The availability of two prophylactic HPV vaccines will require thorough considerations about monitoring and surveillance of those vaccinated and the general population, respectively. Vaccinated populations should be followed-up for long-term safety, sustained immune responses and vaccine efficacy. Effective monitoring will benefit from linkage of vaccination history and screening history, as well as precise measurement of HPV exposure, both DNA and serological testing. Lack of record linkage in many settings is one of the main obstacles for an effective surveillance program, though other surveillance activities can make contributions to assessing HPV vaccine effectiveness, including information from organized screening programs and phase IV studies.