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Papillomavirus vaccine: what should Macron announce?

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Emmanuel Macron promises a decisive announcement “to eradicate the papillomavirus” on Tuesday, February 28, 2023. Human papillomaviruses (HPV) are very common sexually transmitted viruses, generally contracted at the start of sexual life.

[Mis à jour le 28 février 2023 à 10h02] The president of the Republic Emmanuel Macronaccompanied by the Ministers of Health and Education, François Braun and Pap Ndiaye, are expected this Tuesday, February 28 afternoon in a college of Jarnac (Charente) where they must”make a decisive announcement to eradicate the papillomavirus (HPV)“, announced the Elysée Palace. The government will attend an HPV vaccination session organized within the establishment, a few days before the World Awareness Day around HPV-induced diseases (March 4, 2023). , HPV would be responsible for 30,000 precancerous lesions of the cervix and of 6,000 new cases of cancers in women and men. According to the World Health Organization (WHO), these cancers can be completely eliminated through screening and vaccination. But to date, the vaccination coverage rate remains too low in France (37% for girls and 9% for boys). Vaccination against human papillomavirus infections is recommended for girls and boys from 11 to 14 years of age (possible up to 26 years for men who have sex with other men). And in catch-up until 19 years.

The HPV vaccine protects against which diseases? What cancers?

Human papillomaviruses (HPV) are very common sexually transmitted viruses, generally contracted at the beginning of sexual life during vaginal, oral or anal intercourse. They can cause the appearance of warts (papillomas), contagious lesions localized on the skin or on the mucous membranes of the man or the woman. Although the majority of these lesions disappear spontaneously thanks to our natural immunity or with the help of treatments (laser, cryotherapy, medication), certain lesions, most often caused by HPV 16 or 18, can persist and progress to anal and oropharyngeal cancers, of the cervix, vagina or vulva. Vaccination against human papillomaviruses remains the best way to fight these viruses. It consists of introducing an inactive (or very weakened) microbe into the body. To deal with this “fake microbe” and prevent it from spreading, our body makes immune defenses called antibodies. If one day, the “real microbe”, which is active in it, enters the body, it will be recognized by the antibodies which will therefore be able to neutralize it and prevent the development of the disease.

Who should get the HPV vaccine?

Vaccination against HPV is currently recommended and reimbursed up to 65% by Health Insurance (additional organizations often intervene to complete reimbursement) at:

  • young girls from 11 to 14 years old (with a reminder of 15 to 19 years old),
  • young boys aged 11 to 14 (with reminder from 15 to 19) (since January 1, 2021)
  • immunocompromised patients,
  • men who have sex with other men up to the age of 26.

Human papillomavirus vaccine

The vaccine against human papillomavirus protects vaccinated people against several strains of HPV, including types 16 and 18, the two most dangerous. This vaccine is recommended and reimbursed for young girls aged 11 to 14, but also as part of catch-up vaccination, for young women between the ages of 15 and 19, that is to say until the day before the 19 year anniversary. Currently, vaccination coverage against HPV remains insufficient with regard to the recommendations set by the HAS 10 years ago: only 24% of women are vaccinated according to the complete schedule. It should be noted that the vaccine against HPV is all the more effective in young girls who have never had intercourse or at the start of their sexual life, when they have not or little been exposed to the risk of infection by HPV.

human papillomavirus vaccine

Since January 1, 2021, the recommendation for vaccination against human papillomaviruses has been extended to young boys aged 11 to 14, regardless of their sexual orientation. This vaccination has been registered in the 2020 vaccination calendar. If this recommendation comes into force in 2021, it had been formulated by the High Authority of Health in December 2019 to curb the transmission of HPV in the general population and better protect boys as well as unvaccinated girls and women.

Health professionals are thus invited to offer more of this vaccine to each adolescent, girl or boy, whether as part of vaccination programs or during a sexual health consultation. The HAS would like to see easier access to this vaccination implemented, for example by allowing full reimbursement of the vaccine by the Health Insurance. Currently “The vaccine against human papillomavirus (HPV) infection is reimbursed, on medical prescription, at 65%. Complementary organizations usually intervene to complete the reimbursement. Vaccination may be free in certain vaccination centres” informed a communicated of the CNAM in October 2020.

At what age should you get vaccinated against HPV?

  • Young women are invited to be vaccinated between the ages of 11 and 14, and in catch-up between the ages of 15 and 19.
  • Young boys from 11 to 14 years old and in catch-up between 15 and 19 years old (since January 1, 2021).
  • Men who have sex with other men are encouraged to get vaccinated until age 26.
  • Immunocompromised patients, men or women, are advised to be vaccinated between the ages of 11 and 14, and in catch-up between the ages of 15 and 19. If a child is a candidate for a solid organ transplant, vaccination can be done from the age of 9

What is the name of the HPV vaccine?

It exists three vaccines against human papillomaviruses: Gardasil®, Cervarix® and Gardasil 9®. They differ in the number of papillomaviruses against which they protect: 2 to 9 depending on the vaccine. These three vaccines are absolutely not interchangeable and any vaccination started with one of them must be completed with the same vaccine.

What is the HPV vaccine schedule according to age?

Vaccine name Protects against… Age of vaccination Vaccination schedule
Gardasil® (quadrivalent vaccine) HPV types 6, 11, 16 and 18 Vaccination initiated between 11 and 13 years old gone 2 doses spaced 6 months apart
Vaccination initiated between 14 and 19 years old gone 3 doses administered according to a schedule: 0, 2 and 6
For men having sex with men up to 26 years old 3 doses administered according to a schedule: 0, 2 and 6
Cervarix® (bivalent vaccine) HPV types 16 and 18 Vaccination initiated between 11 and 14 years old gone 2 doses spaced 6 months apart
Vaccination initiated between 15 and 19 years old gone 3 doses administered according to a schedule 0, 1 and 6 months
Gardasil 9® (ninevalent vaccine) HPV types 6, 11, 16, 18, 31, 33, 45, 52, 58 Vaccination initiated between 11 and 14 years old gone 2 doses spaced 6 to 13 months apart
Vaccination initiated between 15 and 19 years old gone 3 doses administered according to a schedule 0, 2 and 6 months
For men having sex with men up to 26 years old 3 doses administered according to a schedule 0, 2 and 6 months

Good to know : the High Council for Public Health recommends that girls and young women who have not yet been vaccinated against the papillomavirus should receive the nonavalent vaccine Gardasil 9®.

How effective is the HPV vaccine?

Vaccination does not protect against all types of HPV (there are more than a hundred) and its duration of action is not yet known exactly. As with all vaccines, it does not protect 100%. A study published in The New England Journal of Medicine and relayed by the French Society of Colposcopy and Cervico-Vaginal Pathology (SFCPCV) highlighted in October 2020 the ability of the HPV vaccine to prevent the occurrence of cervical cancer. The study was carried out in Sweden and was based on the analysis of 600,000 women. The researchers managed to show a decrease of almost 50% risk of cervical cancer among vaccinated women. The vaccine was most effective if given at a young age (90% reduction in risk of cervical cancer in women vaccinated before age 17). “Because it takes 10, 15 or even 20 years of persistent HPV infection for a woman to develop cervical cancer, we did not yet have sufficient follow-up to be able to correctly assess this parameter. . With the introduction of the first vaccination policies in 2006-2007, we now have strong evidence“, commented the SFCPCV which recalled that vaccination is recommended for all young girls and young boys between 11 and 14 years old and that it can be made up up to the age of 19. Vaccination against HPV does not replace cervical cancer screening by Pap smear which remains essential from the age of 25, whether you are vaccinated or not. Only the smear makes it possible to detect the presence of an abnormality in the cervix after an infection with HPV viruses and to take charge of it quickly.

What are the side effects of the HPV vaccine?

As with all vaccines, there is a risk of side effects. After the injection, the most frequent risks are: pain, redness, swelling or bruising at the injection sitesometimes associated with fever, headache, nausea, muscle or joint pain. In France, a 2015 study carried out on more than 2 million young girls carried out jointly by the National Agency for the Safety of Medicines and Health Products (ANSM) and Health Insurance confirmed that vaccination against human papillomavirus (HPV) infections with Gardasil® and Cervarix® did not lead to an increased risk of autoimmune diseases and multiple sclerosis.

Where to get vaccinated against HPV?

Vaccination against HPV can be carried out:

  • by a doctor or a midwife,
  • by a nurse provided they have a medical prescription from a doctor or midwife,
  • in a free information, screening and diagnosis center (Cegidd), a family planning center and certain public vaccination centres.

Is the HPV vaccine compulsory?

The human papillomavirus (HPV) vaccine it’s not mandatorybut it is strongly recommended young girls (11 to 14 years old and remedial from 15 to 19 years old), young boys (between 11 and 14 years old and in catch-up up to 19 years old) immunocompromised patients and men who have sex with men up to 26 years old.

Sources:

– Ministry of Health

– Vaccination-info-service.fr

– High Authority for Health


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