Efficacité des Vaccins contre le Papillomavirus Humain

                                     

                                          

En Bref 
La vaccination anti-HPV a été introduite en France en 2007. Elle intervient en complément du dépistage du cancer du col de l'utérus à partir de 25 ans. En décembre 2019, la HAS recommande la vaccination contre les papillomavirus humains (avec le GARDASIL 9) à tous les adolescents, filles et garçons de 11 à 14 ans révolus.  
L’efficacité de la vaccination sur l'incidence du cancer du col de l'utérus ne pouvant être prouvée que plusieurs décennies après l'introduction de la vaccination, des indicateurs intermédiaires sont utilisés pour évaluer son efficacité à court et moyen terme. 
Trois vaccins anti-HPV existent, dont deux sont actuellement disponibles en France (vaccin bivalent et nonavalent). Les vaccins bivalent (HPV 16 et 18), quadrivalent (HPV 6, 11, 16 et 18) et nonavalent (HPV 6, 11, 16, 18, 31, 33, 45, 52, 58) sont efficaces à environ 95% contre les lésions précancéreuses liées aux HPV 16 et 18 (CIN2+), chez les femmes non antérieurement exposées aux HPV. Chez les patients ayant déjà eu des rapports sexuels quelconque, la vaccination réduit également la prévalence du portage des HPV. Les vaccins quadrivalent et nonavalent offrent une protection complémentaire contre les condylomes liés à HPV 6 et 11. Il existe également une diminution des infections buccales, oropharyngées, vulvaires et anales. Les premières données d'efficacité en situation réelle dans la population semblent confirmer les données des essais cliniques, avec également un "effet de troupeau" induit par la vaccination. Cependant, l'efficacité à long terme et l'impact sur l'incidence du cancer du col de l'utérus sont encore incertains et doivent être prouvés

                   

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Articles reliés : infections à Papillomavirus, composition du vaccin HPV, effets secondaires généraux, barrières religieuses, syndrome de Guillain-Barré

                   

                    

Sources                              

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