Vaccines are among the most powerful tools in modern medicine, preventing millions of deaths every year. Human Papillomavirus (HPV) vaccines are highly effective: they protect against cancer-causing viral genotypes and, when coverage is high, reduce the circulation of the virus across populations. Yet vaccines only work if we know who has received them, and too often we don’t.
Fragmented, outdated, or absent immunisation registries leave policymakers and public health departments flying blind. Without strong surveillance to track coverage, we cannot measure impact, target gaps, or make progress toward eliminating cervical cancer and the eight other HPV-related cancers.
The Elimination Imperative
The World Health Organization (WHO) aims to eliminate cervical cancer as a public health problem, with bold milestones this decade for HPV vaccination, cervical screening, and treatment. Many countries that have adopted school-based, universal HPV vaccination are expected to simplify delivery and broaden reach.
However, without accurate records, it is difficult to confirm whether HPV vaccination programmes are reaching intended populations or to plan equitable catch-up campaigns for those missed.
The Data Problem
Immunisation registries should be the backbone of vaccination programmes; yet implementation is inconsistent. Countries such as Denmark, Australia, and the United Kingdom operate centralised systems that allow real-time monitoring of HPV vaccine uptake, enabling timely analysis of trends and effective responses to emerging coverage gaps. In contrast, Canada and Germany rely on incomplete or regional data collected through periodic surveys, providing only snapshots rather than continuous monitoring. This inconsistency hinders comparison, obscures missed populations, and limits evaluation of programme impact.
Weak data systems lead to:
- Missed cohorts: It becomes difficult to identify individuals who were never offered, declined, or missed the vaccine.
- Inefficient catch-up: Without reliable data, targeted campaigns risk becoming expensive and labour-intensive, while still missing many eligible individuals.
- Hidden inequities: Registries help identify disparities by region, income, and migrant status. Without this data, inequities remain hidden, and opportunities to vaccinate are lost.
Even well-resourced programmes fail when they can’t measure who’s left unprotected.
A Global Challenge to Get on Top of HPV Prevention
Even in countries with strong school-based vaccination systems, fragmented data infrastructure undermines the ability to measure success and ensure equity. The paradox is that while delivery systems may excel, weak data systems make it impossible to adapt strategies or demonstrate progress toward elimination goals.
Globally, data interoperability is the missing link. Without shared standards and integrated reporting, countries cannot gain a full picture of HPV vaccine uptake or compare progress across borders. Policymakers are left “flying blind” when planning procurement, designing communication campaigns, or evaluating initiatives.
Across Europe, progress is similarly uneven. While countries such as Denmark, the United Kingdom, and Norway have developed robust, centralised registries, others depend on decentralised systems or periodic coverage surveys. This variability undermines collective efforts to track progress toward regional and global targets for cervical cancer elimination.
Why Strong Data Systems Matter
Robust immunisation registries do more than measure coverage. They:
- Reduce vaccine waste through accurate forecasting of demand and inventory.
- Strengthen accountability by making vaccination rates transparent to the public and policymakers.
- Enable targeted communication by identifying groups with lower uptake.
- Support innovation by providing evidence to evaluate new schedules, such as one-dose programmes, in real time.
Data systems are not a technical afterthought; they are central to the success of HPV vaccination programmes and to the global goal of eliminating cervical cancer.
Recommendations: Building a strong backbone
What should and could be done?
- Invest in interoperable registries: Governments must prioritise funding for digital, secure, and standardised immunisation surveillance systems that connect across regions and sectors.
- Improve public reporting: Transparent publication of vaccine coverage builds trust, informs debate, and holds data systems accountable.
- Link registries with procurement and planning: Accurate data improves forecasting and reduces costs in public tenders.
- Pair vaccination with monitoring: Every new initiative should be accompanied by transparent measurement frameworks.
The path to cervical cancer elimination does not end with the HPV vaccine, it depends on knowing where protection is reaching and where it is not. Europe’s fragmented immunisation data reveal that even the best programmes can stumble without strong registries. The lesson is universal: elimination requires both vaccines and information. Reliable, connected data systems ensure every eligible person is counted, every dose is delivered, and no one is left behind.
Authors:
Amélie McFadyen is CEO of HPV Global Action
Teresa Norris is Founder and President of HPV Global Action
Marc Steban is Co-President of HPV Global Action
Zeev Rosberger is Vice-President of HPV Global Action
