Abstract
BACKGROUND/OBJECTIVES: Human papillomavirus (HPV) vaccination programs play a critical role in the primary prevention of HPV-related diseases, including cervical cancer. However, the principles governing the implementation of these programs vary across European Union (EU) countries. The objective of this study was to analyze and compare the strategies for implementing HPV vaccination programs across the EU, with a focus on access, vaccine selection, and procurement processes. METHODS: This study utilized a comprehensive review of official websites from government bodies, public health organizations, and dedicated vaccination platforms in each of the 27 EU member states. Additionally, a search of Tenders Electronic Daily (TED) was conducted to examine the criteria used in tendering processes for vaccine suppliers involved in national HPV vaccination programs. RESULTS: All 27 EU countries provide public funding for HPV vaccination, with 26 countries offering free vaccination for both girls and boys. In 22 of these countries, the nine-valent HPV vaccine is the only option available for free under national programs. Estonia and Ireland are exceptions, where a single dose of Gardasil 9 is administered. Most countries adhere to the approved vaccination schedules, though slight variations exist. The predominant criterion for selecting vaccine suppliers in national tenders is the lowest price offered. CONCLUSIONS: HPV vaccination programs across the EU are uniformly funded through public health systems, yet access to free vaccination and specific program details vary by country. These variations reflect the diverse healthcare systems and procurement strategies in place, which can impact the systemic approach to HPV prevention. Further harmonization of vaccine procurement and implementation strategies may enhance the effectiveness and equity of HPV vaccination across Europe.