A Segmentation-Based Public Health Strategy for Global Nine-Valent Human Papillomavirus Vaccination: A Multi-Method Framework for Cancer Prevention and Uptake Optimization

Human papillomavirus (HPV) remains one of the leading vaccine-preventable causes of cancer worldwide, yet uptake of nine-valent HPV vaccines continues to vary substantially across populations and health systems. This article presents a global strategic perspective on HPV vaccine uptake using a segmentation-based framework that moves beyond a one-size-fits-all approach to vaccination. The analysis recognizes that age, healthcare access, funding structure, care setting, geographic variation, and vaccine confidence all shape real-world vaccination behavior. A multi-method analytical framework was applied, incorporating cluster analysis, needs-based and value-based segmentation, attitudinal segmentation, journey mapping, geographic modeling, and secondary data analysis. Together, these methods support identification of priority populations, barriers to initiation and completion, and opportunities for more targeted intervention. The article highlights adolescents as the highest-priority segment for routine vaccination, with young adults representing an important catch-up population and older adults requiring more selective, risk-based approaches. It further emphasizes that successful uptake depends not only on vaccine availability, but also on delivery models, provider recommendation, public funding, and tailored communication strategies. Consistent with established frameworks for immunization program optimization (Pirouzi, 2011), a segmented global approach can improve operational efficiency, strengthen vaccine completion, and enhance the long-term public health impact of HPV-related cancer prevention. Keywords: HPV, HPV vaccine, vaccine uptake, market segmentation, global health, cancer prevention