Recently, major progress on HPV vaccination has been made by a research team led by Zhu Lan, Director of the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital (PUMCH), and researcher Chen Hongda, Director of the Center for Prevention and Early Intervention, Institute of Clinical Medicine, PUMCH. The team systematically assessed the current status of global HPV immunization programs. They found that although most countries have incorporated the HPV vaccine into their national immunization programs, global HPV vaccination coverage remains significantly below the World Health Organization (WHO) target of "90% of girls fully vaccinated with the HPV vaccine by the age of 15 by 2030". The research findings were published in eClinicalMedicine, a journal in the family of the prestigious The Lancet, providing important basis for optimizing global HPV vaccination strategies. This study was supported by the National High Level Hospital Clinical Research Funding, among others.
Cervical cancer is one of the malignant tumors with high incidence and mortality rates among women globally. HPV vaccination is a key measure for preventing cervical cancer and other HPV-related diseases, but comprehensive studies on global HPV vaccination coverage remain scarce. The research team performed a comprehensive search of PubMed, Embase, WHO databases, and relevant institutional websites to collect and analyze HPV vaccination policies and coverage rate data from all 194 WHO member states. They focused on analyzing trends in HPV vaccination coverage from 2010 to 2023 and evaluated cervical cancer incidence rates during the same period in 15 early-adopter countries of HPV vaccines.
▲Key milestones in the development of the HPV vaccination
According to the study, as of February 28, 2025, 148 WHO member states have incorporated the HPV vaccine into their national immunization programs. In 2023, among countries that reported vaccination data, the weighted average coverage of the first and full dose of HPV vaccination in girls aged 9–14 years was 61.6% (95% CI: 50.9%–71.8%) and 47.6% (95% CI: 39.7%–57.4%) respectively. Among these countries, only fifteen reached a 90% coverage rate for the first dose. Coverage rates were significantly higher in upper-middle-income countries than lower-middle-income countries. In China, vaccination coverage peaked in women aged 20-24, while coverage in the 9-14 age group still had considerable room for improvement. Time trend analysis demonstrated that in most assessed countries, cervical cancer incidence is showing a declining trend.
▲Global status of the HPV vaccine introduction into national immunization programs by year of introduction in 2024
The study also conducted a comprehensive review of the 46 countries that have not yet incorporated the HPV vaccine into their national immunization programs; among them, 13 countries (28%) have initiated or are preparing for pilot programs, with 11 having completed one or more pilots. Countries that have not yet taken action typically recommend the target population (girls aged 9-14) to receive vaccination at their own expense.
This study provides an important basis for identifying, developing, and implementing more feasible HPV vaccination strategies. Director Zhu Lan stated that in some low-income and lower-middle-income countries, vaccine introduction and promotion still face significant financial challenges, and that collaborative efforts of all parties are crucial for addressing vaccination disparities and promoting health equity. The team will continue to focus on prevention and early intervention research for cervical cancer, working towards the elimination of cervical cancer.
The first author of this article is Han Jingjing, a master's student at the School of Population Medicine and Public Health, Peking Union Medical College. The co-first authors are Zhang Li, Assistant Professor at the School of Population Medicine and Public Health, and Chen Yuqing, a master's student in Epidemiology and Health Statistics at PUMCH.
Pictures courtesy of Zhu Lan
Edited by Chen Xiao and Wang Jingxia