The Final General Assembly of the PERCH Joint Action was held on 13 June 2025 at the Istituto Superiore di Sanità (ISS) in Rome, with over 50 participants attending in person and additional stakeholders joining online. Representatives from all work packages, project partners, and members of the Scientific and Governmental Advisory Boards presented the final results, reflected on lessons learned, and discussed the future use of PERCH tools and approaches.
PERCH has provided tools, evidence, and partnerships that will continue supporting HPV vaccination across Europe. Its legacy will live on through national implementation, future collaborations, and the commitment of its network.
Coordination and Project Structure
Raffaella Bucciardini, the project coordinator, opened the Assembly with a reflection on the structure and execution of PERCH. WP1 ensured the overall coordination and implementation of the action, facilitated strong internal communication, and provided strategic guidance throughout the project’s lifecycle. She highlighted the complementarity of PERCH’s objectives with the European Beating Cancer Plan, especially with regard to addressing health inequalities in HPV vaccination coverage across EU Member States. She also emphasised the importance of creating transferable tools and practices for national implementation, and pointed out the consortium’s collaborative culture as a major success factor.
HPV Vaccination Coverage in Europe: Data Highlights and Challenges
Laia Bruni (ICO, Spain) presented the key findings of WP5, based on a comprehensive data collection toolkit implemented in 13 countries and supplemented by WHO/UNICEF and national administrative data. By November 2024, all 27 EU Member States and 93% of European countries had integrated HPV vaccination into their national immunisation schedules—most targeting 12-year-olds and offering catch-up options up to age 26 or beyond. Despite progress, strong disparities remain: while countries like Norway, Finland, and Ireland approach the WHO’s 90% coverage target for girls, much of Eastern Europe remains below 10%. In 2023, estimated coverage across Europe stood at 43% for girls and 32% for boys, with gender-neutral vaccination adopted in many Western and Northern countries but still lacking in others. Bruni called for harmonised monitoring, expanded use of single-dose schedules, and targeted actions to reduce subnational inequalities and improve uptake in underserved regions.
Towards Better Data Linkage for HPV Vaccination Monitoring
Leandro Bomans (SCI, Belgium) presented a detailed analysis of the current state of individual patient data (IPD) monitoring and linkage across Europe. Drawing on WP5 interviews, surveys, and data models, he highlighted that while most WP5 countries can collect individual-level HPV vaccination data, only a few—such as Norway and Sweden—have successfully linked these datasets with cancer screening and outcomes. Others, like Croatia, Slovenia, Germany, and the Czech Republic, are capable of such linkage and plan to do so in the near future. Bomans introduced a conceptual model illustrating how IPD from HPV vaccination, screening, and cancer registries could be integrated to inform public health planning. He also referenced a 2024 editorial by Marc Arbyn et al., published in JNCI, which underscored the urgent need for IPD linkage to enhance HPV vaccine impact monitoring and cervical cancer prevention. Despite progress, legal and technical barriers continue to hinder the widespread implementation of this crucial data integration.
Building National Capacity through Peer-Led Communication Strategy Development
Urška Ivanuš (IOL, Slovenia) and Lill Trogstad (NIPH, Norway) presented the work of WP2, which focused on supporting countries in developing or improving HPV vaccination communication strategies. WP2 delivered two core resources—the PERCH Guide for National HPV Communication Strategy and the Short Guide—which enabled participating countries to either develop full national strategies or strengthen existing efforts. These guides, along with the PERCH Social Media Strategy, Toolkit, ranked HPV key messages, and a synthesis of national reporting via the CD Reporting Tool, will form the annexes of the updated Communication and Dissemination Plan.
Seven countries—Croatia, Czech Republic, Estonia, Hungary, Lithuania, Romania, and Slovenia—used the WP2 framework to develop or revise their national strategies through a peer-led process, including three structured online review meetings and bilateral consultations. This collaborative method fostered direct feedback and practical learning across contexts.
WP2 also became the living structure of the HPV Vaccination Guild, originally conceived as a knowledge-sharing platform. While two official Guild webinars were held (in October 2023 and November 2024), it was the regular monthly WP2 Working Group meetings that sustained continuous exchange between partners, experts, and stakeholders. Lill Trogstad expressed the hope that these connections will persist and grow beyond PERCH, continuing to serve as a space for shared learning and collaboration.
Urška Ivanuš additionally highlighted that an electronic evaluation survey was launched to assess WP2’s success in reaching its key outcome: at least 80% of targeted stakeholders should report improved knowledge in HPV vaccination communication. The analysis will be part of the final WP3 report.
Ivana Andrijašević (CIPH, Croatia) spoke about the need for adaptability during national planning, particularly in the face of staff changes and limited data. Merilin Vernik (NIHD, Estonia) stressed the importance of trust-based communication, youth-friendly visuals, and the central role of school nurses in Estonia’s strategy.
WP2 has established a model of structured, co-creative support that strengthened communication capacity at the national level while fostering peer learning. All WP2 resources will remain publicly available through the PERCH Repository, offering a legacy toolkit for future HPV vaccination communication planning.
Empowering Healthcare Professionals through Targeted HPV Communication Training
Miriam Gerlich (BIÖG, Germany) presented the achievements of WP7, which focused on equipping healthcare professionals (HCPs) with the knowledge, motivation, and communication skills needed to serve as trusted HPV vaccination advocates. A shared European curriculum was implemented in 11 partner countries, covering both clinical content on HPV and vaccine safety, and practical modules on addressing vaccine hesitancy and misinformation.
The programme trained over 21,500 HCPs, with strong results from post-training evaluations completed by 1,289 participants:
- 89.8% reported improved communication confidence
- 88.7% with low baseline knowledge showed measurable improvement
- 95% were satisfied with the training
- 92% would recommend it to colleagues
WP7 applied a standardized pre–post evaluation tool, which measured knowledge and beliefs, communication confidence across nine clinical scenarios, and satisfaction. The analysis revealed clear learning gains while also identifying some remaining misconceptions, particularly concerning HPV transmission, long-term immunity, and vaccine safety (e.g., confusion regarding Guillain-Barré syndrome).
Gerlich concluded that structured educational programmes like WP7 are crucial for enhancing vaccine communication, fostering public trust, and supporting long-term confidence in HPV vaccination. The training model developed under PERCH provides a scalable and evidence-based approach for future health workforce development initiatives.
Engaging Adolescents and Parents: Creative Communication Strategies
Benedetta Mattioli (ISS, Italy) presented the work of WP6, which tackled one of the most challenging aspects of HPV vaccine communication: effectively engaging adolescents, parents, and education professionals. Implemented across 11 countries, WP6 combined literature reviews, focus groups, national surveys, and stakeholder consultations to better understand local barriers and design impactful communication materials.
Each participating country developed a tailored toolbox of communication materials, including:
- Italy: A co-created rap video “Proteggi il domani” with students
- Greece: Bilingual podcasts for health professionals and the general public
- Croatia, Estonia, Poland, Slovenia: Improved public health websites and access to vaccine information
- France: National roundtables with teachers and youth organizations
- Sweden: Gender-inclusive tools to reach boys more effectively
Findings highlighted the complex roots of vaccine hesitancy—ranging from safety concerns to cultural and socioeconomic factors. Social media emerged as both an opportunity and a challenge. They underlined the need for multilingual and better-evaluated tools, as most remain only in national languages and lack effectiveness assessments.
Pilot evaluations demonstrated high engagement with interactive tools, the effectiveness of school-based communication, and the value of peer-to-peer approaches. Digital platforms and localized content expanded outreach, and institutional sources remained the most trusted—especially when supported by youth-friendly formats.
In conclusion, WP6 confirmed that creative, multi-format, youth-centered communication strategies—involving schools, teachers, and healthcare professionals—can make a meaningful impact on vaccine uptake. The project’s results provide replicable models for other EU countries and reinforce the need for evidence-based, adaptable, and continuously evaluated communication.
Measuring Impact: Internal and External Evaluation Results from WP3
Claudia Robles (ICO, Spain) presented the progress of WP3, focused on evaluation and monitoring. Drawing from 237 indicators initially defined in the project, 214 were retained for analysis. Although the project is still ongoing and some data is pending, preliminary results are promising: over 85% of the indicators were either fully achieved or on track, and most milestones and deliverables were completed on time—defined as being uploaded within five days of the deadline in the SyGMA system. Only four milestones were delayed in the first reporting period, and five deliverables still await final data, though no major risks were identified.
WP3 also assessed progress toward PERCH’s four main objectives: building national capacity for HPV communication and implementation; improving data systems; increasing awareness among adolescents and parents; and strengthening healthcare professionals’ communication skills. Preliminary evaluation shows strong alignment with all four goals.
Project participants expressed high overall satisfaction, particularly regarding internal communication and the opportunities for international collaboration. Satisfaction with WP outputs ranged between 82% and 100%, with slightly lower ratings for WP5 due to its narrower geographical scope. Coordination support was widely appreciated across all work packages.
An independent external evaluation is currently underway, led by the consultancy Effectia. The process has included in-depth interviews with WP leaders and the coordinator (April 2025), focus groups with country representatives (June 2025), and ongoing interviews with advisory board members. A preliminary analysis has been completed, and the final external evaluation report is expected by August 2025.
Integration, Equity and Sustainability
WP4 addressed the long-term integration and sustainability of HPV vaccination efforts across Europe. Hélène De Pauw (SCI, Belgium) highlighted the work conducted in 16 countries to assess HPV programme organisation, integration, procurement policies, the effectiveness of single-dose schedules, and the planning of vaccination actions. These findings informed the development of the forthcoming Integration and Sustainability Plan.
Johannes Berkhof (Amsterdam UMC, Netherlands) presented an in-depth analysis of HPV vaccine pricing trends across Europe between 2016 and 2023, revealing significant variation in tender-based procurement outcomes. Using TED (Tenders Electronic Daily) data, his team identified the 9-valent vaccine as the dominant product on the market, with national procurement strategies driving sharp price divergence. While prices stabilised after 2016, differences in country-specific contract outcomes widened—from 53% variation (2007–2016) to 82% (2016–2023). Romania, despite multiple tender rounds, reported the highest prices. These findings raise concerns over transparency and equity in vaccine access, underlining the need for harmonised procurement practices across the EU.
WP4 also supported 12 country-led pilot vaccination actions tailored to local needs, such as school-based programme expansion, stakeholder roundtables, and improved data linkages. These pilots were assessed using the RE-AIM framework, with countries demonstrating strong adaptability and commitment to long-term planning.
Afsaneh Nejat (EuroHealthNet) presented WP4’s equity analysis based on the 8A Framework—Availability, Affordability, Accessibility, Awareness, Activation, Acceptance, Alliance, and Acquisition. Drawing on a mixed-methods review of 47 scientific articles, 11 grey literature sources, and responses from 16 countries, the analysis showed that multicomponent strategies targeting several of the 8A domains are more effective in reaching underserved populations. School-based delivery models were especially successful in increasing uptake, while affordability and time constraints continue to hinder access among marginalised groups. The results call for greater use of disaggregated data, trust-based communication, and culturally tailored strategies to ensure no population is left behind.
Together, the efforts in WP4 contribute a comprehensive roadmap for embedding HPV vaccination into broader health systems, grounded in equity, sustainability, and institutional ownership.
Closing Remarks
Project Coordinator Raffaella Bucciardini (ISS) closed the Assembly by thanking all partners and underlining the importance of PERCH’s achievements. She noted the value of concrete tools, collaborative spirit, and stakeholder engagement. Raffaella encouraged participants to continue using and promoting PERCH outputs in their national contexts, and proposed the creation of a PERCH Manifesto of Intent to sustain momentum and shared values beyond the project.