Cangelosi Giovanni, Sacchini Francesco, Mancin Stefano, Petrelli Fabio, Amendola Antonella, Fappani Clara, Sguanci Marco, Morales Palomares Sara, Gravante Francesco, Caggianelli Gabriele
Experimental Medicine and Public Health Unit, School of Pharmacy, University of Camerino, 62032 Camerino, Italy.
Department of Nursing, Polytechnic University of Ancona, 60121 Ancona, Italy.
Vaccines (Basel). 2025 Apr 25;13(5):460. doi: 10.3390/vaccines13050460.
BACKGROUND/OBJECTIVES: Human papillomavirus (HPV) is a leading cause of cervical cancer. Despite the proven effectiveness of vaccination programs, global coverage remains uneven, with significant disparities across regions due to various socioeconomic, cultural, and political factors. This study explores the primary barriers to HPV vaccination worldwide and proposes recommendations to improve access to screening and vaccination programs.
A systematic literature review was conducted, analyzing studies published in the past ten years from databases such as PubMed, Scopus, and Embase, following the PRISMA methodology. Study selection involved multiple researchers, with discrepancies resolved through consultation. The quality of the included studies was assessed using CASP checklists. The protocol was registered on Open Science Framework (OSF).
Out of 2119 records, eight studies were included. The findings indicate that the main barriers to HPV vaccination include insufficient public awareness, cultural and religious resistance, financial constraints, and limited access in rural and underserved areas. Additionally, political factors, such as low prioritization of HPV vaccination and the absence of supportive policies, were identified as significant obstacles. Multidisciplinary and cross-cultural collaboration, along with the integration of HPV vaccination into existing health programs, was suggested as a strategic approach to improve vaccine uptake.
Barriers to HPV vaccination, including limited awareness, inadequate healthcare infrastructure, and socioeconomic factors, vary across regions but must be addressed to improve global coverage. Targeted interventions such as health education, inclusive policies, and culturally sensitive campaigns can significantly boost vaccine uptake. Strengthening local health systems and fostering international collaboration are key strategies to overcoming these barriers and ensuring equitable access to HPV vaccination.
背景/目标：人乳头瘤病毒（HPV）是宫颈癌的主要病因。尽管疫苗接种计划已被证明有效，但全球覆盖率仍不均衡，由于各种社会经济、文化和政治因素，各地区存在显著差异。本研究探讨了全球HPV疫苗接种的主要障碍，并提出了改善筛查和疫苗接种计划可及性的建议。
按照PRISMA方法，进行了系统的文献综述，分析了过去十年在PubMed、Scopus和Embase等数据库中发表的研究。研究筛选由多名研究人员参与，通过协商解决分歧。使用CASP清单评估纳入研究的质量。该方案已在开放科学框架（OSF）上注册。
在2119条记录中，纳入了八项研究。研究结果表明，HPV疫苗接种的主要障碍包括公众意识不足、文化和宗教抵制、经济限制以及农村和服务不足地区的可及性有限。此外，政治因素，如HPV疫苗接种的优先级低和缺乏支持性政策，被确定为重大障碍。建议采用多学科和跨文化合作，以及将HPV疫苗接种纳入现有卫生计划，作为提高疫苗接种率的战略方法。
HPV疫苗接种的障碍，包括认识有限、医疗保健基础设施不足和社会经济因素，因地区而异，但必须加以解决以提高全球覆盖率。有针对性的干预措施，如健康教育、包容性政策和具有文化敏感性的宣传活动，可以显著提高疫苗接种率。加强地方卫生系统和促进国际合作是克服这些障碍并确保公平获得HPV疫苗接种的关键战略。
