Reliable, comprehensive vaccination registries or equivalent data systems are a foundational condition for monitoring HPV vaccination coverage over time, identifying gaps across populations, and enabling timely programme management and corrective action.
HPV vaccination programmes target different age groups and delivery platforms compared with routine infant immunisation, and a reduction in HPV cancer incidence cannot be detected for a significant time after the vaccine has been introduced in a country [1]. WHO guidance highlights that HPV vaccine coverage data is essential to guide strategy and interpret impact, and that monitoring HPV vaccination presents unique challenges due to wide age eligibility, multiple delivery settings, and doses delivered outside routine public-sector systems, reinforcing the need for comprehensive registries or equivalent data systems [1, 2].
European experience shows substantial variation in the availability, completeness, and functionality of vaccination registries, with implications for the ability to measure and manage HPV vaccination performance [3]. ECDC analyses of immunisation information systems (IIS) across EU and EEA countries highlight differences in whether countries can routinely monitor HPV vaccination coverage by age and sex, identify under-vaccinated groups, and use data to support programme oversight [4].
Interoperable vaccination data systems enable HPV vaccination data to be linked, shared, and used across relevant health and administrative systems, which is fundamental to coordinated programme management and policy decision making
Once HPV vaccination data is captured, its value depends on whether it can be linked and used across systems involved in delivery, follow up, and planning. WHO guidance highlights that HPV vaccination programmes often involve multiple actors and settings, and that fragmented data systems limit the ability to coordinate programme management and decision making beyond basic coverage reporting [1,2]. This includes linkage with health management information systems, population or civil registration systems, education systems (when school-based delivery is used), and cancer screening and cancer registries [2,5].
European experience shows that differences in system interoperability affect whether vaccination data can be shared and used across the health system and relevant public services. ECDC analyses describe variation in the extent to which IIS interface with other health and administrative systems [3,4]. This shapes whether vaccination data can support coordinated oversight, planning, and evaluation across health, education, and other delivery settings, rather than remaining confined to stand-alone registries.
Recent European Joint Action work illustrates this variation. The PERCH project assessed countries’ capacity to collect individual-level HPV vaccination data and link these records with cervical cancer screening and cancer registries, documenting wide differences across EU Member States, from countries with established national linkage to others where linkage is partial, not yet operational, or not planned, often due to technical, legal or administrative barriers [6].
Technical guidance on immunisation systems identifies interoperability as a core design feature that enables data linkage, reduces duplication, and improves the efficiency and usability of vaccination data for public health action [4,5]. Interoperable, individual level IIS can also support operational functions such as reminder-recall, helping programmes identify and follow up individuals who are due or overdue for HPV vaccination. Where systems are not interoperable, data use is constrained to basic coverage reporting, limiting their contribution to coordinated programme management.
The availability and interoperability of HPV vaccination data are necessary but not sufficient. Vaccination data only drives programme improvement when it is routinely reported, reviewed, and acted upon through clear feedback and accountability mechanisms.
Global immunisation guidance consistently emphasises that vaccination data are intended to inform programme review and decision making, rather than serving solely as a reporting function. Frameworks such as Immunization Agenda 2030 highlight the importance of using immunisation monitoring data within regular review and feedback processes to support accountability and course correction over time [7]. HPV-specific guidance further frames coverage reporting as a practical tool to assess progress, identify gaps in uptake, and adapt delivery strategies, particularly given the long time-lag before the impact of vaccination on disease outcomes can be observed [1].
Explicit vaccination targets and transparent reporting mechanisms provide a concrete basis for accountability and corrective action [7]. In the European context, the European Code Against Cancer frames HPV vaccination programmes as needing to be resourced and monitored to reach the 90% coverage target for both girls and boys [8]. Translating such targets into routine reporting dashboard-style monitoring helps make progress visible, enables performance review, and clarifies responsibility for action when coverage falls short [3]. Reporting national data through ECDC monitoring and reporting mechanisms can support regional comparison, accountability, and programme improvement.
Ultimately, being able to demonstrate to the general public how vaccination and screening uptake reduces the burden of HPV cancers is a way to communicate the value of these interventions and can play a part in generating confidence in immunisation programmes.
