Why don’t adults get the HPV vaccine (while it can be helpful)?

HPV stands for Human Papillomavirus: a virus that can cause cervical cancer. The virus can be transmitted through any sexual contact, and 80 to 90 percent of people are infected with it. Usually, the immune system clears the virus again.

This does not happen in 10 to 20 percent of cases, so there is a possibility that the virus may cause cervical cancer. This is especially common among young women. This is why women between the ages of 30 and 60 receive an invitation to have a Pap smear every five years. Children and young people between the ages of 10 and 18 receive a call for free HPV vaccination.

abnormal cells

But if you wanted to be vaccinated as an adult, it would be very expensive, according to Rachel, 35, of Utrecht. While her first smear at the age of 30 was still completely correct, on the second smear it turned out to be wrong: abnormal cells were found.

It didn’t mean anything serious yet, but Rachel needed therapy. underwent a buttonhole excision; A process in which a thin metal ring is electrically heated. This removes the abnormal part of the cervix.

You might think all is well, but treatment may not be necessary if Rachel is aware of the HPV vaccines for adults. “I first heard about this from my gynecologist. She told me you can take it when you’re clean.”

No equal opportunity

This vaccination turned out to be very expensive: she had to pay about 450 euros for the total vaccination, which includes three shots. She describes it as “awesome”. Especially because it’s about cancer prevention, not travel vaccination – which is sometimes offset. “I’m lucky to have a piggy bank in which I can pay this, but not many people have it. That way there are no equal opportunities.”

Rachel finds this disturbing. “Now there is a lot of interest in HPV, but the generation I belong to is at unnecessarily high risk. We are like the generation that cannot participate in the vaccination programme. And getting cancer is neither fun nor necessary if you know that it can be prevented by vaccination.”

More and more adults are buying HPV shots

Outside the national immunization programme, more and more adults in the Netherlands are taking the HPV vaccination on their own initiative, according to figures from the Farmaceutische Kengetallen (SFK). The number has been growing steadily for years, and has grown more rapidly in the past two years.

• names in 2020 5566 people * HPV self vaccination
• Names in 2021 8213 people * HPV self vaccination

This mainly concerns women, but more than 1,000 men have also taken the HPV vaccine in recent years.

* The figures mainly concern adults, but a few hundred minors have also received the HPV vaccination on their own initiative. The exact number in numbers is not clearly broken down.

As far as Rachel is concerned, there needs to be better information about the adult HPV injection and it should be (at least partially) compensated.

The fact that this has not yet happened has something to do with the effectiveness of the vaccine. The National Institute of Public Health and the Environment writes that, if you are not yet infected with HPV, the effectiveness is greater.

‘We could have prevented this’

However, adult women can also benefit from the vaccination, says Rod Beckers, MD, a gynecologist at Katharina Hospital and professor of women’s cancer prevention in Maastricht. Treating women with cervical cancer. “With every patient I think: We could have prevented that.”

He finds that people sometimes think easily of abnormal cells. “Ah well, then you take it away.” But such an operation on the cervix is ​​simply not pleasant. In addition, you have a greater chance of premature birth after that. This chance ranges from 6 to 9 percent. “

second smear

Beckers advocates vaccinating all women who have ever been treated for primary stage cervical cancer. “But maybe that’s not possible because of the cost.”

That is why he wants in any case to start vaccinating at-risk patients. “I am talking about women who have already had to undergo surgery because of the disturbed cells. If they have a second Pap smear that shows they have HPV, that is actually a sign that the body is not in good shape. It is possible to remove the virus yourself. This group of patients will definitely benefit from the HPV vaccine.”

Advice for such a vaccination is not yet included in the NVOG (Dutch Society of Obstetrics and Gynecology) guidelines. Beckers, gynecologist: “We are only discussing the possibility when a woman will have to have a second treatment. But we can’t give advice, because we can’t put people at risk.”

research

NVOG has now launched a study to show that vaccinating women is beneficial when they are found to have HPV. “If our study is positive, we will press on it. We want the insurance to pay it off and then the minister can lower the price.”

So in addition to women infected with HPV for the second time, about 5,000 to 6,000 each year, others may also benefit from the vaccine. “It’s about gay men, people who have had a kidney or someone else transplanted or people who have a low immune system for some other reason.” According to Baker, it is about ten to twenty thousand vaccines a year. “This is one tenth of the number of HPV vaccines being administered now, and it could save lives.”