HPV Vaccination Rates in France: An Example of Information Mistrust

Only 19% of 16-year-old women in France were HPV vaccinated in 2016
Vintage Paris paper with woman's face
France (Vax Before Travel)

Vaccines, often lauded as one of the greatest public health interventions, are losing public confidence in certain countries.

As an example, France is being confronted by various constituencies regarding vaccine-preventable diseases, such as cervical cancer.

Cervical cancer is associated with several serotypes of the human papillomavirus (HPV) and is a leading cause of women mortalities.

In a letter to the editor published in New England Journal of Medicine, several researchers believe it is imperative for France to improve the distribution of credible vaccination information, unbiased and scientifically supported by a strong institutional position.

Hervé Lefèvre, M.D., M. Rose Moro, M.D., Ph.D., and Jonathan Lachal, M.D., Ph.D. said it's time ‘to rethink the place of the clinician in the system of adolescent health and disease prevention in France.’

The lack of comprehensive general and medical information and the flood of disinformation (“fake news”) from anti-vaccine lobbies are major obstacles to HPV vaccination in France, said these doctors.

They say cervical cancer prevention is an example of why new policies are needed. In France, only 19 percent of 16-year-old girls were vaccinated against HPV in 2016.

The France immunization rate is far below similar countries with high levels of coverage, such as 45 percent in the United States

But, according to these doctors, France has modified its vaccination policy radically in response to the low level of vaccination coverage.

Below are excerpts from this letter to the editor from these doctors:

This change in policy has two goals.

The first is to dispel the ambiguity in decision making between mandatory and recommended vaccinations.

This (segmentation) ambiguity may partly explain the lower vaccination coverage in France than in its European neighbors and in much of the world.

This ambient suspicion affects doctors, themselves citizens, who can no longer find the arguments to defend the use of this vaccine.

Since the beginning of January 2018, a total of 11 vaccines have been mandatory in France. This is a true revolution.

This change needs to be accompanied by clear and neutral scientific information, which would enable the French to renew their confidence in vaccination.

Nonetheless, the problems of ambiguity and low confidence remain regarding the use of many non-mandatory vaccines, including those against influenza, varicella, hepatitis A virus, and especially HPV.

The second goal is to reconcile the general population in France to the use of HPV vaccines, at a time when the level of confidence in them here is among the lowest anywhere.

Mandatory HPV vaccination would increase the rate of recommended vaccination.

Although the decision is political, the stakes are measured in human lives.

Moreover, the opportunity to prevent thousands of cases of cervical cancer each year could be achieved.

The communications contact is: [email protected] Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.