Human Papillomavirus (HPV): More Needs to Be Done in Terms of Information and Education

Switzerland lags far behind the sought-after immunization rate of 80% of 16-year-old girls, which is intended to prevent HPV-related types of cancer. This is demonstrated by the latest figures from the Immunization Monitor, which is published each year by the Federal Office of Public Health1,2.

Lucerne, September 2, 2019. Immunization in Switzerland against HPV-related diseases such as vulvar, vaginal, cervical and anal cancer remains low. This is demonstrated once again by the figures from the Immunization Monitor, which is published each year by the Federal Office of Public Health.

Immunization Coverage Rate of 80% Required

The Federal Office for Public Health (BAG) conducts annual cantonal immunization surveys to record the level of immunization coverage in Switzerland for the recommended basic and supplementary vaccinations for 2, 8 and 16-year-olds1. The immunization rate among 16-year-old girls for preventing human papillomavirus (HPV) infection is at 56%2. This is with a two-dose schedule, as recommended for boys and girls aged between 11 and 14 for maximum protection against genital and anal cancers as well as genital warts (condylomata).

The immunization rate sought by the BAG for 16-year-old girls, however, is at least 80%3. Based on the existing vaccines available, the BAG asserted in October 2018 that with a high immunization coverage rate, it was possible to protect the population from around 90% of HPV-associated diseases4.

Addressing Shortfalls in Information and Awareness

Shortfalls in information and awareness play a significant role in the situation in Switzerland. This was established by a recent comparative study in Europe (March 2019), which was conducted in ten countries, among them Switzerland. Here is the data from this study which is of relevance for Switzerlandat a glance5:

  • Along with Germany and Austria, Switzerland is one of the countries with the lowest awareness of HPV. In Switzerland, 48% of those surveyed said they were familiar with the term HPV; in contrast to this, according to the survey, the European average awareness level is 62%. Every second person in Switzerland did not know what the term HPV (human papillomavirus) means5.
  • Knowledge of the frequency of HPV infection is also low: In addition to the 52% of those who did not know what HPV means, 31% assume that HPV infection occurs rarely to somewhat rarely5. On the contrary, the risk of a person being infected with HPV at least once in their lifetime is over 75%6.
  • It is also little known in Switzerland that HPV can also cause cancer in men: 36% of those surveyed think that only girls are at risk of infection. Only 8% knew that boys are just as exposed to this risk5.

This means that more work needs to be put into education and resources must be dedicated to providing access to objective, evidence-based information, especially given that HPV is the most common viral genital infection and causes a range of diseases in men and women7. Such educational efforts must be applied at multiple levels: as part of precautionary medical measures, through education at schools, during compulsory medical examinations for military service and also – as before – through the publications of BAG (“Vaccinations – good to know!” and “Cancer and genital warts: Protect yourself before having sex for the first time! HPV vaccinations for youths”). This is supplemented by the platform https://hpv-info.ch/ initiated by MSD in February 2018 and since supported by numerous partners.

This information is intended for representatives of the media only. MSD draws attention to the advertising provisions of pharmaceutical law, in particular to the prohibition of advertising to the public for prescription-only pharmaceutical products.

About Cantonal Immunization Monitoring

Cantonal immunization monitoring is performed on behalf of the Federal Office of Public Health (BAG). The annual surveys are performed by the Epidemiology, Biostatistics and Prevention Institute at the University of Zurich in collaboration with the cantons1. Following the initial survey between 1999 and 2003, a series of surveys has been performed every three years since 2005. A certain number of the cantons participates each year. The national values are based on the data of all cantons participating in a survey period1.
For 2018, values were collected in eight cantons2.The surveyed immunization coverage rates among 16-year-old girls for HPV vaccinations according to the 2018 data is 62% for one dose, 56% for two doses and 7% for three doses2.

About HPV6

Almost all forms of cervical cancer (99%) are caused by infection with one of the high-risk strains of HPV. According to the World Health Organization (WHO), it is the fourth most common type of cancer among women and is associated with a high level of mortality worldwide. HPV infections can also cause several other cancers in both men and women that are associated with a serious risk of mortality and are a strain on healthcare systems. Some HPV strains can cause highly unpleasant genital warts (condylomata), while others can cause genital, anal or oral cancer.

About the European Survey on HPV5

Ipsos carried out interviews for MSD on a representative sample of 15,000 adults between the ages of 16 and 60 within Europe (in alphabetical order): Belgium 1,000, Germany 2,000, France 2,000, Greece 1,000, Italy 2,000, Austria 1,000, Portugal 1,000, Switzerland 1,000, Spain 2,000 and United Kingdom 2,000. The survey was conducted online from January 7 to 21, 2019. The population was based proportionally on gender, age, region and work status at country level, and survey data was weighted according to given population ratios. The market research was initiated and funded by MSD. MSD owns the distribution rights to the study results. In Switzerland, a total 1,000 people (two-thirds of whom were adolescents, one-third adults) were interviewed from across all language regions.

For more information:

References

1 https://www.bag.admin.ch/bag/de/home/gesund-leben/gesundheitsfoerderung-undpraevention/impfungen-prophylaxe/informationen-fachleute-gesundheitspersonal/durchimpfung.html, accessed on August 13, 2019

2 Federal Office of Public Health, “Vaccination Rates of 2, 8 and 16-Year-Old Children in Switzerland, 1999-2018 (XLS, 459 kB, June 13, 2019), accessed on August 23, 2019

3 3 Federal Office for Public Health, “National Vaccination Strategy” (November 23, 2018), page 37: https://www.bag.admin.ch/bag/de/home/strategie-und-politik/nationale-gesundheitsstrategien/nationalestrategie-impfungen-nsi.html, accessed on August 13, 2019

4 https://www.bag.admin.ch/bag/de/home/krankheiten/krankheiten-im-ueberblick/hpv.html or HPV vaccination: Recommendations of BAG and EKIF on the new vaccine Gardasil 9® (PDF, 133 kB, October 22, 2018 Bull BAG 2018; No. 43: 10-15, accessed on August 13, 2019

5 Ipsos Healthcare Service Line: https://www.ipsos.com/en-ch/human-papillomavirus-europe, bzw. PDF “EU HPV Consumer Awareness Study” from March 4, 2019, accessed on August 13, 2019

6 Syrjänen K et al. Prevalence, Incidence, and estimated life-time risk of cervical Human Papillomavirus Infections in a non-selected Finnish female population. Sex Transm Dis 1990;17:15-19.

7 World Health Organization: Immunization, Vaccines and Biologicals https://www.who.int/immunization/diseases/hpv/en/, accessed on August 13, 2019

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CH-CIN-000180, 08/2019