Vaccination against the papillomavirus: putting an end to misinformation, by Alain Fischer

HPV viruses infect most of us. Some are transmitted sexually. They cause warts and warts but above all about 30,000 precancerous lesions of the cervix per year and 6,000 cancers (of the cervix but also of the vulva, vagina, anus, penis and oral sphere -pharyngeal). They strike 4,500 women and 1,500 men, and cause some 2,000 deaths. These cancers are insidious because the latency time between infection and the appearance of the tumor can exceed twenty to thirty years.

A vaccine has been developed against the major carcinogenic HPV strains: first two, then four and now nine. We owe it to American researchers Douglas R. Lowy and John T. Schiller, honored with the prestigious Lasker Prize. This vaccine contains a virus protein (L1) combined with an aluminum adjuvant. Used since 2006, it induces a powerful and long-lasting immune response. Vaccination has been the subject of a promotion program in certain countries such as Australia. This vaccine is effective: with hindsight, we know that it prevents approximately 90% of cervical cancers if administered before the start of sexual activity. This vaccine is safe: it sometimes causes a little fever, a feeling of malaise, headaches and fatigue for twenty-four hours, but that’s about all! Vaccination is therefore recommended for girls and boys aged 11 to 14 in the form of two injections spaced six to twelve months apart.

To date, 300 million doses have been administered worldwide. In northern European countries, Great Britain, Portugal and Australia, 70-90% of adolescents are vaccinated. In France, just under 40% of girls and 6% of boys aged 15 are. Why this failure? This vaccine has been and still is in our country the object of attacks as virulent as they are erroneous. Some claim that it would not be necessary because it is possible to detect precancerous lesions of the cervix by studying the cervical smear. Unfortunately, many women are not supervised. And above all, vaccination prevents where the smear detects a lesion that requires treatment. We also hear that this vaccine would cause cancer. But this assertion is based on a fanciful reading of statistics showing an increase in the frequency of cancers of the cervix in certain countries… in unvaccinated women!

Limited offer. 2 months for 1€ without commitment

Should this vaccination be made compulsory?

Another misconception, the vaccine would be dangerous, because responsible for autoimmune diseases and syncope. Several studies of millions of young girls vaccinated show that this is not the case. These suspicions caused in some countries, in particular in Denmark and Japan, a drop in vaccination and even led to a decision to stop in Japan, fortunately today canceled. Others, finally, affirm that the vaccination of the boys is useless, because they do not risk anything. We saw above that this is incorrect. Moreover, vaccinating boys protects girls, which makes this vaccination fairer. Finally, it has been argued that vaccination hastened the onset of sexual activity. Studies show that this is not the case.

So, how to react to this flood of fake news often carried by doctors without competence in the field, relayed by politicians and the media? Given what is at stake – preventing 90% of 6,000 cancers and 2,000 deaths each year – large-scale public action should be undertaken: launching information campaigns targeting, on the one hand, general practitioners, pediatricians, gynecologists, and, on the other hand, parents and adolescents, in particular within the framework of the interventions of health and citizenship education committees in secondary schools.

The question of the possible obligation of this vaccination deserves to be asked. These vaccines are expensive – around 100 euros per dose – their reimbursement by Medicare must be full and not just 65%. Finally, (re)vaccinating at school by relying on nurses and doctors outside the establishment, as is the case in most countries where this vaccination is a success, would make it possible to reach all social classes. . Not carrying out this action for the obvious benefit would not be to the honor of France. Mobilization of all stakeholders is essential.