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Papillomavirus vaccine: name, effectiveness, until what age?

Vaccin contre le papillomavirus : nom, efficacité, jusqu

Human papillomaviruses (HPV) are contagious viruses responsible for more than 6000 cancers each year in France. Vaccination (Gardasil®, Gardasil 9® or Cervarix®) is the best way to protect yourself. At what age ? Is it compulsory for women and men? Are there any side effects?

Human papillomaviruses (HPV) are very common sexually transmitted viruses, usually contracted at the start of sex during vaginal, oral or anal sex. They can cause the appearance of warts (papillomas), Contagious lesions localized on the skin or on the mucous membranes of men or women. If 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 develop in anal and oropharyngeal, cervical, vaginal or vulvar cancers.

Vaccination against human papillomaviruses remains the best way to fight these viruses. It consists in introducing into the body an inactive (or very weakened) microbe. To deal with this “false microbe” and prevent its spread, 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 antibodies which will therefore be able to neutralize it and prevent the development of the disease.

HPV vaccination is currently recommended and reimbursed up to 65% by Health Insurance (complementary organizations often intervene to complete the reimbursement) at:

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

The human papillomavirus vaccine protects people vaccinated against several strains of HPV, including types 16 and 18, the two most dangerous. This vaccine is recommended and reimbursed in young girls between 11 and 14 years old, but also as part of the catch-up vaccination, in young women between 15 and 19 years old, that is to say until the day before l anniversary of 20 years. Currently, HPV vaccination coverage remains insufficient in relation to the recommendations set by the HAS 10 years ago: only 24% of women are vaccinated according to the complete scheme. Note that the HPV vaccine is all the more effective in young girls who have never had sex or at the start of their sexual life, when they have been exposed to little or no risk of infection by the HPV.

In a statement* from Monday 16 December 2019, the High Authority for Health (HAS) recommends extending human papillomavirus (HPV) vaccination to all boys aged 11 to 14 whatever their sexual orientation, with a possible catch-up between 15 and 19 years old. A decision made after consulting patient and user associations as well as national colleges of professionals or manufacturers. The objective: slow down the transmission of HPV in the general population and better protect unvaccinated boys and girls and women.

The Ministry of Solidarity and Health, “wish that this recommendation be included in the 2020 vaccination schedule for implementation by summer“Health professionals will therefore be 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. HAS would like to see ‘easier access to this vaccination, by allowing, for example, a full reimbursement of the vaccine by Health Insurance.the technical committee on immunization will start work to redefine the methods of catching up, both for girls and for boys, in a context of changing knowledge and possible tensions in the supply of vaccines worldwide“, says HAS in its press release.

  • Young women are invited to be vaccinated between 11 and 14 years old, and in catch-up between 15 and 19 years old.
  • Men who have sex with men are invited to be vaccinated up to the age of 26.
  • Immunocompromised patients, men or women, are invited to be vaccinated between 11 and 14 years of age, and catch-up between 15 and 19 years of age. If a child is a candidate for a solid organ transplant, vaccination can be done from the age of 9 years

It exists three vaccines against human papillomaviruses: Gardasil®, Cervarix® and Gardasil 9®. They differ in the number of papillomaviruses 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.

Vaccine nameProtects against …Age of vaccinationVaccination schedule
Gardasil® (quadrivalent vaccine)HPV type 6, 11, 16 and 18Vaccination initiated between 11 and 13 years old over2 doses spaced 6 months apart
Vaccination initiated between 14 and 19 years old over3 doses administered according to a scheme: 0, 2 and 6
For men who have sex with men up to 26 years old3 doses administered according to a scheme: 0, 2 and 6
Cervarix® (bivalent vaccine)HPV types 16 and 18Vaccination initiated between 11 and 14 years old over2 doses spaced 6 months apart
Vaccination initiated between 15 and 19 years old over3 doses administered according to a 0, 1 and 6 month schedule
Gardasil 9® (nonavalent vaccine)HPV type 6, 11, 16, 18, 31, 33, 45, 52, 58Vaccination initiated between 11 and 14 years old over2 doses spaced 6 to 13 months apart
Vaccination initiated between 15 and 19 years old over3 doses administered according to a 0, 2 and 6 month schedule
For men who have sex with men up to 26 years old3 doses administered according to a 0, 2 and 6 month schedule

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

Vaccination does not protect against all types of HPV (there are more than a hundred) and its duration of action is not yet exactly known. As with all vaccines, it does not protect 100%. However, vaccination against HPV has demonstrated its effectiveness on precancerous lesions, such as in Australia, England and Sweden (where a high proportion of young girls are vaccinated). It has contributed to a significant decrease in the number of precancerous lesions of the cervix in this population

However, HPV vaccination does not replace cervical cancer screening with a cervical smear which remains essential from the age of 25, whether one is vaccinated or not. Only the smear can detect the presence of an abnormality in the cervix after infection with HPV viruses and take care of it quickly.

As with all vaccines, there is a risk of side effects. The most common risks after injection are: pain, redness, swelling, or bruising at the injection site, sometimes associated with fever, headache, nausea, muscle or joint pain. More serious side effects such as damage to the nervous system (Guillain-Barré syndrome) are very rarely observed.

Vaccination against HPV can be carried out:

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

Human papillomavirus (HPV) vaccine it’s not mandatory, But it is highly recommended young girls (11-14 and catch-up 15-19), immunocompromised patients and men who have sex with men up to 26 years of age.

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