The European Commission on 31 January put forward a Recommendation to support EU Member States in their efforts to prevent cancer through vaccination. Notably, it focuses on boosting the uptake of two key vaccinations that can prevent viral infections that may lead to cancer: against Human papillomaviruses (HPV) and Hepatitis B virus (HBV), as well as improving the monitoring of coverage rates.
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Why does the Commission focus on vaccination as a key tool for cancer prevention?
Vaccination against both Human Papillomaviruses (HPV) and Hepatitis B virus (HBV) can prevent viral infections that may lead to cancers. Vaccination is therefore key to protect individual and public health and to support resilient and fair public health systems.
The Commission is supporting Member States in reaching the goal set in Europe’s Beating Cancer Plan, to fully vaccinate at least 90% of the target population of girls against HPV and to significantly increase the vaccination of boys by 2030.
The Commission also wants to support Member States to boost HBV vaccination uptake and prevent diseases caused by the virus, including liver cancer.
What does the Commission recommend on HPV and Hepatitis B vaccination?
The Commission has put forward several concrete recommendations to support Member States in increasing the uptake of HPV vaccination amongst girls and boys and to support Member States ensure access to vaccination against Hepatitis B:
- Strengthen HPV and HBV vaccination programmes as part of national immunisation programmes, and integrate such vaccinations in cancer prevention programmes;
- Improve the monitoring of vaccination coverage rates through electronic vaccination registries in full compliance with the General Data Protection Regulation;
- Strengthen national efforts to reach, by 2030, the target of fully vaccinating at least 90% of adolescent/pre-adolescent girls and significantly increase the vaccination of boys. This can include offering vaccination to adolescent and preadolescent girls and boys in schools and educational settings.
- Define a concrete goal for the percentage of boys that should be vaccinated by 2030, in parallel to the one for girls.
- Specifically for HBV, strengthen national efforts to reach the 2030 targets set by WHO:
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- 95% vaccination coverage (3rd dose) of childhood HBV vaccination;
- 95% of pregnant women screened for hepatitis B;
- 95% of newborns who received timely (within 24 hours of birth) HBV birth-dose vaccination, including by strengthening systems for the monitoring of progress towards those targets and by making use of available support from ECDC if needed.
- Continue targeted communication and outreach efforts, including to disadvantaged groups, and high-risk groups to highlight and explain the benefits of vaccination;
- Engage with and exchange best practices with other Member States on increasing vaccination uptake, including in the context of the Commission’s Public Health Expert Group.
Why is it important that girls and boys get vaccinated against HPV?
HPV is the most common viral infection of the reproductive tract and can cause a range of conditions in both women and men. Most HPV infections are asymptomatic and disappear spontaneously, but some result in diseases, including cervical, vulvar, vaginal, penile, anal and certain head-and-neck cancers. For cervical cancer alone, there are around 28,600 cases and 13,700 deaths every year in EU/EEA countries.
The HPV vaccines approved and used in the EU have shown to prevent more than 90% of the precancerous lesions caused by the virus. All vaccines licensed in Europe protect against the HPV types associated with over 70% of all cervical cancer cases worldwide. Together with screening, vaccinating girls and boys against HPV is therefore highly effective in preventing cancers that can occur later in life.
How widespread is vaccination against HPV in the EU today?
All EU Member States recommend vaccinating adolescent and preadolescent girls against HPV. Many also already recommend it for boys of those age groups. Some countries are extending the recommendations to also cover young adults who did not get vaccinated during adolescence or preadolescence.
However, vaccination coverage rates vary significantly across the EU. For example, a few EU Member States have vaccinated 90% or more of adolescent and preadolescent girls, whereas this figure remains below 50% in others, and in some Member States it is as low as 1%. There is currently limited data available for vaccination uptake in boys and young adults.
Why is it important to vaccinate against the Hepatitis-B virus (HBV)?
HBV is a bloodborne virus that is transmitted from infected mothers to children, or through sexual intercourse, unsafe drug injections, contaminated blood or poor healthcare settings. Across the EU/EEA and the UK, HBV and HCV infections are responsible for approximately 55% of all liver cancer deaths and 45% of all deaths due to cirrhosis and other chronic liver diseases. This amounts to around 64,000 deaths annually.
How widespread is vaccination against HBV in the EU today?
Most EU Member States recommend the vaccination of all children against HBV. In addition, countries have various strategies in place to prevent vertical transmission, including screening of pregnant women, vaccination within 24 hours of birth, and preventative measures for children born to HBV-infected mothers.
The World Health Organization (WHO) has put forward the targets on HBV that should be reached by 2030: 95% childhood vaccination coverage, 95% of pregnant women screened, and 95% of newborns receiving HBV vaccination within 24 hours of birth. However, many EU Member States still have some way to go to reach these targets.
Many EU Member States also recommend vaccination for high-risk groups, such as people who inject drugs, prison populations and migrants from countries where HBV is endemic, as well as for health professionals. However, more data is needed on this vaccination uptake.
How will the Commission boost HBV vaccination rates in the EU?
The proposed Council Recommendation contains recommendations to Member States to strengthen national efforts to reach the WHO 2030 targets (see above).
Member States are also recommended to adapt vaccination services to the needs of different target groups, including by offering vaccination in local settings and by targeting high-risk groups.
What support will be provided by the Commission?
The Commission plans to carry out a series of actions to support EU Member States in implementing the Recommendation on vaccine-preventable cancers.
- On communication, the Commission is ready to help Member States with evidence-based awareness-raising campaigns, including on social media to reach younger audiences, on the importance of HPV and HBV vaccination, adaptable to national challenges and needs. It will also ask the European Medicines Agency (EMA) and the European Centre for Disease Control (ECDC) to communicate regularly on the safety and effectiveness of the HPV and HBV vaccines, including through the European Vaccination Information Portal.
- On monitoring, the Commission plans to support EU Member States in developing or upgrading electronic vaccination registries, including by mapping national approaches across the EU and discussing successful ones with Member States. The Commission will also support Member States in streamlining their vaccination administrative procedures, including by sharing and discussing national approaches. In addition, the Commission will ask the ECDC to create a dashboard of national data on HPV and HBV in the Member States by the end of 2024, together with national monitoring methodologies and targets. In collaboration with ECDC, the Commission will also continue to develop state-of-the-art guidance to EU Member States on building or upgrading electronic vaccination registries to improve and strengthen the monitoring of vaccination coverage rates.
- The Commission also intends to continue to promote research, development and innovation in relation to HPV and HBV vaccines, including through the Horizon Europe programme. It will also support action to promote HPV and HBV vaccination at global level, together with international partners, such as the WHO, the OECD and UNICEF.
What is the Commission doing to tackle mis- and disinformation around vaccination?
The spread of mis- and disinformation around vaccination can affect confidence and ultimately the uptake of vaccination. To tackle this, the Commission and EU agencies regularly publish reliable, science-based information across all channels and through trusted multipliers, such as healthcare professionals.
Through the United in Protection awareness-raising campaign, the Commission monitors social and traditional media for conversations about vaccination to identify new and emerging false narratives that could impact public health.
These efforts fit into the Commission’s wider approach to addressing online disinformation and information manipulation through the European Democracy Action Plan and the Digital Services Act.
The Commission intends to develop a model for evidence-based awareness-raising campaigns on the importance of HPV and HBV vaccination as cancer prevention tools, adaptable to national challenges and needs, with a strategy to continue monitoring and addressing mis- and disinformation.
Proposal for a Council recommendation on vaccine-preventable cancers
Factsheet “Europe’s Beating Cancer Plan: Making a difference”
Factsheet on vaccination coverage
European Cancer Inequalities Registry
Source: European Commission
