Papillomaviruses are sexually transmitted viruses responsible for nearly 6,400 cancers in France each year. The vaccine could prevent up to 90% of HPV infections that cause cancer.
We hear more and more about papillomavirus (HPV in English). These viruses sexually transmitted (oral, anal and vaginal) infect 80% of women and men (usually at the beginning of sexual life). There are nearly 200 different ones, including 12 are carcinogenic. Papillomaviruses are thus responsible for nearly 6,400 cancers each year in Francereminds himInca. Vaccination recommended from the age of 11 could prevent “up to 90% of HPV infections cause cancer” continues the authority. How to do it concretely?
At what age should you be vaccinated against papillomavirus?
Vaccination is recommended (not obligatory) for girls and boys aged 11 to 14 with a diagram 2 doses six months apart (M0-M6). For those who were not vaccinated at age 14, it is possible to be vaccinated between 15 and 19 years inclusive with three doses of vaccines. Vaccination is also recommended for men who have sex with men up to 26 years old (27 years less 1 day).
Papillomavirus vaccine and cancers
Out of 200 papillomaviruses, 12 are carcinogenic in women and men. The vaccine protects against 9 types of HPV involved in 90% of cervical cancers, 80% of anal cancers and 90% of anogenital warts (condyloma). The vaccine is therefore recommended against:
- THE precancerous lesions and/or cancers of the cervix, vulva, vagina and anus;
- THE genital warts or condyloma (benign but disabling and painful lesions which appear on the skin and mucous membranes of the anus and genital area due to HPV).
| Types of cancers | Men | Women |
|---|---|---|
| Penile cancers / Vulvar and vaginal cancers | 100 | 200 |
| Anal cancers | 400 | 1100 |
| Oropharynx cancers (mouth, throat, etc.) | 1300 | 400 |
| Cervical cancers | 2900 | |
| Precancerous lesions of the vulva, vagina, anus | 130 | 2500 to 3000 |
| Precancerous lesions of the cervix (CIN 2+) | around 30,000 | |
| Anogenital warts | approximately 50,000 | approximately 50,000 |
Papillomavirus vaccine in women
The human papillomavirus vaccine 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 aged 15 to 19, that is to say until the day before the birth. 19th birthday. Vaccination does not protect against all HPV linked to cervical cancer. This is the reason why smear screening should be carried out in women every three years from 25 to 65 years of agewhether vaccinated or not.
Human papillomavirus vaccine
The benefit of vaccination against papillomavirus in men is to protect them from the occurrence of recurrent anogenital warts (around 50,000 cases/year in France), oropharynx cancers (mouth, throat… approximately 1300 cases/year in France), penile and anal cancers. Boys can get vaccinated from the age of 11 and up to 19 years. Men who have sex with men are encouraged to be vaccinated until they are 26 years old.
What are the conditions for reimbursement for the vaccine?
HPV vaccination is 100% reimbursed when it is carried out in colleges. In other cases, it is refunded up to 65% by Health Insurance (the remaining amount is generally reimbursed by complementary health insurance (mutual insurance)).
What are the names of papillomavirus vaccines?
Two vaccines are available:
- The vaccine Gardasil 9® protects against HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58, and must be used for any new vaccinations.
- Only for girls: The vaccine Cervarix® protects against HPV 16 and 18.
What is the vaccination schedule for the papillomavirus vaccine?
Any new vaccination should be started with the Gardasil 9 vaccine® for people not previously vaccinated. In case of delay, there is no need to start all over again, just top up with the missing dose(s). Vaccines are not interchangeable and any vaccination started with one must be continued with the same vaccine. Vaccination must be deferred in case of acute illness with fever.
| Name of vaccine | Protects against… | Age of vaccination | Vaccination schedule |
|---|---|---|---|
| Gardasil 9® | HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58 | between 11 and 14 years old | 2 doses spaced 6 months apart (up to 13 months) |
| between 15 and 19 years old | 3 doses administered according to a schedule: 0, 2 and 6 | ||
| For men having relationships with men up to 26 years old | 3 doses administered according to a schedule: 0, 2 and 6 | ||
| Cervarix® (only for girls) | HPV 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 0, 1 and 6 month schedule |
How effective is the papillomavirus vaccine?
Vaccination does not protect against all types of HPV and its duration of action is not yet exactly known but what is confirmed by health authorities is that if vaccination is carried out before the start of sexual life, its protection is close to 100%. HASafter the start of sexual life, protection is lesserbecause the vaccine does not protect against previous HPV infections (the virus can infect at the start of sexual life and remain dormant for several years before appearing in the form of warts or cancers).
Vaccination does not exempt young women from having regular smears.
► 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 anti-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 reduction of almost 50% risk of cervical cancer among vaccinated women. The vaccine was all the more effective if it was given at a young age (90% reduction in risk of cervical cancer in women vaccinated before age 17). HPV vaccination does not replace cervical cancer screening by cervical 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 anomaly in the cervix after infection by HPV viruses and to treat it quickly.
What are the side effects ?
As with all vaccines, there is a risk of side effects. According to’Medicines Agencythe most frequently observed adverse reactions with the Gardasil 9 and Cervarix vaccines during clinical studies are:
- reactions at the injection site (redness, pain and/or inflammation),
- headaches.
These undesirable effects are generallymild or moderate intensity and short duration. Other frequently encountered side effects are:
- feelings of dizziness,
- gastrointestinal disorders (nausea, diarrhea, abdominal pain),
- fever,
- fatigue.
These effects appear quickly after vaccination and last a short time. Some Rvery rare but serious allergic reactions, may occur after vaccination. If you experience any of the symptoms described below, contact a doctor or medical emergency immediately:
- a rash that may be itchy or blistering;
- swelling of the eyes and face;
- difficulty breathing or swallowing;
- sudden discomfort which can lead to loss of consciousness.
What are the risks of the HPV vaccine?
For more than 10 years, more than 6 million doses have been prescribed in France and more than 300 million worldwiderecalled the Inca in September 2023. “Monitoring implemented at international level and the results of specific studies have confirmed that these vaccines are very safe“.
► rare Guillain-Barré syndromes have been reported after use of these vaccines. A study French pharmaco-epidemiology (Cnam/ANSM) in 2015 highlighted an increased risk of the order of 1 to 2 additional cases of Guillain-Barré syndrome per 100,000 young girls vaccinated. “To date, in fact, no other study in the world has found such an increased risk” indicates the ANSM.
► In 2013, doctors carried out the “link between the two injections of Gardasil (previous version of Gardasil 9, editor’s note) and the occurrence” of a multiple sclerosis in a 15-year-old girl, informed The world. For’Inca, “the temporal coincidence of the occurrence of a disease after vaccination cannot be assimilated to a causal link”. And to emphasize that the 2015 French study carried out on more than 2 million young girls “confirmed that vaccination against human papillomavirus (HPV) infections with Gardasil® or Cervarix® does not cause no excess risk autoimmune diseases (MAI), nor multiple sclerosis.
- Vaccination Info Service, Human papillomavirus infections, September 26, 2023
- Understanding vaccination against HPV or human papillomavirus, Inca, September 2023
- “Facilitating access to the HPV vaccine for all children aged 11 and over: vaccination offered free of charge to 5th grade students”, Press release, National Cancer Institute, September 4, 2023