Health technology assessments on human papillomavirus vaccinations in Europe: A survey from VENICE network

Background: VENICE II is a project funded in 2008 by the European Centre for Disease Prevention and Control to collect information on the national vaccination programmes, to increase their knowledge and to know the impact of new vaccines introduced in member states (MS). In 2006-2007, two vaccines against human papillomavirus (HPV) were authorized in Europe. Methods: An online survey was carried out to investigate the decision-making process undertaken regarding the potential introduction of the HPV vaccinations into MS national immunization programmes as well as to investigate the modalities of implementation of the vaccination programmes. There were specific questions about health technology assessment and reports of the countries that had carried them out were reviewed. Results: In 21 of the 29 MS, the national advisory body recommended to introduce HPV vaccination in their national immunization schedule and in 18 countries introduced it. Only 6 countries have realized a health technology assessments (HTA) report, each one with different methodology, but in all of them both vaccines show positive evaluations. Conclusion: From the available HTA, HPV vaccination is cost-effective under the assumption of a lifelong protection. Screening programme for cervical cancer and HPV vaccination programme should be always complementary. Organizational aspects need to be taken into account to improve the vaccination. HPV vaccination should target girls before the debut of their sexual life. Instead HPV vaccination of boys has not been demonstrated as bringing significant epidemiological benefits and has not been shown as being cost-effective.