HPV vaccination of university students in Novi Sad: Analysis of vaccination coverage and dropout dynamics

Introduction/Aim: Assessing the response and continuity of human papillomavirus (HPV) vaccination is crucial for evaluating newly introduced, free immunization programs for young adults in the Republic of Serbia. The aim of this study was to quantify and analyze HPV vaccination coverage among students at the University of Novi Sad, as well as to assess vaccination dynamics over a 12-month period and evaluate existing systemic mechanisms for retaining students in the vaccination program. Methods: The study was designed as a retrospective cohort study and it was conducted at the level of primary health care at the Institute for Student Health Care in Novi Sad. The observed period was between April 1st, 2024 and April 1st, 2025. The study cohort comprised students of the University of Novi Sad aged 19 to 26 years. Data on vaccinated students aged 19 to 26 were collected from the health information system (Heliant, v8.3) and the record books. Absolute and relative frequencies of vaccinated students were analyzed according to sex, along with stage-specific and cumulative vaccination dropout rates. Results: During the study period, 509 students initiated the vaccination process, with a total of 1,301 vaccine doses administered. A pronounced sex imbalance was observed: 453 (89.0%) female students and only 56 (11.0%) male students were vaccinated. All students received the first dose (509/100.0%), 450 received the second dose (88.4%; dropout rate 11.6%), and 342 students received the third dose (67.2%). The cumulative dropout rate across the entire three-dose schedule was 32.8% (167). Conclusion: A pronounced sex disparity in vaccine uptake was observed, highlighting the need for targeted education of the male population. The high cumulative dropout rate underscores the importance of implementing and automating systemic reminder mechanisms to improve completion of the vaccination schedule.