2024-08-28 17:03:14
Vaccination rates falling sharply
HPV and cancer: Many people are unaware of their risk
27.08.2024 – 12:43Reading time: 3 min.
A vaccination against human papilloma viruses can protect against various tumors. Despite this, vaccination rates in Germany are low. Why is that?
Human papilloma viruses (HPV) are among the most common sexually transmitted infections worldwide. According to the Robert Koch Institute (RKI), almost every sexually active person becomes infected with it at least once in their life. Depending on the type of virus – there are 200 different types in total – an infection can have no consequences. Most people do not notice that they are infected and the infection disappears again.
But in rare cases it can cause cancer. This includes cervical cancer in particular, but also penile cancer, anal cancer and cancer in the oropharynx area. According to the RKI, around half of all infection-related cancers worldwide are caused by HPV.
The good news is: There is a vaccination that, according to the RKI, provides almost 100 percent protection against certain types of HPV. But too few people use it. This is again shown by figures published on Tuesday by the Barmer health insurance company. According to them, only 60 percent of girls aged 14 were fully vaccinated against HPV in 2022.
Among boys, the vaccination rate was much lower, at 25 percent for 13-year-olds. However, HPV vaccination for boys between 9 and 14 years of age has only been recommended since 2018, which is why Barmer does not yet have any meaningful data for 14-year-olds for 2022.
“The low vaccination rate is worrying,” said Nobila Ouédraogo, public health expert at the German Cancer Research Center (DKFZ) in Heidelberg. The Barmer study shows that although the vaccination rate has increased slightly overall in recent years, the increase has slowed significantly. “We are making progress, but we are getting slower,” said Ouédraogo.
The Standing Committee on Vaccination has recommended HPV vaccination for girls since 2007 and for boys aged 9 to 14 since 2018. Two vaccinations at least five months apart are necessary for protection. A missed immunization should be made up by the age of 17.
According to Barmer, vaccination activity has declined particularly from 2021 to 2022. This could be due, among other things, to a decline in doctor visits during the corona pandemic, estimates Ouédraogo. Lack of information, general vaccination fatigue and the lack of school vaccination programs are other possible explanations.
According to the DKFZ, HPV viruses are transmitted primarily through sex. Both women and men can become infected. Depending on the HPV type, different symptoms can appear later. So-called low-risk HPV types can lead to skin warts on the face, feet or hands, as well as genital warts, which are relatively harmless but sometimes painful.
- Read also: These sexually transmitted diseases are increasing rapidly among older people
High-risk types that can cause cancer, on the other hand, do not cause any symptoms at first. For women over 35, an HPV test has therefore been part of the early detection program for cervical cancer for several years. Women between the ages of 20 and 34 receive a cervical smear from their gynecologist to detect possible cell changes.
According to estimates, around 7,700 people in Germany develop cancer every year due to an HPV infection, according to the DKFZ. Before early detection was available in Germany, cervical cancer – a malignant tumor of the cervix – was the most common cancer in women. It has now become much rarer. And the effects of the vaccination should become apparent in the coming years, according to the RKI.
According to the DKFZ, condoms do not offer absolutely reliable protection against HPV, so vaccination is the safest protection. The fact that this can be administered from the age of nine is sometimes difficult to explain to parents, says Tanja Brunnert, spokeswoman for the Professional Association of Paediatricians and Adolescent Doctors (BVKJ). “When we mention the word sexually transmitted diseases, there is sometimes an incredibly great inhibition and also shame,” explains Brunnert, who runs a practice in Göttingen. “There are many parents who say that you don’t have to do that at nine, we can do it at twelve or thirteen.”
For Brunnert, this is one of the reasons for the low vaccination rate. According to her, children respond very well to vaccination when they are still very young. “The earlier, the better.”
Nevertheless, many parents are very critical of the vaccination. According to Brunnert, when the vaccine was approved, there were many critical voices, including from experts. “That still really bothers us, even though we know that the vaccination is well tolerated and effective.” This makes it all the more important that pediatricians provide good information. And even if that is not always easy in the stressful everyday working life, every appointment must be used to check the vaccination status.