In France, low rate of HPV vaccination raises concerns among health experts

Vaccination against human papillomavirus (HPV) in France remains one of the lowest in the European Union, prompting health professionals to warn of a risk to public health and the importance of vaccinating boys too.

The vaccination coverage at 28% in 2020 was nearly three times lower than in some other European countries, such as Portugal, Spain, and the United Kingdom, where it reached 75%.  Overall in Europe in 2020, vaccination coverage exceeded 50% in 20 countries and 75% in 11 countries.

HPV vaccination, which requires two doses, is not compulsory in France and it is up to parents to decide whether to have their child vaccinated.

“The key question is: should we impose this vaccine or should we wait for people to come and get vaccinated?” Richard Villet of the French National Academy of Medicine said in an interview with Euractiv.

However, the fact that vaccination is not compulsory in France does not seem to be the main reason for the low vaccine rate as HPV vaccination is not compulsory in any country in the EU except in Latvia, where it is mandatory for girls aged twelve.

The main difference is that in some European countries like Italy, Spain, the UK or Denmark, the vaccine is automatically offered to children in middle schools.

Given the low vaccination rate in France, former health minister Aurélien Rousseau announced the introduction of a nationwide vaccination campaign for all pupils in the fifth grade last October.

He posted on X that the campaign would offer “schoolchildren in Year 5 a vaccine that prevents up to 90% of infections”, although it is not compulsory.

Although it is still too early to analyse the effects of the vaccination campaign, the new Health Minister Catherine Vautrin will have to analyse the results, whether good or bad and draw conclusion in order to draw up a potential future action plan, said Catherine Amalric, a French MEP (Renew) and member of the European Parliament’s committee on the environment and public health.

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Vaccinating both: boys and girls

The majority of people vaccinated against HPV in France are girls: 41.5% of sixteen-year-old girls had been fully vaccinated by 2022, according to the French National Cancer Institute (INCA), compared with 8.5% of boys.

“Yet, it is important to vaccinate both girls and boys from secondary school onwards,” warned Amalric.

According to a study published in August in the scientific journal The Lancet, almost one man in three worldwide is infected with at least one papillomavirus.

“Sexually active men of all ages are at high risk of genital HPV infection,” the study stated.

People infected with HPV can develop cervical, vaginal, vulvar, anal cancers, and mouth, throat, head and neck cancers. It is thought to be the cause of 6,400 new cases of cervical cancer each year in France. Villet said that better screening programs are needed to address the issue.

“Screening is not regular in France, particularly in disadvantaged areas where there is a shortage of gynaecologists,” Villet explained, talking about cervical cancer.

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French reluctance to be vaccinated

Another explanation is the reluctance of the French to be vaccinated, whatever the vaccine. A report by the Fondation Jean Jaurès revealed that when French people were asked whether they would be willing to be vaccinated against COVID-19, 24% said they would probably not and 19% said they would certainly not.

“These figures are not surprising, given that France has become one of the most sceptical countries in Europe, and indeed the world, about vaccination coverage in recent years”, stated the report, published in November 2020.

According to Villet, the anti-vax lobby in France is strong and has a large audience on social networks, which encourages the spread of false information.

“Fake news is having a devastating effect on vaccination in France,” Catherine Amalric confirmed to Euractiv.

In the case of the HPV vaccine, in addition to the general reluctance to vaccinate, there is also the fact that it is linked to sexuality, which is a “brake”, according to the French MEP. There is a risk of contamination from the very first intercourse.

There are also disparities in terms of access to vaccination in France. “The more privileged social groups are better informed because they were in a position to ask for it,” said Amalric.

HPV is addressed in an EU-wide manner in Europe’s Beating Cancer Plan, launched in 2021 and considered “a key pillar of the European Health Union”. The plan sets a target of vaccinating at least 90% of girls for HPV by the age of 15 and increasing the vaccination of boys by 2030.

“The EU’s role is to limit the cross-border risk. Viruses know no borders: when populations move, exposure to a virus increases,” explained Amalric.

“We need to vaccinate as many girls and boys as possible, as early as possible.”

[Edited by Giedrė Peseckytė/Zoran Radosavljevic]

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