Against papillomaviruses, it is necessary to vaccinate not only adolescents, but also young adults, including men and women: this is the recommendation issued on January 29 by the National Academy of Medicine (ANM), which is in favor “to extend and encourage HPV vaccination in the general population up to 26 years of age”. HPV – or human papillomaviruses – which are transmitted sexually, cause more than 6,000 new cancers per year in France, including nearly 3,000 cervical cancers causing more than 1,000 deaths. 1,500 ENT cancers and 1,500 anus cancers.
In France, the bivalent Cervarix vaccine is available, which protects against type 16 and 18 viruses responsible for most cancers, and the nonavalent Gardasil, also effective against five additional types. Today, vaccination is recommended for all boys and girls aged 11 to 14. According to Public Health France, as of December 31, 2022, only 47.8% of girls and 12.8% of boys born in 2007 had received one dose out of the two planned for this age group. The vaccine is also recommended, with three doses this time, for 15-19 year olds in catch-up and for men who have sex with men up to 26 years old.
Through a spokesperson, the High Health Authority said it had taken note of the opinion of the ANM on this “very important subject”. As mentioned by his work program for 2024 published on January 18, the HAS intends to study this year the possibility of recommending vaccination for women and men aged 20 to 26 regardless of their sexual orientation. In the United States, the Centers for Disease Control and Prevention, the federal public health agency, recommend vaccination for everyone up to 26 years old.
Essential effectiveness observed in the 14-18 year old age group
To base its opinion, the ANM emphasizes that “the risk of HPV infection persists throughout life in both sexes” and “50% of cervical cancers are due to infections contracted after the age of 20.” Gold, “if the benefit of vaccination is optimal for uninfected people, it remains important for infected people.” The Academy adds that “several studies show the effectiveness and good tolerance of the vaccine between 16 and 26 years of age on preneoplastic lesions [états précancéreux] and genital warts in women and men.
The ANM cites a study published in the New England Journal of Medicine in 2020, which studied data from around 1.7 million Swedish women aged 10 to 30. In this population, the cumulative incidence of cervical cancer at age 30 reached 94 cases per 100,000 women if they were not vaccinated, but only 54 cases per 100,000 if they were vaccinated between ages 17 and 30. . Girls vaccinated before the age of 17 had a cumulative incidence of 4 cases per 100,000 at the age of 28.
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