Healthcare extends human papilloma vaccine to children

Fifteen years after Spain incorporated human papilloma virus protection into its vaccination programme, the Ministry of Health has extended its administration to children as well. This means that the human papilloma vaccine for childrenand not just for girls like until now, it’s incorporated into the Common vaccination schedule for life.

Vaccination against human papillomavirus (HPV) has hitherto been performed generally in girls and males certain risk groupsbut now the autonomous communities must include their immunization in the vaccination calendar by the end of 2024. Some, however, had already included children in the vaccination, thus anticipating the recommendation approved by Health. This is the case in Galicia, Catalonia and the Valencian Community, which began vaccinating 12-year-old children between September and October.

What do we know about HPV and why have only girls been vaccinated?

Some of the human papilloma virus strains can cause cancer, the most frequent being cervical cancer (although it can also be in the anus, throat, penis, or vulva). The papilloma is also the most common sexually transmitted infection (STI).

Just like explain it World Health Organization (WHO), “In general, HPV infections usually disappear without intervention a few months after they are acquired, and approximately 90% resolve after two years.” That is, the body clears the virus after a while in the vast majority of cases. However, adds the WHO, “a small percentage of infections caused by some types of papilloma can persist and turn into cervical cancer”. [o en algún otro tipo de cáncer, aunque el más prevalente es el de útero o cérvix]”.

Saverio Bosch, doctor, researcher and winner of the Maurice Hilleman Award for his contribution to the human papillomavirus vaccine, celebrates that the human papillomavirus vaccine for children is now a reality. “In 2006 and 2007, when the vaccine began to be introduced in the autonomous communities, scientific information was very concentrated on cervical cancer, which is by far the most common. The vaccine was touted as a way to prevent that specific cancer, but more than a decade later it was seen to affect men as well. It makes sense that vaccination is universal,” Bosch explains to Newtral.es.

In 2018, the Vaccine Conference recommended vaccination —in adulthood— of certain risk groups. Between them, women with a conization (an operation to remove a precancerous lesion caused by the human papilloma virus) but also men who have sex with other men (MSM).

Xavier Bosch points out that “risk groups have become known over time”: “After the cervix, probably the area most susceptible to oncogenic transformation is the anal area. Given the higher prevalence of anal sex practices among men who have sex with men, it makes sense that they have been included in vaccination schedules.

“Last sexual practices They constitute a very dynamic concept on which it is not always easy to adequately question oneself in order to obtain an answer to evaluate the risk. Therefore, it is better to vaccinate regardless of gender ”, he points out in a conversation with Newtral.es Ana Silva, doctor researcher at the STI Unit of the Hospital de Bellvitge (Barcelona) and specialized in HPV.

Furthermore, considering that only girls were vaccinated and not boys, although in the future they could be part of the group of men who have sex with men (MSM), “it was a presumption of heterosexuality”, underlines Silva. “With this new guideline, it doesn’t matter what the child’s gender is, what their sexual orientation or sexual practices are. It is important that all minors between the ages of 9 and 12 are vaccinated, and it is important to raise awareness of the use of barrier methods to avoid minimizing the risk of contagion from an STI ”, he adds.

Human papilloma vaccine for children: ‘A matter of equity’

In his opinion European Center for Disease Prevention and Control (ECDC), Austria, Belgium, Denmark or Germany are European countries that already vaccinate minors regardless of their gender. “It’s a question of vaccine equity,” Newtral.es explains Fernando Moraga-Llop, pediatrician and spokesperson for the Spanish Vaccination Association (EAV).

Emphasize that “the appropriate thing would be vaccinate with the novevalent [Gardasil 9] which covers more oncogenic genotypes, but also others that cause anogenital warts”. The Gardasil 9 vaccine, which covers more HPV types than the Cervarix and Gardasil vaccines (bivalent and quadrivalent respectively), is already the vaccine administered in most autonomous communities.

María José Cilleruelo, pediatrician and secretary of the Vaccine Advisory Committee of the Spanish Association of Pediatrics (CAV-AEP), points out in a conversation with Newtral.es that “science has shown that to eradicate the virus it is necessary that vaccination is universal”. “It’s great news that children will also be vaccinated against human papilloma,” he adds.

Of course, Cilleruelo warns that “it will be necessary to work to raise awareness of the importance of vaccination also in boys and not only in girls, as up to now”. As Dr. Ana Silva explains, “He is a vaccine linked to sexuality and, therefore, to stigma”. “I still remember when girls started getting vaccinated, there were parents who said they wouldn’t vaccinate their daughters because they would only have affairs with their husbands when they got married,” Silva says.

For this Cilleruelo believes that at the time “it was advertised as a vaccine for a cancer that affects women, but can also protect men,” he explained to Newtral.es. “There are many misconceptions, but the human papilloma vaccine for boys and girls is the best way to prevent future infections and illnesses,” he adds.