“Today the state must take strong positions” for pediatrician Robert Cohen

Professor Robert Cohen, pediatrician-infectiologist at the Créteil intercommunal hospital and president of the National Professional Pediatric Council, calls on Thursday April 28 on franceinfo for the State to take “positions fortes” to strengthen the vaccination of adolescents against papillomaviruses, while the League against cancer is launching a campaign in this direction.

This vaccination is slipping with only 45% of 16-year-old girls having taken their first dose in 2021, and barely 6% of 15-year-old boys, for whom this vaccine has been recommended for only a year. According to the League Against Cancer, which commissioned a survey from Opinion Way, about a third of parents are not convinced of the benefits of this vaccination for their children.

franceinfo: Do ​​we feel mistrust of the vaccine among the parents of your patients?

Robert Cohen : Yes, we feel it all the more since it is a vaccine that we do in adolescence, in a period when it is more difficult to vaccinate than when children are very young. At first, this vaccine raised a lot of controversy, and gradually, they found scientific answers. It is no more dangerous than other vaccines, it is effective not only against papillomavirus infections but also against precancerous lesions. We now know that it is effective against cancers too, with a very high rate of effectiveness. Gradually, we had answers to these controversies, but we did not give them enough to parents and adolescents. There are several vaccines to be given to children around 11 years old. We have diphtheria-tetanus-polio-whooping cough, we need to update those against chicken pox and hepatitis B. We have a real vaccination crossroads around 11-12 years old, it is essential for this vaccination.

Do teenagers and their parents know that boys are also affected by this vaccine?

At first, this vaccine was labeled “against cervical cancer”, because 99% of cervical cancers are associated with this virus. We realized over the years that there were many other cancers for which these papillomaviruses could play a role: we think of ENT cancers which are more frequent in boys than in girls, cancers of the vulva, vagina, penis. These are cancers less strongly linked to papillomaviruses than cervical cancer, but they are linked to it. Vaccination also protects against these cancers.

Is the difficulty in vaccinating against papillomaviruses linked to the fact that it is often linked to the start of sexuality?

Yes ! It is true that it is a sexually transmitted disease, but one does not need complete sexual intercourse to become infected with the papillomavirus. The papillomavirus can be transmitted by flirtations a little pushed, by caresses. By age 30 or 40, 80% of people have been in contact with papillomaviruses. It is an extremely common infection.

Why do we have poor HPV vaccination coverage?

First, the vaccine is not offered enough by doctors who fear being faced with a refusal. When it is proposed, parents accept it in 60% to 70% of cases: it is not enough. You have to give them all the explanations. Some parents say that [ce vaccin] is too recent. Do people know that it has been studied for 22 years? Do people know that in Australia and throughout Northern Europe, 90% of girls and now boys are vaccinated, and that we are already at hundreds of millions of teenagers vaccinated without additional risks?

Is this low vaccination coverage also explained by a distrust of the French towards vaccination?

There is this report which dates practically from the hepatitis B crisis, again before the 2000s, since this is where France began to differentiate itself from other countries in terms of vaccine hesitation. All that could be taken as the scandal of the vaccine against hepatitis B, it is what resounded on the images of the vaccination. For a long time, the authorities were also more reluctant to get involved in vaccination programs. Now, that is no longer the case. Vaccines for infants have been made compulsory for 18 years. We see how the State has committed itself to vaccination against Covid-19. The State must now take strong positions on vaccination [contre les papillomavirus], as for the Covid-19. Making it compulsory is not the point, but all questions must be answered through official channels, accompanied by publicity campaigns.

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