HPV Vaccination in Italian Males: Policy Gaps and Regional Inequities

Human papillomavirus (HPV) causes several cancers in both males and females. Although Italy adopted a gender-neutral HPV vaccination policy in 2017, vaccination coverage among males remains well below the Italian target of 95%, with substantial regional disparities. This study assessed policies supporting male HPV vaccination in Italy, using the Marche region as a case study, to identify implementation gaps and propose strategies to improve gender-neutral coverage. This mixed-methods study combined a health policy literature review with semi-structured online interviews. The review examined twenty-three national and regional guideline documents related to HPV vaccination. For the qualitative component, thirteen key informants, including policymakers and healthcare providers from the Marche region and seven other Italian regions, were interviewed to ensure balanced representation. Data were analysed using thematic analysis. The policy review revealed substantial heterogeneity in free HPV vaccine access for males, with regional differences in age limits and eligible birth cohorts. Thematic analysis identified three main barriers: female-centred communication, low perceived HPV-related risk among males as a driver of vaccine hesitancy, and logistical challenges in gender-neutral delivery settings, such as schools. Informants also highlighted the lack of routine healthcare contact points for young men and the need for greater national policy harmonization.

The gap between national policy and fragmented regional implementation undermines equitable access to HPV vaccination for males in Italy. Improving coverage requires coordinated, gender-sensitive strategies. Recommendations include improving institutional communication, harmonizing vaccination offers across regions, strengthening primary care engagement, and translating regional advocacy documents, such as the Marche Region’s “Loreto Charter”, into actionable frameworks to support cancer prevention goals.

Key messages

• Gender-sensitive communication and clear institutional messaging are needed to improve male HPV vaccine uptake.

• Regional differences in HPV vaccines offer equity concerns; harmonized policies are needed to improve accessibility for males.