A systematic literature review of human papillomavirus vaccination strategies in delivery systems within national and regional immunization programs

Figures & data

Table 1. PICO(+) framework for scope of systematic literature review.

Category	Details
Population	Countries with NIPs offering HPV vaccine to adolescents
Intervention	HPV vaccination within NIP or other regional programs
Comparator	Not applicable
Outcomes	Primary Outcomes: HPV immunization strategies (information campaigns/community awareness, HPV education, HPV training, systematic vaccination invitations and reminders, HPV VCR monitoring system/digital information system, funding methods) HPV in NIPs or other regional programs HPV delivery system (school-based, community-based, health center-based, in pharmacy, mixed) If and how parental consent is obtained Strategies to increase equity in terms of HPV vaccine access, such as outreach campaigns for underserved population Multisectoral collaboration, such as description of how the ministry of health and ministry of education may collaborate in a school-based program HPV VCR and series completion
Time	January 2012 to January 2022
Study design	Observational studies including: Prospective or retrospective design Registry/database analysis Surveillance Case-control
	Surveys/interviews
	Systematic literature reviews and other reviews
	Programs
	Reports
Language	No restrictions

HPV, human papillomavirus; NIP, National Immunization Program; PICO, Population, Intervention, Comparator, Outcome; VCR, vaccine coverage rates.

Figure 1. PRISMA flow diagram of the screening and selection process.

*8 records were obtained from gray literature search.

Table 2. Type of strategies in identified papers.

Type of strategy	Number of papers*
The educational strategies	71
Information campaign/Community Awareness	54
HPV training	37
Delivery location	52
Stakeholders’ collaboration	48
Funding	40
HPV VCR monitoring system via information systems	27
Systematic vaccination invitations and reminders	37
Parental consent	17

*There were 74 articles (65%) connected to multiple interventions and 40 articles (35%) to single strategy from research articles.