USA vs France : vaccination against Human papillomavirus

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© Shutterstock
Two vaccines are currently available in France and the US, Merck & Co.’s Gardasil® and GlaxoSmithKline’s Cervarix®. While, in France, the HPV vaccination coverage rate is under 30%, in the USA , The Department of Health and Human Services goal is to boost HPV vaccination rates to 80 percent by 2020.

 

HPV vaccination in France

The French guidelines currently indicate vaccination of girls aged 14 with a catch-up program for females from 15 to 23 years old.
So far the situation was relatively blocked because Gardasil®’s marketing authorisation was retaining as an indication the prevention of female genital cancers and genital warts. If we had recommended the HPV vaccine for boys, we could have done it only for the prevention of condyloma.
This blocking factor has been lifted as, since June, the European authorities have extended the European marketing authorisation of Gardasil® to the prevention of anal cancer and pre-cancerous anal lesions.
In 2013, InVS stated that only a third of girls affected by the recommendation on the HPV vaccine had been fully vaccinated. So how imagine a higher coverage among boys although they would gain less profit ?

 

What about the USA ?

After researchers discovered a link between HPV and cervical cancer in the 1980s, it was considered a women’s-only issue. Now, as cervical-cancer rates are falling and oral-cancer rates in men steadily rise, HPV cancers are shifting to men.
Experts recommend the vaccine at age 11 or 12, but it can be given to girls up to age 26 and boys up to age 21. It is important for children to receive all three doses of the vaccine before they become sexually active.
Federal goal is to vaccinate 80 percent of boys and girls against HPV by 2020. Thus, the National Cancer Institute recently announced that it was investing nearly $2.7 million into 18 U.S. cancer centers to boost HPV vaccinations among boys and girls.
Nonetheless, according to the National Immunization Survey of teenagers, only 38 percent of girls and 14 percent of boys completed the three-dose course of the HPV vaccine in 2013.
Achieving higher HP vaccination rate might be difficult. Indeed pediatricians feel uneasy talking to parents of young children about this vaccination because there’s an implication of sexual activity: a study conducted in 2011 by the Moffitt Cancer Center in Tampa, Fla, found fewer than 15% of physicians always recommended the vaccine to boys, and no more than 55% always recommended it to girls.

 

Conclusion

Will French boys be vaccinated against HPV ? One of the major obstacles is the extra cost of the vaccination among boys while the profit they can get is limited.
According to the President’s Cancer Panel[1], a number of things need to be done to increase HPV vaccination rates. These include public education and other efforts to increase teens’ and parents’ acceptance of the vaccines; encouraging doctors and other health care providers to recommend and give vaccinations; and making sure that the vaccines are available where teens receive health care.

 


 Sources

Aude Lecrubier, Vaccin anti-HPV aux garçons : encore des obstacles, http://www.medscape.fr/voirarticle/3600897 (November 10, 2014)

Caitlin McCabe, Federal Goal Is to Vaccinate 80% of Boys and Girls Against HPV by 2020 http://online.wsj.com/articles/federal-goal-is-to-vaccinate-80-of-boys-and-girls-against-hpv-by-2020-1415647100 (November 11, 2014)

President’s cancer panel , http://deainfo.nci.nih.gov/advisory/pcp/pcp.html (November 10, 2014)