HPV vaccination coverage trends in women across 11 EU countries: a joinpoint analysis
Abstract
Background: Disparities in female HPV vaccination coverage across Europe highlight the critical role of contextual and structural determinants beyond mere vaccine access. This study examines temporal coverage trends across 11 EU countries from 2010 to 2024 using joinpoint regression, evaluating their descriptive associations with delivery model architecture, programmatic stability, and crisis management.
Methods: Annual female HPV coverage data were retrieved from WHO/ECDC databases for 11 countries (Denmark, France, Germany, Ireland, Italy, Latvia, Luxembourg, Netherlands, Portugal, Slovenia, Spain). Joinpoint regression estimated the Annual Percent Change (APC) per trend segment (p < 0.05). Correlations with policy variables were explored descriptively, without direct causal inference.
Results: Coverage ranged from ∼15% (Denmark, 2015) to 93% (Portugal, 2024). Portugal and Spain achieved the highest levels (>90%, ∼88%), whereas Italy and France remained persistently below 50%; Italy recorded a significant decline (2016–2021, APC −4.81%) and recent partial recovery (APC +7.01%). Denmark and Ireland displayed V-shaped trajectories, while Germany and Luxembourg showed volatile but increasing trajectories, whereas Slovenia remained broadly stable. Latvia declined early (APC −6.57%) then partially recovered (APC +1.63%), and Netherlands displayed a uniform linear trend over the entire period (APC +0.58%).
Conclusions: The stark contrast between the high coverage in Portugal and Spain (≥90%) and the persistently low uptake in France (<45%) suggests that national policy architecture is a primary driver of vaccination success. Such disparities emphasize the need for comparative policy analysis to identify transferable practices across European health systems. Additionally, marked temporal trends in countries like Denmark highlight the necessity of investigating the contextual factors that shape coverage trajectories over time.
Key messages: • Between 2010 and 2024, HPV vaccination coverage across 11 EU countries followed markedly different trajectories, ranging from ∼15% (Denmark, 2015) to 93% (Portugal, 2024).
• The contrast between high-performing and low-coverage EU countries highlights the value of identifying transferable policy practices to improve HPV vaccination across European health systems
Related
- Vaccine Confidence, Healthcare Digitalization, and HPV Vaccination Coverage Across EU Countries
- Patterns, distributions and predictors of human papillomavirus vaccination coverage among girls across 31 African countries
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- Hepatitis B vaccination coverage and factors associated with higher uptake among children aged 5–35 months in eight selected sub-Saharan African countries: a multilevel ordinal logistic regression analysis
- Optimising HPV Vaccination for Cervical Cancer Prevention in Women Living with HIV: A Cost-Effectiveness Analysis Across 13 African Countries
BibTeX
@article{medico2026vaccination,
title = {{HPV vaccination coverage trends in women across 11 EU countries: a joinpoint analysis}},
author = {M Del Medico and T Scirocco and PE Risuleo and D D’Addario and V De Vita and GE Calabrò},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.634},
url = {https://doi.org/10.1093/eurpub/ckag169.634},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - HPV vaccination coverage trends in women across 11 EU countries: a joinpoint analysis
AU - M Del Medico
AU - T Scirocco
AU - PE Risuleo
AU - D D’Addario
AU - V De Vita
AU - GE Calabrò
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.634
UR - https://doi.org/10.1093/eurpub/ckag169.634
AB - Background: Disparities in female HPV vaccination coverage across Europe highlight the critical role of contextual and structural determinants beyond mere vaccine access. This study examines temporal coverage trends across 11 EU countries from 2010 to 2024 using joinpoint regression, evaluating their descriptive associations with delivery model architecture, programmatic stability, and crisis management. Methods: Annual female HPV coverage data were retrieved from WHO/ECDC databases for 11 countries (Denmark, France, Germany, Ireland, Italy, Latvia, Luxembourg, Netherlands, Portugal, Slovenia, Spain). Joinpoint regression estimated the Annual Percent Change (APC) per trend segment (p < 0.05). Correlations with policy variables were explored descriptively, without direct causal inference. Results: Coverage ranged from ∼15% (Denmark, 2015) to 93% (Portugal, 2024). Portugal and Spain achieved the highest levels (>90%, ∼88%), whereas Italy and France remained persistently below 50%; Italy recorded a significant decline (2016–2021, APC −4.81%) and recent partial recovery (APC +7.01%). Denmark and Ireland displayed V-shaped trajectories, while Germany and Luxembourg showed volatile but increasing trajectories, whereas Slovenia remained broadly stable. Latvia declined early (APC −6.57%) then partially recovered (APC +1.63%), and Netherlands displayed a uniform linear trend over the entire period (APC +0.58%). Conclusions: The stark contrast between the high coverage in Portugal and Spain (≥90%) and the persistently low uptake in France (<45%) suggests that national policy architecture is a primary driver of vaccination success. Such disparities emphasize the need for comparative policy analysis to identify transferable practices across European health systems. Additionally, marked temporal trends in countries like Denmark highlight the necessity of investigating the contextual factors that shape coverage trajectories over time. Key messages: • Between 2010 and 2024, HPV vaccination coverage across 11 EU countries followed markedly different trajectories, ranging from ∼15% (Denmark, 2015) to 93% (Portugal, 2024). • The contrast between high-performing and low-coverage EU countries highlights the value of identifying transferable policy practices to improve HPV vaccination across European health systems
SN - 1101-1262
SN - 1464-360X
ER -