Vaccination against human papilloma virus infections

Vaccination against human papilloma virus infections is currently the subject of high-profile controversy.

The General health directorate has asked the French High Council of public health (HCSP) to review the latest scientific data and specify the conditions in which HPV vaccination could also provide collective protection through herd immunity.

The HCSP reminds that virtually all industrialised countries, inside and outside of Europe, have issued HPV vaccination recommendations very similar to the French recommendations, some countries achieving a high vaccination coverage.

The HCSP observes that:

• The vaccine's efficacy on HPV infection prevalence and condyloma and precancerous lesion incidence has now been demonstrated. Studies suggest that this vaccine induces herd immunity;
• in France, the observed vaccination coverage is very low for the full schedule, and on the decrease since 2010; this low coverage does not provide the efficacy observed in other countries;
• the pharmacovigilance data, both international and national, with back data going back more than seven years, do not support the existence of a causal link between this vaccination and the serious adverse events which have been attributed to it in France;
• in pilot areas, despite the significant increase in organised cervical cancer screening, the percentage of women screened barely reaches 70% for the most performing areas. Immunisation is therefore a necessary complementary strategy;
• those populations who adhere neither to screening nor immunisation overlap in part, leaving a significant portion of the population devoid of any prevention. The current "opportunistic" approach to screening and vaccination in France can therefore exacerbate social and geographical inequalities in matters of health.

The HCSP reiterates its recommendations for: 

• the speedy roll out of organised cervical cancer screening;
• the implementation of management procedures for immunisation to achieve a high uptake in young girls, independently of their social background.