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The French High Authority for Health (HAS) has recommended expanding catch-up vaccination against Human Papillomavirus (HPV) to all young women and men up to the age of 26 who were not vaccinated during adolescence. This new guidance aims to reduce the burden of HPV-related diseases, including precancerous lesions and cancers, notably cervical cancer.
HPV infection is highly common, especially at the onset of sexual activity, with nearly 80% of sexually active individuals infected at some point in their lives. Although most infections are transient and cleared by the immune system, persistent infection in 5 to 10% of cases can lead to precancerous lesions and cancer. Each year in France, HPV causes approximately 6,400 new cancer cases and 35,000 precancerous lesions, with cervical cancer accounting for nearly half of these cancers. In 2023 alone, 3,159 new cervical cancer cases were diagnosed, resulting in 1,100 deaths.
Vaccination against HPV has been recommended in France since 2007 for girls aged 11 to 14, and since 2021 for boys in the same age group, with catch-up vaccination previously limited to those up to 19 years old for heterosexual individuals and up to 26 years for men who have sex with men (MSM). This created disparities in vaccine access based on gender and sexual orientation. The HAS has now evaluated and endorsed extending catch-up vaccination to all young adults up to 26 years old, regardless of gender or sexual orientation, to address these inequalities and improve public health outcomes.
The recommendation is based on robust evidence of the long-term effectiveness and safety of the Gardasil 9 vaccine, which remains effective up to 12 years post-vaccination and has a favorable safety profile in both adolescents and adults. Studies show that about three-quarters of young adults aged 20 to 26 have not yet been exposed to HPV and remain at high risk of infection and transmission, with the highest incidence among women aged 20 to 24.
Despite efforts to increase vaccination coverage, rates remain below targets: in 2024, only 48% of 16-year-old girls and 24.5% of boys had completed the HPV vaccine series, well below the national goal of 80% coverage by 2030. The HAS emphasizes that vaccination is most effective when administered early, ideally between 11 and 14 years of age, and should not be delayed until adulthood. However, the expanded catch-up program offers an important opportunity for those who missed vaccination during adolescence.
The HAS also notes that Gardasil 9 can be administered concomitantly with other vaccines recommended for young adults, such as the dTcaP booster at age 25 and meningococcal ACWY vaccines between 15 and 24 years. Healthcare professionals are advised to monitor vaccine recipients for 15 minutes post-injection to manage rare adverse events like syncope.
This expanded vaccination strategy aligns with practices in other European countries that have achieved high HPV vaccine coverage through inclusive catch-up programs. It complements cervical cancer screening programs, which remain essential since the vaccine does not protect against all high-risk HPV types nor treat existing infections.
Disclaimer: This article is based on information provided by the French High Authority for Health (HAS) as of May 2025. Vaccination decisions should be made in consultation with healthcare professionals, considering individual health status and risk factors. The vaccine does not replace regular cervical cancer screening.
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