---
title: "Global policy drivers of national HPV vaccine introductions (2006–2025)"
id: "pubmed-42770688"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42770688"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42770688/"
doi: "10.1080/14760584.2026.2736328"
published_at: "2026-09-22T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Global policy drivers of national HPV vaccine introductions (2006–2025)
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42770688
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42770688/)
- **DOI:** [10.1080/14760584.2026.2736328](https://doi.org/10.1080%2F14760584.2026.2736328)
- **Published At:** 2026-09-22T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The study evaluated global policy determinants that influenced national introductions of **human papillomavirus (HPV) vaccine** in low- and middle-income countries (LMICs) between 2006 and 2025. - Authors analyzed policy events using two complementary quantitative approaches: generalized linear models (GLMs) to assess pre-specified policy events and changepoint analysis to detect shifts in adoption trends. - Key policy factors considered included World Health Organization (WHO) recommendations, Gavi, the Vaccine Alliance funding policy changes for HPV vaccines, and disruptions from the COVID-19 pandemic. - Across multiple GLMs and outcome specifications, WHO's 2022 recommendation for a **one-dose** HPV schedule was most strongly associated with an increase in national introductions. - Expansion of **Gavi** funding for HPV vaccines (period defined as 2017–2025 in the study) was also associated with increased introductions in some model specifications. - Comparing model projections with and without the WHO one-dose recommendation estimated an additional **22.46** national HPV vaccine introductions in LMICs attributable to that recommendation. - Changepoint analysis independently identified a statistically significant increase in national HPV vaccine introductions in **2022**, consistent with the GLM findings. - The study concludes that the WHO one-dose recommendation and Gavi funding policies were primary global drivers of HPV vaccine uptake in LMICs during 2006–2025, with implications for strategies to expand equitable access. - The analysis used observed national introduction data through 2025; methodological details were GLMs for predetermined events and changepoint detection for trend shifts. - Article metadata: published in Expert Review of Vaccines (Dec 2026 issue, Epub 22 Sep 2026), PMID 42770688, DOI 10.1080/14760584.2026.2736328. Authors affiliated with institutions including New York University, Université Laval, Harvard T.H. Chan School of Public Health, and London School of Hygiene & Tropical Medicine.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 22. # Global policy determinants of national human papillomavirus vaccine introductions in 2006-2025 [Jiyeon Suh](https://pubmed.ncbi.nlm.nih.gov/?term=Suh+J&cauthor_id=42770688)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-1 "Department of Global and Environmental Health, School of Global Public Health, New York University, New York, NY, USA."), [Marc Brisson](https://pubmed.ncbi.nlm.nih.gov/?term=Brisson+M&cauthor_id=42770688)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-2 "Centre de recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-3 "Département de médecine sociale et préventive, Université Laval, Québec City, Québec, Canada.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-4 "Saw Swee Hock School of Public Health, National University of Singapore, Singapore."), [Emily A Burger](https://pubmed.ncbi.nlm.nih.gov/?term=Burger+EA&cauthor_id=42770688)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-5 "Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-6 "Department of Health Management and Health Economics, University of Oslo, Oslo, Norway."), [Jane J Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+JJ&cauthor_id=42770688)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-5 "Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA."), [Jean-François Laprise](https://pubmed.ncbi.nlm.nih.gov/?term=Laprise+JF&cauthor_id=42770688)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-2 "Centre de recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada."), [Mark Jit](https://pubmed.ncbi.nlm.nih.gov/?term=Jit+M&cauthor_id=42770688)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-1 "Department of Global and Environmental Health, School of Global Public Health, New York University, New York, NY, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-4 "Saw Swee Hock School of Public Health, National University of Singapore, Singapore.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-7 "Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#full-view-affiliation-8 "School of Public Health, University of Hong Kong, Hong Kong SAR, China.") Affiliations Expand ### Affiliations * 1 Department of Global and Environmental Health, School of Global Public Health, New York University, New York, NY, USA. * 2 Centre de recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada. * 3 Département de médecine sociale et préventive, Université Laval, Québec City, Québec, Canada. * 4 Saw Swee Hock School of Public Health, National University of Singapore, Singapore. * 5 Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA. * 6 Department of Health Management and Health Economics, University of Oslo, Oslo, Norway. * 7 Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. * 8 School of Public Health, University of Hong Kong, Hong Kong SAR, China. * PMID: **42770688** * DOI: [ 10.1080/14760584.2026.2736328 ](https://doi.org/10.1080/14760584.2026.2736328) Item in Clipboard # Global policy determinants of national human papillomavirus vaccine introductions in 2006-2025 Jiyeon Suh et al. Expert Rev Vaccines. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Expert Rev Vaccines Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Expert+Rev+Vaccines%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Expert+Rev+Vaccines%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) . 2026 Dec;25(1):2736328. doi: 10.1080/14760584.2026.2736328. Epub 2026 Sep 22. ### Authors [Jiyeon Suh](https://pubmed.ncbi.nlm.nih.gov/?term=Suh+J&cauthor_id=42770688)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-1 "Department of Global and Environmental Health, School of Global Public Health, New York University, New York, NY, USA."), [Marc Brisson](https://pubmed.ncbi.nlm.nih.gov/?term=Brisson+M&cauthor_id=42770688)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-2 "Centre de recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-3 "Département de médecine sociale et préventive, Université Laval, Québec City, Québec, Canada.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-4 "Saw Swee Hock School of Public Health, National University of Singapore, Singapore."), [Emily A Burger](https://pubmed.ncbi.nlm.nih.gov/?term=Burger+EA&cauthor_id=42770688)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-5 "Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-6 "Department of Health Management and Health Economics, University of Oslo, Oslo, Norway."), [Jane J Kim](https://pubmed.ncbi.nlm.nih.gov/?term=Kim+JJ&cauthor_id=42770688)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-5 "Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA."), [Jean-François Laprise](https://pubmed.ncbi.nlm.nih.gov/?term=Laprise+JF&cauthor_id=42770688)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-2 "Centre de recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada."), [Mark Jit](https://pubmed.ncbi.nlm.nih.gov/?term=Jit+M&cauthor_id=42770688)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-1 "Department of Global and Environmental Health, School of Global Public Health, New York University, New York, NY, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-4 "Saw Swee Hock School of Public Health, National University of Singapore, Singapore.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-7 "Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42770688/#short-view-affiliation-8 "School of Public Health, University of Hong Kong, Hong Kong SAR, China.") ### Affiliations * 1 Department of Global and Environmental Health, School of Global Public Health, New York University, New York, NY, USA. * 2 Centre de recherche du CHU de Québec-Université Laval, Québec City, Québec, Canada. * 3 Département de médecine sociale et préventive, Université Laval, Québec City, Québec, Canada. * 4 Saw Swee Hock School of Public Health, National University of Singapore, Singapore. * 5 Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA. * 6 Department of Health Management and Health Economics, University of Oslo, Oslo, Norway. * 7 Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK. * 8 School of Public Health, University of Hong Kong, Hong Kong SAR, China. * PMID: **42770688** * DOI: [ 10.1080/14760584.2026.2736328 ](https://doi.org/10.1080/14760584.2026.2736328) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Although safe and effective human papillomavirus (HPV) vaccines have been available since 2006, national introduction in low- and middle-income countries (LMICs) has progressed slowly. HPV vaccine adoption may have been shaped by evolving World Health Organization (WHO) recommendations, funding policies of Gavi, the Vaccine Alliance, and the disruption from the Coronavirus Disease 2019 pandemic. However, their relative contributions have not been quantified. **Research design and methods:** This study analyzed policy determinants of national HPV vaccine introduction rate in LMICs from 2006 to 2025, using: (i) generalized linear model (GLM) to assess predetermined policy events, and (ii) changepoint analysis to identify shifts in adoption trends. **Results:** Across a range of GLMs exploring different events and outcome variables, WHO's one-dose recommendation in 2022 was most strongly associated with an increase in country introductions, with the expansion of Gavi's funding policy for HPV vaccines (2017-2025) also important in some models. Comparing model projections with and without the one-dose schedule yielded an estimated 22.46 additional national HPV vaccine introductions in LMICs. Changepoint analysis identified a significant increase in introductions in 2022. **Conclusions:** These results quantify the primary global drivers of HPV vaccine uptake, offering actionable insights for expanding equitable vaccine access. **Keywords:** Human papillomavirus; changepoint analysis; generalized linear model; low- and middle-income countries; vaccine. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool. ](https://pubmed.ncbi.nlm.nih.gov/23146319/) Hutubessy R, Levin A, Wang S, Morgan W, Ally M, John T, Broutet N.Hutubessy R, et al.BMC Med. 2012 Nov 13;10:136. doi: 10.1186/1741-7015-10-136.BMC Med. 2012.PMID: 23146319Free PMC article. * [ Cost-effectiveness of female human papillomavirus vaccination in 179 countries: a PRIME modelling study. ](https://pubmed.ncbi.nlm.nih.gov/25103394/) Jit M, Brisson M, Portnoy A, Hutubessy R.Jit M, et al.Lancet Glob Health. 2014 Jul;2(7):e406-14. doi: 10.1016/S2214-109X(14)70237-2. Epub 2014 Jun 9.Lancet Glob Health. 2014.PMID: 25103394 * [ Optimal human papillomavirus vaccination strategies to prevent cervical cancer in low-income and middle-income countries in the context of limited resources: a mathematical modelling analysis. ](https://pubmed.ncbi.nlm.nih.gov/34245682/) Drolet M, Laprise JF, Martin D, Jit M, Bénard É, Gingras G, Boily MC, Alary M, Baussano I, Hutubessy R, Brisson M.Drolet M, et al.Lancet Infect Dis. 2021 Nov;21(11):1598-1610. doi: 10.1016/S1473-3099(20)30860-4. Epub 2021 Jul 7.Lancet Infect Dis. 2021.PMID: 34245682Free PMC article. * [ 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. * [ Human papillomavirus vaccine introduction--the first five years. ](https://pubmed.ncbi.nlm.nih.gov/23199957/) Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS, Brotherton JM.Markowitz LE, et al.Vaccine. 2012 Nov 20;30 Suppl 5:F139-48. doi: 10.1016/j.vaccine.2012.05.039.Vaccine. 2012.PMID: 23199957Review. [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42770688) ## MeSH terms * Developing Countries Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Developing+Countries%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Developing+Countries) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) * Health Policy* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Health+Policy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Health+Policy) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) * Human Papillomavirus Viruses Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Human+Papillomavirus+Viruses%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Human+Papillomavirus+Viruses) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) * Immunization Programs* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Immunization+Programs%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Immunization+Programs) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) * Immunization Schedule Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Immunization+Schedule%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Immunization+Schedule) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42770688/) * Papillomavirus Infections* / prevention & control Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Papillomaviru
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