Purpose and justification of the indicator

Infection with human (human) papillomaviruses (HPV) is the most common sexually transmitted infection in the world. The profession assumes that most sexually active people are infected with HPV at least once in their lives. The prevalence of HPV infections is highest in young people shortly after starting sexual activity (20-25 years). The infection mostly takes place without characteristic symptoms and signs, but it can lead to the appearance of various pathological changes in both women and men. In case of infection with less dangerous (non-oncogenic) genotypes, HPV infection can cause anogenital warts, throat papillomas and skin warts. Long-term infections with more dangerous (oncogenic) genotypes of HPV can cause precancerous changes and cancer of the cervix, buttock, vagina, vulva, penis and oropharynx.
Vaccination against HPV infection is an effective public health measure, as it prevents infection with the virus and the diseases it causes. HPV vaccination is safe, side effects are usually mild and transient. The effectiveness of the vaccine is greatest when the vaccination is carried out before the start of sexual activity, when the person has not yet been exposed to HPV infection. Therefore, it is recommended that vaccination be carried out in the 6th grade of primary school, as provided for in the national vaccination program. In Slovenia, vaccination of girls against HPV infection has been included in the national vaccination program since 2009, and vaccination of boys since 2021. Vaccination is carried out during a systematic examination in the 6th grade of primary school. Latecomers can also be vaccinated against the burden of compulsory health insurance. In the 2023/2024 school year, the vaccination program also included a free vaccination for boys during a systematic check-up in the 1st and 3rd year of high school, at which girls who are late can also be vaccinated. For all others, vaccination is available on a self-pay basis.
Ensuring a high level of vaccination against HPV is an effective measure that can lead to the elimination of cervical cancer and has a significant impact on reducing the burden of other diseases related to this infection. To achieve these goals, according to the World Health Organization strategy, it is necessary to achieve at least 90% vaccination of girls. Parents' awareness and the promotion of vaccination at various events in the local community contribute significantly to the increase in vaccination rates. Health workers and educational institutions, with the support of the local community, play a key role in raising awareness of the benefits of vaccination and help parents decide to vaccinate their children.

Definition of indicator

Vaccination against HPV infections describes the proportion of children who were 12 years old during the observed period and were vaccinated with at least one dose of the vaccine against HPV infection, calculated on the number of all 12-year-old children during the same observed period.

Unit of measure

Calculation of the indicator

Vaccination of children against HPV infections in the 6th grade of primary school is the ratio between the number of children who were 12 years old during the observed period and were vaccinated with at least one dose of the vaccine against HPV infection, and the number of all 12-year-old children in the same observed period.
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When calculating the indicator, all children who meet the above-mentioned conditions and are registered in eRCO and have a temporary or permanent residence address in Slovenia are taken into account. Vaccination by municipality is shown according to the address of residence.

Data sources for Slovenia

eRCO - Electronic register of vaccinated persons and adverse reactions after vaccination.

Time availability

Year of publication of the indicator in Health in the municipality

The indicator has been published since 2024.

Men in literature

1. Moscicki AB, Schiffman M, Burchell A, Albero G, Giuliano AR, Goodman MT, Kjaer SK, Palefsky J. Updating the natural history of human papillomavirus and anogenital cancers. Vaccines. 2012 Nov 20;30 Suppl 5(0 5):F24-33.
2. Kocjan BJ, Poljak M. Papillomaviruses. In: Medical Virology. Poljak M, Petrovec M, eds. Medical virology. Ljubljana: Medical views; 2011 41&ndash;60.
3. International HPV reference center [Internet]. Stockholm: Karolinska Istituet [cited on 2023-11-13]. Available at: https://ki.se/en/labmed/international-hpv-reference-center
4. de Martel C, Plummer M, Vignat J, Franceschi S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer. 2017 Aug 15;141(4):664-670.
5. &Scaron;inkovec Zorko N, Učakar V, Grgič Vitek M. Vaccination against HPV in Slovenia: results in the 2020/21 school year and news - vaccination of girls and boys. Collection of lectures. Ljubljana: Institute of Oncology; 2021: 97-101.
6. World Health Organization. Guide to introducing HPV vaccine into national immunization programs. Geneva: World Health Organization; 2016.
7. National Institute of Public Health. Vaccination against human papillomavirus infections [Internet]. [cited on 2023-11-13]. Available at: https://www.nijz.si/sl/cepljenije-proti-okuzbam-s-humanimi-papilomavirusi

Notes

eRCO does not have information about which class the child attends. Therefore, the indicator is recalculated for the birth cohort that turned 12 in the reference period. It is assumed that the majority of children from this birth cohort attended the 6th grade of primary school in the reference period to which the data refer (e.g.: for the school year 2021/22 or the reference year 2022, this is the cohort of children born from 1.1. to 31.12. . 2010).

Preventive

Prepared by: Metka Zaletel 
Date of last modification: September 2016

Residents and community

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: January 2018

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: September 2016

Prepared by: Mojca Simončič 
Date of last change: March 2017

Prepared by: Gregor Starc 
Date of last modification: September 2016

Health risk factors

Prepared by: Gregor Starc, Kristina Orožen 
Date of last change: September 2016

Prepared by: Tina Lesnik 
Date of last change: March 2021

Prepared by: Andreja Belščak 
Date of last change: September 2016

Prepared by: Mateja Rok Simon and Tina Zupanič 
Date of last change: March 2017

Prepared by: Metka Zaletel 
Date of last modification: March 2019

Prepared by: Victoria Zakrajšek 
Date of last change: March 2021

Prepared by: Martin Ranfl, Jona Bambič 
Date of last change: November 2017

Prepared by: Victoria Zakrajšek, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Jasmina Staroveški Anderlič 
Date of last change: March 2020

Prepared by: Victoria Zakrajšek 
Date of last change: November 2021

Prepared by: Victoria Zakrajšek 
Date of last change: March 2023

Prepared by: Tatjana Kofol Bric 
Date of last modification: September 2016

Prepared by: Victoria Zakrajšek and Sonja Tomšič 
Date of last change: March 2017

Prepared by: Bonia Miljavac 
Date of last change: March 2017

Prepared by: Sonja Tomšič 
Date of last change: November 2019

Prepared by: Sonja Tomšič 
Date of last change: March 2021

Health status

Prepared by: Victoria Zakrajšek 
Date of last change: March 2017

Prepared by: Aleš Korošec 
Date of last change: September 2016

Prepared by: Aleš Korošec
Date of last change: September 2016

Prepared by: Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Aleš Korošec and Sonja Tomšič 
Date of last change: September 2016

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: October 2019

Prepared by: Kristina Orožen 
Date of last change: March 2019

Prepared by: Tatjana Kofol Bric, Jona Bambič 
Date of last change: March 2018

Prepared by: Victoria Zakrajšek, Tatjana Kofol Bric 
Date of last change: February 2020

Prepared by: Ema Ahačič 
Date of last change: April 2023

Prepared by: Ema Ahačič 
Date of last change: March 2023

Mortality

Prepared by: Sonja Tomšič, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Sonja Tomšič 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2020