Background and Objective:
Since 2017 HPV vaccination is free in Sicily for women up to 45 years old; screening is free for women aged between 25 and 64. HPV vaccination coverage in Sicily decreased during the COVID-19 pandemic. Consequently, the letter of screening invitation was updated inserting indications to book vaccination. The aim of the study is to evaluate vaccination coverage in women of the Province of Catania aged 25 to 45, after sending the updated letter for screening.

Methods:
Women aged between 25 and 45 tested for cervical cancer in 2021 was extracted from software used for screening. The anti HPV vaccination coverage in above mentioned age group was provided by Epidemiology Service. The screening invitation letter was updated including the HPV vaccine booking methods. A vaccination coverage monitoring plan has been defined since the start of the involvement of target population through the updated letter.

Result:
In 2021, n. 8616 screening test were performed in women aged 25 to 45. Data from Epidemiology Service ASP Catania shows a low HPV vaccination coverage in women aged 25 to 45. During 2023, cross-reference through tax code between unvaccinated women invited for screening and vaccination registry will be provider for evaluate the effectiveness of updated invitation letter in promoting vaccination. The crossing will be carried out after 6 and 12 months from the first sending of the letter.

Conclusion:
More information on free HPV vaccination program are needed in women up to the age of 45, also providing counselling on HPV vaccine with screening. Updated letter could improve HPV vaccination and further investigations will be needed to verify changes in vaccination coverage.