Vacation days in Europe are still paid time off technically.

Paid time off in the US includes sick leave. It’s not useful to stick to acronyms which aren’t applicable n that specific context.

I didn't know the US has a monopoly on the term paid time off.

Surely you understand my overall point. The concept of PTO doesn’t apply because PTO in the US includes sick leave. Most European countries carve out that separately. The word is not used in Europe and exclusively an US import. Not only is the term not reflective of the situation, it’s ambiguous and an acronym that’s US specific. So better to use a word that isn’t. Europe has vacation and sick leave. That’s how it works. US citizens can adapt to local terms which are better for a specific context. It’s just that easy and better.