“One dose is much better than nothing, but it may be a little worse than two doses”, estimates Tuesday April 12 on franceinfo the doctor François Vié Le Sage, pediatrician and member of the expert group in vaccinology “Infovac” within the French Association of Ambulatory Pediatrics (Afpa). The World Health Organization (WHO) has looked into the vaccine against the papillomavirus which is responsible for cancer of the cervix. The WHO expert committee now believes that a single dose is sufficient, whereas until now two vaccine injections were recommended for those under 21 years of age. Nevertheless, doctor François Vié Le Sage doubts that this will improve vaccination coverage in France where “only 35 to 40% of adolescents, girls and boys, are vaccinated.”
franceinfo: Our readers may be surprised that we are asking a pediatrician, but remember that children can be vaccinated against the papillomavirus…
Francois Vie Le Sage: In France, it is possible to be vaccinated from the age of 9 but it is recommended from the age of 11 and up to 19, and 26 for homosexual men. The period of 9-15 years is the period when immunity is best in life. And that’s where the vaccine takes the best and the longest. Two doses are enough or even just one, since we have this excellent news from the WHO. This is excellent news because it proves the excellent effectiveness of this vaccine, which has existed since 2007. We have Indian studies which, already since 2016, have shown that one dose was almost as effective as two or three doses, especially for so-called low- and middle-income countries. This was the WHO’s problem.
“In these countries, access to care is difficult and therefore taking a dose is already good if you cannot do both. A dose is always better than nothing, much better than nothing, but it may be a little worse than two doses six months apart.”
Dr François Vié Le Sage, pediatricianat franceinfo
Would this improve vaccination coverage in France?
I don’t think so because vaccination coverage in France is one of the worst in developed countries anyway: only 35 to 40% of adolescents, girls and boys, are vaccinated. We are bad compared to countries like Australia which are 90% or to Great Britain or most other European countries. Australia is on its way to getting rid of cervical cancer because very quickly they managed to vaccinate all their teenagers. But we must differentiate between the two different objectives: the WHO, its objective is the planet, as its name suggests. So these are also the so-called developing or low-income countries. 90% of cancers of the cervix due to the papillomavirus occur in these countries. That does not mean that in France, it should not be done since we still have 6,000 to 7,000 cancers per year, including 4,500 in women and 1,700 in men. And just because of cancer of the cervix, which is the main cancer given by this virus, we have 1,000 to 1,500 deaths a year in France. So this is not a negligible problem in France. For the WHO, it is important, especially in developing countries. It’s not so much that they don’t have the vaccines but because they don’t have the structures so that people can have access to these vaccines. So one dose is much easier to do. For the WHO, it is important, especially in developing countries. It’s not so much that they don’t have the vaccines but because they don’t have the structures so that people can have access to these vaccines. So one dose is much easier to do.”
Why in France is it hard to get into morals?
It’s a good question. You know that France has the world record for vaccine hesitation and therefore Pasteur’s country finds itself among the countries which have the fewest European vaccines in their vaccination schedule and which have the worst vaccination coverage. It also concerns measles. For the Covid-19, we were pretty good. But now, overall the papillomavirus vaccine is made in adolescents with a link to sexuality, this is probably a bit of an obstacle. While it is a vaccine against cancers: almost all cervical cancers are due to the papillomavirus, but it is also more than a third of throat cancers, it is also 80% of anal cancers and glans cancers. Nearly 1,000 to 1,500 deaths, also counting ENT cancers, we must rise to 2,000 per year in general, adults who are generally 40 or 50 years old, so in top form for age. It’s still not nothing. Even if indeed, it is a problem of great interest to low-income countries that do not have the means to do so. So, for the WHO, it’s very good to say that. The best is certainly two doses, to be vaccinated young, whether you are a boy or a girl, whether you have risk factors or not.
“That doesn’t mean that in France, you shouldn’t continue to give two doses because it’s still safer: we have more efficiency with two doses six months apart and especially over time. efficiency.”
Dr François Vié Le Sage, pediatricianat franceinfo
Once you’ve passed your twenties, when you’re a woman, is there no point in getting vaccinated?
Absolutely not, it’s still useful. A very fine English study showed that when you were vaccinated before the age of 17, you had 88% effectiveness. When you are vaccinated after 17 years – and there, these are protocols with two or three doses – you are at 50, 60% efficiency. It’s still a lot. This is already very good, but it is true that it is better to vaccinate when you are young before sexual problems appear. And up to the age of 26, it remains effective. The vaccine even has marketing use authorization for up to 45 years in the United States.