| Sumario: | Background & Significance: Human papillomavirus (HPV) vaccination represents a critical cancer prevention strategy, yet significant policy variations exist globally despite shared WHO cervical cancer elimination goals. Understanding how different countries design and implement HPV vaccination policies is essential for optimizing program effectiveness and achieving health equity. Comparative policy analysis can identify best practices and inform evidence-based recommendations for policy makers and international organizations working toward cervical cancer elimination by 2030. Purpose: To systematically analyze and compare HPV vaccination policies across USA, Brazil, UK, Sweden, Rwanda, Nigeria, Australia, and Japan using the Health Policy Triangle framework, identifying policy archetypes, implementation models, and factors contributing to successful vaccination programs. Methods: This comparative policy analysis employed Walt & Gilson's Health Policy Triangle framework to examine HPV vaccination policies across eight strategically selected countries representing diverse geographic regions (Americas, Europe, Africa, Asia-Pacific), economic contexts (high-income to low-income), and health system structures. Data collection involved systematic literature review of national immunization guidelines, WHO reports, government policy documents, and peer-reviewed literature published 2020-2024. Standardized data extraction templates captured information across four analytical dimensions: Actors, Context, Content, and Process. Cross-case pattern identification and policy archetype development guided comparative analysis. Findings and Interpretations: Analysis revealed distinct policy archetypes: school-based universal programs (UK, Australia, Sweden, Rwanda), federal/decentralized systems (USA, Nigeria), and gender-neutral progressive models (Sweden, UK, Australia, Brazil). School-based delivery systems achieved highest coverage rates, with Rwanda (98%), UK (85%), and Australia (85%) leading globally. Gender-neutral policies in Sweden, UK, Australia, and Brazil demonstrated superior population-level impact compared to girls-only programs. Countries with strong political commitment sustained high coverage regardless of economic context. Japan's policy reversal and recovery highlighted importance of stakeholder engagement. Brazil's adoption of WHO single-dose recommendations demonstrates evidence-based policy adaptation. Discussion: Findings demonstrate that implementation strategy and stakeholder alignment matter more than policy specifications for achieving vaccination goals. School-based programs with multi-sectoral coordination represent optimal delivery models across diverse contexts. Gender-neutral approaches maximize population health benefits and support health equity principles. Rwanda's exceptional success despite resource constraints shows partnerships can overcome economic barriers. Results provide evidence-based guidance for nursing leaders, policy makers, and international organizations developing HPV vaccination programs, contributing to nursing science through systematic policy analysis and informing global cancer prevention advocacy strategies.
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