Human papillomavirus vaccine and sexual activity: How do we best address parent and physician concerns?
Menée aux Etats-Unis à partir des données d'assurance maladie portant sur 208 011 adolescentes âgées de 12 à 18 ans et vaccinées ou non contre le papillomavirus humain (HPV), cette étude évalue l'association entre le statut vaccinal vis-à-vis du HPV et l'augmentation du taux d'infections sexuellement transmissibles (chlamydia, gonorrhée, herpès, VIH, ...)
Compared with other routinely recommended adolescent vaccines (eg, diphtheria and tetanus toxoids and acellular pertussis [Tdap] vaccine and quadrivalent meningococcal conjugate [MCV4] vaccine), human papillomavirus (HPV) vaccine uptake has been lower, with only 57% of adolescent females and 35% of adolescent males initiating the 3-dose HPV vaccine series.1 Often, the reasons cited for these low HPV vaccination rates pertain to the vaccine’s role in preventing a sexually transmitted infection (STI). Parents commonly indicate that they have not had their children vaccinated against HPV because the vaccine is not needed or because their child is not sexually active,2 and even some physicians express hesitancy toward strongly recommending the HPV vaccine. In a recently published series of qualitative interviews,3 physicians expressed concerns about discussing sexual activity with 11- and 12-year-olds and indicated preferences for deferring vaccination to later ages. However, just as we do not wait until we have been in the sun for 2 hours to apply sunscreen, we should not wait until after an individual is sexually active to attempt to prevent HPV infection.
JAMA Internal Medicine , commentaire, 2014