the campaign. Over 20,300 healthcare workers were trained through 671 in-person sessions, with statistically significant improvement in knowledge scores. Two adverse events were reported, none serious.
Lessons: Introduction of new vaccines during conflict is feasible when built on prior system strengthening. Institutionalized decision-making, innovative procurement, and sustained investments in coordination, training, and supervision enabled adaptive implementation. This highlights the importance of continuous health system strengthening to build resilience and offers lessons for other crisis-affected settings. Rationale to prioritize HPV over other non-covered antigens deserves further analysis.
Key messages: • HPV vaccination can be introduced during war using strong coordination, evidence-based policy tools, and integration into routine services.
• Pre-crisis investments in NITAG, HTA, procurement, and workforce training enable rapid vaccine introduction in crisis settings.
Related
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- Conducting a RCT during wartime in Ukraine: methodological implications and lessons learnt
- Alcohol use in Ukraine: evidence of polarisation during wartime (2023–2024 comparative analysis)
- Dual and polyuse of nicotine and tobacco products among adolescents in wartime Ukraine
- Effect of HPV Vaccine Introduction at 9-10 years: A Randomized Clinical Trial
BibTeX
@article{grechukha2026wartime,
title = {{Wartime HPV vaccine introduction in Ukraine: strategy, results and lessons}},
author = {G Grechukha and S Gaievskyi and D Nestor and D Deineha and O Bondarenko and O Koshalko and O Zaika and L Pavliuk and F Lapii and J Habicht},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.284},
url = {https://doi.org/10.1093/eurpub/ckag169.284},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Wartime HPV vaccine introduction in Ukraine: strategy, results and lessons
AU - G Grechukha
AU - S Gaievskyi
AU - D Nestor
AU - D Deineha
AU - O Bondarenko
AU - O Koshalko
AU - O Zaika
AU - L Pavliuk
AU - F Lapii
AU - J Habicht
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.284
UR - https://doi.org/10.1093/eurpub/ckag169.284
AB - Issue: Cervical cancer is among the top five cancers in women in Ukraine, causing approximately 3,300 cases and over 1,100 deaths annually. Ukraine remains one of the few countries in the European Region that has not yet introduced the HPV vaccine into the national immunization schedule. Introducing HPV vaccination under wartime conditions is critical to reducing the long-term cancer burden and strengthening public trust in the health system more broadly. Practice: In January 2026, Ukraine introduced single-dose HPV vaccination nationally for girls aged 12–13. The strategy combined evidence-based policy, strong coordination, and integration into routine primary healthcare. Key tools included National Immunization Technical Advisory Group recommendations, health technology assessment, and managed entry agreements for procurement. Implementation was supported by the strong national coordination mechanism, an operational plan covering core program components, and a network for training and supervision centers established during COVID-19, enabling rapid cascade training, microplanning, and crisis-sensitive communication. Results: HPV vaccination was introduced nationwide despite conflict. Around 401,000 girls were targeted, reaching 13% coverage in the first two months of the campaign. Over 20,300 healthcare workers were trained through 671 in-person sessions, with statistically significant improvement in knowledge scores. Two adverse events were reported, none serious. Lessons: Introduction of new vaccines during conflict is feasible when built on prior system strengthening. Institutionalized decision-making, innovative procurement, and sustained investments in coordination, training, and supervision enabled adaptive implementation. This highlights the importance of continuous health system strengthening to build resilience and offers lessons for other crisis-affected settings. Rationale to prioritize HPV over other non-covered antigens deserves further analysis. Key messages: • HPV vaccination can be introduced during war using strong coordination, evidence-based policy tools, and integration into routine services. • Pre-crisis investments in NITAG, HTA, procurement, and workforce training enable rapid vaccine introduction in crisis settings.
SN - 1101-1262
SN - 1464-360X
ER -