Work

Vaccine Confidence, Healthcare Digitalization, and HPV Vaccination Coverage Across EU Countries

Year: 2026

Type: article

Abstract: Background HPV vaccination coverage remains highly heterogeneous across EU member states, most lagging behind the 90% target set by the 2024 EU Council Recommendation. This study assesses the independent associations of HPV vaccine confidence and healthcare system digitalization with vaccination coverage across EU countries in 2022. Methods First-dose female HPV vaccination coverage by age 15 was obtained from the WHO data portal (2022) for 23 EU countries (four excluded due to missing data). A composite HPV vaccine confidence score (0–100) was derived from the State of Vaccine Confidence in the EU 2022 report as the mean of four country-level items (importance, safety, efficacy, and belief compatibility), justified by their high inter-correlation (r = 0.89–0.97). The Digital Economy and Society Index (DESI 2022) score (0-100) was used a proxy for healthcare system digitalization acting as a measure of systemic digital maturity and the capacity of public infrastructures to support healthcare services. Pearson correlations and multiple linear regression were conducted. Results Mean coverage was 70.5% (±19.5%), ranging from 10% (Bulgaria) to 96% (Portugal). Mean confidence score was 75.3 (±7.5) and mean DESI 54.9 (±8.1). Vaccine confidence correlated moderately with coverage (r = 0.60, p = 0.002), as did DESI (r = 0.55, p = 0.006). In the multiple regression model, a 10-unit increase in confidence score was associated with a 13.6 (95%CI 5.5; 21.8) percentage increase in coverage, and a 10-point increase in DESI with 11.1 (95% CI 3.6; 18.5) percentage point increase. Conclusions Higher vaccine confidence and greater healthcare digitalization are associated with higher coverage levels, independently of each other. These findings highlight the need for integrated strategies combining targeted communication with investments in digital health systems to improve uptake. Key messages • EU countries with higher HPV vaccine confidence show significantly greater first-dose coverage. • Healthcare system digitalization independently contributes to HPV vaccination coverage, highlighting the role of health information infrastructure as a public health lever.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckag169.595

Authors: E Peruzzo, C Colombo, AM Pezzullo

Institution: Università Cattolica del Sacro Cuore

Language: English

Topic: Cervical Cancer and HPV Research

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,181