Human papillomavirus infections are among the most common sexually infections. About 80 % of the population is exposed to HPV during their lifetime and the majority of contaminations occur in the first years of sex life. HPV with high oncogenic risks are responsible for precancerous lesions at the level of the cervix, the vulva, the vagina, the anus and cancers of the collar, the ENT sphere, the anus, the penis, the penis, vulva and vagina. It is therefore recommended that all young people, girls and boys, from 11 to 14 years old to be vaccinated (two-doses vaccine scheme). In catch -up, vaccination with 3 injections is recommended in young people from 15 to 19, and even up to 26 years specifically for men with sex with men.
The HPV vaccine (Gardasil 9) is based on protein that imitates the virus envelope but do not infect the vaccinated person. It induces an extremely effective immunogenicity against the virus. “Its first efficiency lies in the prevention of chronic HPV infection targeted by the vaccine. Recall that chronic infection is the first risk factor in collar cancer and other HPV cancers induced. With vaccination, the risk of chronic infections at HPV 16 and 19 (highly oncogenic HPV) is reduced by more than 99 %. said Professor Xavier Carcopino, gynecologist-obstetrician, during a press conference of the French Société de Colposcopie and Cervico-Vaginal pathology.
Lower efficiency in the vaccine after 14 years
But the age of vaccination plays a major role in this efficiency. Thus, according to a Swedish study published in 2020 in The New england journal of medicinevaccination before 17 years reduces the risk of cervical cancer by 88 %. After only 17 years, only 53 %.
A second study, British it and published in 2021 in The Lancetshows that vaccination avoids 97 % of precancerous lesions if it takes place between 12 and 13 years old, 75 % if it takes place between 14 and 16, finally 39 % if it is made between 16 and 18 years old. According to this same study, cancers are reduced by 87 % when vaccination is carried out before 14 years, 62 % before 17 years, 34 % before 19 years.
In addition to the benefits of early vaccination on the occurrence of cancer, it logically impacts the appearance of precancerous lesions “Each year, in France, nearly 30,000 precancerous lesions are diagnosed. Collar cancer is a little forgotten by the general public because it has fallen due to screeningunderlines Professor Carcopino, But precancerous lesions are extremely frequent. And for the 30,000 women treated each year, it is an event. This implies a treatment that will affect the most intimate, to sexuality, to fertility problems, with a risk on pregnancies. »» As a reminder, precancerous lesions are mainly processed by surgery, with conization (resection of the mucosa affected).
-Girls’ vaccination is essential, that of boys is essential
Vaccination before 14 years old and that during catching up between 15 and 19 are not equal. Vaccinal catch -up, up to 19 years old, will not have the same efficiency on the occurrence of lesions and the appearance of cancers.
As a reminder, the HPV vaccination campaign, the second of which started at the start of the school year in September 2024, concerns students of 5e. If the vaccination of young girls is essential, that of boys is also essential. “Vaccination against boys HPV will, subject to sufficient vaccination coverage, to slow down the transmission within the general population, and thus to better protect boys and men, but also to better protect girls and non -vaccinated women ”, underlines the National Cancer Institute.
Source: SFCPCV press conference, National Cancer Institute, Ameli.fr
