HPV vaccination coverage in the federal state of Belgium according to regions and their impact


HPV, vaccination coverage, Belgium, difference, Walloon Region, Flanders, cervical cancer

Published online: Feb 20 2019

W. A. A. Tjalma1, C. Brasseur2, G. Top3, N. Ribesse4, I. Morales2, P. A. Van Damme5

Multidisciplinary Breast cancer clinic, Gynaecological Oncology Unit, Department of Obstetrics & Gynaecology, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650 Antwerpen, Belgium; French Community, Immunization programme, Health department, Office of Birth and Childhood, Chaussée de Charleroi 95, B–1060 Bruxelles, Belgium;
Infectious Disease Control and Vaccination, Flemish Agency for Care and Health, Ellipse Building, K. Albert II-laan 35, box 33, B-1030 Brussels, Belgium;
French community, School Health Services support, Health department, Office of Birth and Childhood, Chaussée de Charleroi 95, B-1060 Bruxelles, Belgium;
Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Campus 3 Eiken, Universiteitsplein, 1, 2610 Antwerpen, Belgium.


Long-term results of the HPV vaccination programs in Australia and Scotland have shown a tremendous impact on the reduction of HPV infection rates and precancerous diseases. Both countries started mass vaccination ten years (Australia) and eight years (Scotland) ago and achieved a vaccination coverage of more than 80 %. Within 20 to 30 years a reduction in cervical cancer by more than 75 % is expected. Furthermore, there will be a reduction in other HPV related cancers like vaginal, vulva, perineal, anal and oropharyngeal cancers. In order to be successful, a high vaccination coverage is needed. In Belgium, the vaccination was introduced in 2010 in the Flemish community and in 2011 in the French community. In the first vaccinated cohorts the coverage in Flemish and French Communities was respectively 84% (2010) and 29% (2012-2013).

The latest data suggest that the Flemish Community (Flanders Region) attained a coverage of 91 % while the French Community (Walloon Region) attained a coverage of around 36 %. The regional difference in coverage offers a real-life case. The worst-case scenario could end up with proportionally one half of country having more HPV related cancers than the other half. Currently efforts are performed to increase the coverage rates in both regions and consequently decreasing this difference.

Additionally, the updated recommendations regarding the HPV vaccination by the Belgian NITAG (National Immunization Technical Advisory Group) stated that the HPV vaccination should be gender neutral. This could stimulate the vaccination program and increase the coverage. The coverage rate in Flanders is among the highest in the world and the rate in the French Community is increasing. Efforts should be continued in order to maintain trust and increase the coverage rate.