More than 1.3 million young adults can get a free shot against HPV cancer this year. But the catch-up session for this group also raises questions. Readers on our response platform NUjij, for example, wonder why a 26-year-old can get the HPV shot for free and a 28-year-old cannot.
HPV stands for the human papilloma virus. In rare cases, that virus can lead to cancer. Vaccination reduces the risk.
The catch-up campaign is aimed at the more than 1.3 million 18 to 26-year-olds who have not previously received an HPV vaccination. This shot is only free for young adults this year. “You have to draw the line somewhere,” RIVM previously told NU.nl.
The Ministry of Health, Welfare and Sport refers to the advice of the Health Council. Based on scientific research, he sees no point in a vaccination campaign for people over the age of 26, because “vaccination at a higher age is not effective”.
“From the government you have to choose what you use your money for. You prefer to do that where the greatest effect is expected,” says Daniëlle Timmermans. She is professor of Risk Communication and Public Health at the Amsterdam UMC. Such a consideration has also been made for, for example, the flu jab, which people over sixty and other risk groups can get free of charge.
“The question is whether the vaccination provides so much health benefit that everyone should get it for free. Probably not, because the risk of cervical cancer is small. Each case is one too many, but there are greater risks.”
From a public health perspective, it therefore seems to be the right policy, but citizens may think differently. “People often assess risks differently than experts. For some, even a small risk is not acceptable. If there is a vaccine against cervical cancer, then they think it is logical that it should be available to everyone,” explains Timmermans.
Wat is HPV?
- Het humaan papillomavirus (HPV) kan in zeldzame gevallen kanker veroorzaken. Ieder jaar krijgen duizend vrouwen baarmoederhalskanker of kanker aan de vagina of schaamlippen of in de mond- of keelholte. Bij mannen gaat het om ongeveer vierhonderd personen die penis-, anus- , mond- of keelholtekanker krijgen.
- HPV is zeer besmettelijk en seksueel overdraagbaar. De meeste mensen krijgen het, maar merken daar niets van. Meestal verdwijnt het virus na twee jaar weer uit het lichaam.
- Kinderen krijgen op hun tiende de vaccinatie gratis aangeboden. Dit jaar kunnen ook 18- tot 27-jarigen de prik gratis halen. Dit voorjaar ontvangt een groep tieners onder de achttien opnieuw een uitnodiging.
‘The jab can also be useful for older people’
Not only citizens, but also some experts are calling for the group to be expanded. For example, Jacqueline Louwers of gynecologists’ association NVOG sees thirty-year-old women who could have gotten the shot years ago, but didn’t. “I have to tell them that they have cervical cancer,” says Louwers, who also works as a gynecologist at the Diakonessenhuis. “That would not have been necessary if they had received a shot.”
The jab can also be useful for older people. “We know that women benefit if we vaccinate around the treatment of a precancerous stage of cervical cancer. But we run into the fact that women have to pay for that shot themselves. You lose 155 euros per vaccine and you need two or three. That is a cost that not everyone can afford. That creates enormous inequality.”
Louwers says that ideally everyone can get such a shot, but understands that “choices have to be made”. “As far as I am concerned, we ensure that as many young people as possible are vaccinated and then people on indication.” She points to certain risk groups, including people who have a malfunctioning immune system.
Waarom prikken we met Cervarix?
Op ons NUjij-platform vroegen jullie je ook af waarom de jongvolwassenen en kinderen het HPV-vaccin van Cervarix krijgen toegediend. Er zijn namelijk ook andere prikken beschikbaar. Zo beschermt Gardasil tegen meer soorten HPV-kanker.
Het ministerie zegt dat Cervarix is gekozen op basis van de goede werking en de prijs. Daarom is in het zogenoemde aanbestedingsproces Cervarix geselecteerd. Volgend jaar wordt opnieuw naar de aanbesteding gekeken. Dan zou dus een ander vaccin aangekocht kunnen worden.
“Het voordeel van Gardasil is dat het ook beschermt tegen genitale wratten. Maar bij dit soort grote vaccinatiecampagnes tellen kosten ook mee”, zegt Louwers hierover. “Het einddoel is kanker voorkomen, niet genitale wratten. Dan is dit een betere kandidaat.”