Loss Of Opportunity Linked With The Suboptimal Coverage Rate Of Hpv Vaccination In France

Abstract

Objectives: HPV vaccination is recommended in France for girls aged 11 to 14 with a catch-up from 15 to 19 years old. Though, with a cumulative coverage rate (VCR) of less than 20% in girls aged 16 years old for the HPV vaccine, France has one of the lowest VCR in Europe. The objective of the present study is to estimate the burden that would be averted by reaching in France the VCR currently observed in several EU countries. Methods: A dynamic transmission model including a wide range of health and cost outcomes related to cervical, anal, vulvar, vaginal diseases and genital warts, was adapted to French setting. The health outcomes resulting from the vaccination of girls with quadrivalent HPV vaccine was assessed according to two different vaccine coverage rates: (i) the 2014 cumulative coverage rate in girls aged 16 years old of 17.2% (reported by the InVS in July 2014) (ii) a VCR of 70% as observed in several European countries. Results: The analyses demonstrated that reaching in France a VCR comparable to those observed in other European countries would lead to avert additional 3,873,070 genital warts, 582,339 CIN2/3, 78,899 cervical cancers, 1,253 vaginal cancers, 1,756 vulvar cancers, and 17,993 anal cancers (including 4,774 in males) over 100 years. Overall, 27,222 deaths from HPV cancers could be averted by increasing the VCR at 70%. Conclusions: The present study shows that the suboptimal HPV vaccination coverage rate observed in France is linked with a tremendous loss of opportunity for the French population. Even though the applied VCR is not representative of the VCR of the entire targeted population, it is clear that benefits of HPV vaccination are still undermined. In a context where cancer is a health priority in France, combined efforts to improve HPV vaccination coverage rate must be pursued.