---
title: "HPV vaccination coverage in Campania: socioeconomic gaps and territorial variation (2006–2023)"
id: "pubmed-42763966"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42763966"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42763966/"
doi: "10.1016/j.vaccine.2026.129169"
published_at: "2026-10-24T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# HPV vaccination coverage in Campania: socioeconomic gaps and territorial variation (2006–2023)
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42763966
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42763966/)
- **DOI:** [10.1016/j.vaccine.2026.129169](https://doi.org/10.1016%2Fj.vaccine.2026.129169)
- **Published At:** 2026-10-24T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The authors conducted a population-based longitudinal ecological study in the **Campania** Region covering 2006–2023 and the 1997–2011 birth cohorts. - Immunisation registry records were linked with demographic data, the 2011 **Deprivation Index (DI)**, and vaccination-centre density at Health District (HD) level. - Outcomes assessed: one-dose coverage, full-immunisation coverage, and catch-up coverage (≥1 dose after age 18). - Mixed-effects linear regression models were fitted with HDs nested within Local Health Authorities (LHAs) as random intercepts. - Overall coverage stayed below recommended targets for both sexes across cohorts. - Female peak cohort coverage: one dose 68.5% (2005 cohort); full immunisation 62.2% (2002 cohort); catch-up 2.2% (1998 cohort). - Male peak cohort coverage: one dose 41.1% (2007 cohort); full immunisation 29.9% (2007 cohort); catch-up 0.6% (1999–2002 cohorts). - Coverage varied across LHAs and HDs in ways not explained by vaccination-centre density. - Higher deprivation was associated with lower male one-dose and full-immunisation coverage (coefficients: -1.56 [-2.83 | -0.29] and -1.36 [-2.35 | -0.37]). - Among females, routine coverage did not associate with deprivation, but catch-up coverage was negatively associated with deprivation (coeff: -0.057 [-0.094 | -0.020]). - The authors concluded that territorial heterogeneity and socio-economic inequalities shape **HPV vaccination** uptake in Campania, with routine female uptake less affected by deprivation—supporting equity aims of a universal, actively offered programme. - The abstract did not report detailed study limitations or specific local interventions; the full text would be required for those particulars.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 20. # Influence of socio-economic inequalities and healthcare organisation on HPV vaccination coverage in both sexes in the Campania region: A population-based study between 2006 and 2023 [Michelangelo Mercogliano](https://pubmed.ncbi.nlm.nih.gov/?term=Mercogliano+M&cauthor_id=42763966)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-1 "National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Department of Public Health, University of Naples "Federico II", Naples, Italy. Electronic address: michelangelo.mercogliano@unina.it."), [Paolo Montuori](https://pubmed.ncbi.nlm.nih.gov/?term=Montuori+P&cauthor_id=42763966)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-2 "Department of Public Health, University of Naples "Federico II", Naples, Italy."), [Francesco Bencivenga](https://pubmed.ncbi.nlm.nih.gov/?term=Bencivenga+F&cauthor_id=42763966)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-3 "Prevention and Public Health - Directorate General for Health Protection and Regional Health Service Coordination, Naples, Italy."), [Giuseppe Errico](https://pubmed.ncbi.nlm.nih.gov/?term=Errico+G&cauthor_id=42763966)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-4 "Institute of Psychology and Health and Social Care Research, Italy."), [Vincenzo Giordano](https://pubmed.ncbi.nlm.nih.gov/?term=Giordano+V&cauthor_id=42763966)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-5 "Medical Directorate, Sant'Anna and San Sebastiano National Hospital, Caserta, Italy."), [Maria Triassi](https://pubmed.ncbi.nlm.nih.gov/?term=Triassi+M&cauthor_id=42763966)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-6 "Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele University of Rome, Rome, Italy."), [Raffaele Palladino](https://pubmed.ncbi.nlm.nih.gov/?term=Palladino+R&cauthor_id=42763966)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#full-view-affiliation-7 "Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom; Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare \(CIRMIS\), Naples, Italy.") Affiliations Expand ### Affiliations * 1 National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Department of Public Health, University of Naples "Federico II", Naples, Italy. Electronic address: michelangelo.mercogliano@unina.it. * 2 Department of Public Health, University of Naples "Federico II", Naples, Italy. * 3 Prevention and Public Health - Directorate General for Health Protection and Regional Health Service Coordination, Naples, Italy. * 4 Institute of Psychology and Health and Social Care Research, Italy. * 5 Medical Directorate, Sant'Anna and San Sebastiano National Hospital, Caserta, Italy. * 6 Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele University of Rome, Rome, Italy. * 7 Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom; Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy. * PMID: **42763966** * DOI: [ 10.1016/j.vaccine.2026.129169 ](https://doi.org/10.1016/j.vaccine.2026.129169) Free article Item in Clipboard # Influence of socio-economic inequalities and healthcare organisation on HPV vaccination coverage in both sexes in the Campania region: A population-based study between 2006 and 2023 Michelangelo Mercogliano et al. Vaccine. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42763966/) . 2026 Oct 24:92:129169. doi: 10.1016/j.vaccine.2026.129169. Epub 2026 Sep 20. ### Authors [Michelangelo Mercogliano](https://pubmed.ncbi.nlm.nih.gov/?term=Mercogliano+M&cauthor_id=42763966)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-1 "National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Department of Public Health, University of Naples "Federico II", Naples, Italy. Electronic address: michelangelo.mercogliano@unina.it."), [Paolo Montuori](https://pubmed.ncbi.nlm.nih.gov/?term=Montuori+P&cauthor_id=42763966)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-2 "Department of Public Health, University of Naples "Federico II", Naples, Italy."), [Francesco Bencivenga](https://pubmed.ncbi.nlm.nih.gov/?term=Bencivenga+F&cauthor_id=42763966)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-3 "Prevention and Public Health - Directorate General for Health Protection and Regional Health Service Coordination, Naples, Italy."), [Giuseppe Errico](https://pubmed.ncbi.nlm.nih.gov/?term=Errico+G&cauthor_id=42763966)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-4 "Institute of Psychology and Health and Social Care Research, Italy."), [Vincenzo Giordano](https://pubmed.ncbi.nlm.nih.gov/?term=Giordano+V&cauthor_id=42763966)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-5 "Medical Directorate, Sant'Anna and San Sebastiano National Hospital, Caserta, Italy."), [Maria Triassi](https://pubmed.ncbi.nlm.nih.gov/?term=Triassi+M&cauthor_id=42763966)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-6 "Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele University of Rome, Rome, Italy."), [Raffaele Palladino](https://pubmed.ncbi.nlm.nih.gov/?term=Palladino+R&cauthor_id=42763966)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42763966/#short-view-affiliation-7 "Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom; Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare \(CIRMIS\), Naples, Italy.") ### Affiliations * 1 National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Department of Public Health, University of Naples "Federico II", Naples, Italy. Electronic address: michelangelo.mercogliano@unina.it. * 2 Department of Public Health, University of Naples "Federico II", Naples, Italy. * 3 Prevention and Public Health - Directorate General for Health Protection and Regional Health Service Coordination, Naples, Italy. * 4 Institute of Psychology and Health and Social Care Research, Italy. * 5 Medical Directorate, Sant'Anna and San Sebastiano National Hospital, Caserta, Italy. * 6 Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele University of Rome, Rome, Italy. * 7 Department of Public Health, University of Naples "Federico II", Naples, Italy; Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom; Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy. * PMID: **42763966** * DOI: [ 10.1016/j.vaccine.2026.129169 ](https://doi.org/10.1016/j.vaccine.2026.129169) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract Human papillomavirus (HPV) and hepatitis B vaccinations are the only immunisation programmes that directly prevent cancer. Despite the expansion of universal, gender-neutral HPV programmes, a free and actively offered vaccination does not ensure achievement of coverage targets. We conducted a population-based longitudinal ecological study in the Campania Region, the most populous Region in Southern Italy, to investigate socio-economic deprivation as a barrier to HPV vaccination. The study covered 2006-2023 and the 1997-2011 birth cohorts. Immunisation registry records were linked with demographic data, the 2011 Deprivation Index (DI), and vaccination-centre density, all aggregated at Health District (HD) level. Outcomes were one-dose, full-immunisation, and catch-up coverage (at least one dose after 18 years of age). Mixed-effects linear regression models were fitted with HDs nested within Local Health Authorities (LHAs) as random intercepts. Coverage remained below recommended targets. The highest cohort-specific coverage for one dose, full immunisation and catch-up was, respectively, 68.5% (2005 cohort), 62.2% (2002) and 2.2% (1998) among females, and 41.1% (2007), 29.9% (2007) and 0.6% (1999-2002) among males. Coverage varied across LHAs and HDs, independently of vaccination-centre density. Higher deprivation was associated with lower male one-dose and full-immunisation coverage (Coeff:-1.56 [-2.83|-0.29] and - 1.36 [-2.35|-0.37]). Among females, routine coverage was not associated with deprivation, which instead affected catch-up (Coeff: -0.057 [-0.094|-0.020]). HPV uptake in Campania is shaped by territorial heterogeneity and, for males and for catch-up pathways, by socio-economic inequalities, whereas routine female coverage was not affected by deprivation, supporting the equity value of a universal, actively offered programme and the need for locally tailored strategies. **Keywords:** HPV vaccination; Health inequalities; Prevention; Socioeconomic deprivation; Vaccine coverage. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Human papillomavirus (HPV) vaccine coverage and associated sociodemographic factors among individuals eligible for publicly funded vaccine in Ontario, Canada from 2007 to 2023: A Canadian immunization research network study. ](https://pubmed.ncbi.nlm.nih.gov/41666786/) Grewal R, Alessandrini J, Wilson SE, Hernandez A, Basta NE, Burchell AN, Deeks SL, Lim GH, Navarro C, Ogilvie G, Paul LA, Buchan SA.Grewal R, et al.Vaccine. 2026 Mar 19;76:128303. doi: 10.1016/j.vaccine.2026.128303. Epub 2026 Feb 10.Vaccine. 2026.PMID: 41666786 * [ Human papillomavirus (HPV) Vaccination programmes across European countries: time-harmonized coverage among adolescent females, socioeconomic predictors, and impact on public interest. ](https://pubmed.ncbi.nlm.nih.gov/42623713/) Pavia G, Quirino A, Marascio N, Licata F, Matera G, Bianco A, Di Gennaro G.Pavia G, et al.Vaccine. 2026 Oct 3;91:129058. doi: 10.1016/j.vaccine.2026.129058. Epub 2026 Aug 20.Vaccine. 2026.PMID: 42623713 * [ Coverage of the English national human papillomavirus (HPV) immunisation programme among 12 to 17 year-old females by area-level deprivation score, England, 2008 to 2011. ](https://pubmed.ncbi.nlm.nih.gov/24457007/) Hughes A, Mesher D, White J, Soldan K.Hughes A, et al.Euro Surveill. 2014 Jan 16;19(2):20677. doi: 10.2807/1560-7917.es2014.19.2.20677.Euro Surveill. 2014.PMID: 24457007 * [ Prophylaxis of cervical cancer and related cervical disease: a review of the cost-effectiveness of vaccination against oncogenic HPV types. ](https://pubmed.ncbi.nlm.nih.gov/20331326/) Armstrong EP.Armstrong EP.J Manag Care Pharm. 2010 Apr;16(3):217-30. doi: 10.18553/jmcp.2010.16.3.217.J Manag Care Pharm. 2010.PMID: 20331326Free PMC article.Review. * [ HPV vaccination in the WHO South-East Asia Region: A scoping review of uptake, implementation challenges, and pathways to acceleration. ](https://pubmed.ncbi.nlm.nih.gov/42518306/) Kolambkar S, Tomar M, Arif N, Hussain S, Gupta E, Singh S.Kolambkar S, et al.Hum Vaccin Immunother. 2026 Dec;22(1):2693359. doi: 10.1080/21645515.2026.2693359. Epub 2026 Jul 28.Hum Vaccin Immunother. 2026.PMID: 42518306Free PMC article. [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42763966) ## MeSH terms * Adolescent Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adolescent%22%5BMeSH%5D&sort=date
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