It was supposed to vaccinate at least 30% of 5th grade students against papillomaviruses, the viruses responsible for several cancers, including cervical cancer. The HPV (human papillomavirus) vaccination campaign, launched in September 2023, has not (yet) fulfilled its promises. The figures are indeed very disappointing: at the end of November, only 11% of students had received their first injection of Gardasil, three times less than the stated target. And these data - the only ones available to date - are very fragmented and possibly above reality: they are those communicated by the Health Agency of the Grand Est region, a territory that is rather a good student. "This region is ahead of the curve in terms of information about this campaign, it has been communicating about it for several years and it has implemented several programmes," says Professor Geoffroy Canlorbe, a gynaecologist at the Pitié-Salpêtrière hospital in Paris.
France, a poor student of HPV vaccination
However, the goal of 30% of students in 5th grade vaccinated was far from ambitious. "In 2023, there are more than 100 countries around the world that practice this vaccination in schools. In Europe, some twenty countries are already doing so. They all have a vaccination coverage of more than 70%, and some of them even reach 90%," reports Professor Canlorbe. France is lagging far behind in this area, even though vaccination coverage has doubled in ten years. At last count, only 48% of 15-year-olds have received at least one of the two doses provided for in the vaccination schedule. Among boys, the rate is only 13%. However, vaccination coverage must exceed 80% to get rid of these carcinogenic viruses. "We expected this vaccination campaign to start better, especially since the objectives set were quite moderate," Canlorbe said at a press conference on January 11 organized by the French Society of Colposcopy and Cervico-Vaginal Pathology (SFCPCV). "It's a bit disappointing but I'm confident we can do better.
»As of 2023, there are more than 100 countries around the world that practice this vaccination in schools. In Europe, some twenty countries are already doing so. They all have a vaccination coverage that exceeds 70%, and some reach 90%.
Prof. Geoffroy Canlorbe, gynaecologist at the Pitié-Salpêtrière Hospital (Paris)
One of the reasons given to explain this difficult start is a certain administrative "burden" that weighs on families. "Both parents must have signed the authorisation form to be vaccinated and the child must come with his or her health booklet," explains the gynaecologist. This requires a bit of organization, especially for blended families. "There is no follow-up in the colleges, the arrival of the vaccination teams is punctual. If the child is not there on D-Day or has forgotten his health booklet, he will not be vaccinated," says Professor Xavier Carcopino, head of the obstetrics and gynaecology department at the North Hospital in Marseille. Families who are keen to get their children vaccinated will still be able to make an appointment with their GP to make up for this missed attempt.
Read alsoHPV vaccine: a single dose could be enough
Lack of information and trust
But the main obstacle to the smooth running of the campaign is not only a matter of forgotten health records, as evidenced by the rate of authorizations signed by both parents. It varies from 18% in the Indre department to 30% in Brittany. Parents who are in favour of vaccinating their child in principle are therefore not in the majority, unless they believe that they have already had this vaccination carried out by their attending physician.
Basically, the real problem is a lack of information from families, who do not always see the point of injecting their little ones with yet another vaccine. It must be said that the subject is complex. We are told about a vaccine that is supposed to protect against cervical cancer, but we still need to vaccinate boys... A funny idea? In reality, this protects girls by blocking the circulation of the virus on the one hand, but also boys themselves, who can declare HPV-related cancers. In practice, a quarter of cancer cases due to HPV occur in men (ENT, anal and penile cancers).
Moreover, in recent decades, many scientific controversies (now settled in favor of vaccines) have instilled doubt. Examples include the alleged link between the hepatitis B vaccine and multiple sclerosis, the link between the measles-mumps-rubella vaccine and autism, or the theory of the alleged toxicity of aluminum, often used as an adjuvant... At the end of October, the death of a 12-year-old schoolboy, eight days after feeling unwell during a vaccination session against the papillomavirus in Saint-Herblain (Loire-Atlantique), launched a new controversy. This sad event, however, has nothing to do with the vaccine, as his autopsy revealed. The young man died "following a head injury following a malaise with loss of consciousness", as the Agency for the Safety of Medicines reminds us. But this tragedy has undoubtedly damaged the confidence of many parents. Catholic Education even recommended that its schools, which were not forced to participate in the campaign, suspend it.
An effective way to prevent cancer
However, the effectiveness of HPV vaccination has been proven. As a reminder, its objective is to protect against a possible infection by these viruses, responsible for 6300 new cases of cancer each year in France. In the United Kingdom, where vaccination coverage has been excellent for 15 years, a study showed a 97% reduction in precancerous lesions on the cervix when vaccination is done between the ages of 12 and 13. In 2018, Australia had already announced the collapse of HPV virus infections among young women. The same is true in all countries that vaccinate their young people widely. Without circulating viruses, cancers also decrease. This was shown by a large Swedish study published in 2020 in TheNew England Journal of Medicine: cervical cancer cases fell by almost 90% in all women vaccinated before the age of 17. Australia is in the process of eradicating it.
The safety profile of vaccines against HPV virus infectionshas been confirmed after more than 15years of use and more than 300 million doses administered worldwide, including more than 12 millionin France.
the National Agency for the Safety of Medicines
Experts also reassure about the vaccine's safety. "The safety profile of vaccines against HPV virus infectionshas been confirmed after more than fifteen years of use and more than 300 million doses administered worldwide, including more than 12 millionin France," says the Agency for the Safety of Medicines. "In 2020, a large Australian study, which followed the fate of 9 million doses of vaccines over eleven years, concluded that there were no more complications in the vaccinated group than in the unvaccinated," notes Professor Geoffroy Canlorbe. On the other hand, there is a very low risk of discomfort or anaphylactic reaction, which is why people receiving the vaccine should be monitored for 15 minutes after the injection.