With an HPV vaccination against cancer

The HPV vaccination is effective against sexually transmitted viruses. It has also been recommended for boys for four years - but the vaccination rate is still too low for herd protection. A new vaccine should provide a remedy.

Susanne Müller still has a little time before she has to make a final decision. But at some point, the moment will come when her children will have sex for the first time. And before then, the mother of two boys aged 8 and 11 is already pretty sure that she will have her children vaccinated against human papillomavirus (HPV), which is transmitted through sexual contact and can lead to genital cancer in both sexes, with the development of cervical cancer posing the greatest risk.
«I think the vaccination recommendation for boys makes perfect sense. Because the more people are vaccinated, the better the chances are that the spread of dangerous HP viruses and, as a result, deaths from cervical cancer in women will eventually be stopped,» explains the lawyer, who would like to have her children vaccinated against HPV not only to protect them, but also out of solidarity with her future sexual partners.

When and how often is vaccination advisable?

Since 2015, the Federal Office of Public Health (FOPH) and the Federal Commission for Vaccination Issues (EKIF) have also recommended the HPV vaccination as a supplementary vaccination for boys and young men. «The authorisation for the vaccination applies from the age of nine and the Swiss vaccination schedule provides for two vaccinations for all children aged 11 to 14,» explains Brigitte Frey Tirri, head physician at the Baselland Women's Clinic, who sees several advantages in the vaccination recommendation for boys: «In young men, the vaccination protects against genital warts, penile cancer, anal cancer and cancer in the throat and pharynx area.»
In addition, says the doctor, extending the vaccination recommendation to boys and young men will lead to increased immunity against HPV in the population. «The vaccination rate among girls is still too low for comprehensive herd protection. If you also vaccinate boys, you can protect many more people from HPV infection,» summarises Frey, who - like Susanne Müller - appeals to the social responsibility of parents in connection with the vaccination recommendation for boys.

Only 56 per cent of all girls aged 16 have been vaccinated against HPV.

A look at the figures confirms Brigitte Frey's statement: between 2014 and 2016, just 56 per cent of all girls aged 16 in Switzerland were vaccinated against HPV, which is well below the 80 per cent mark required for herd protection. It should be noted that this figure is a national average which, according to Mark Witschi from the Federal Office of Public Health, fluctuates significantly upwards or downwards depending on the canton.

"The more people are vaccinated, the better the chances of stopping the spread of dangerous HP viruses" Susanne Müller, lawyer and mother of two boys.
"The more people are vaccinated, the better the chances of stopping the spread of dangerous HP viruses" Susanne Müller, lawyer and mother of two boys.

The Head of the Vaccination Recommendations and Control Measures Section cites the different organisation of cantonal vaccination programmes as the reason for these fluctuations. «In cantons with a well-organised school vaccination programme, such as Valais or Aargau, vaccination coverage rates are much higher than in cantons where vaccination is not carried out by the school doctor.»

Vaccination opponents warn of side effects

According to Witschi, a lack of information, cultural aspects and the critical attitude of vaccination opponents, who cite potentially dangerous side effects of the HPV vaccination, also have an influence on the very different willingness to be vaccinated in different cantons.
«In the case of the HPV vaccination, opponents argue with reports of deaths, an alleged increase in multiple sclerosis and other neurological diseases, which has been refuted by many studies. Many people are wrongly unsettled by this,» says Brigitte Frey Tirri in response to the accusations made by opponents of the vaccination. After the HPV vaccination, localised redness, swelling and pain at the injection site, nausea, headaches or fever can occur. «However, there are no more serious side effects to be feared.»

Increase the population's immunity to HPV

Both the FOPH and the World Health Organisation therefore see no reason to doubt the safety of the HPV vaccination and even classify it as «extremely safe». According to Brigitte Frey Tirri, this is also supported by the fact that the scientific advisory board of the Swiss Multiple Sclerosis Society is in favour of vaccinating adolescents.

«The latest vaccines can prevent up to 90 per cent of all cervical cancers and other diseases worldwide.»

Various vaccines are available to doctors in Switzerland to increase the population's immunity to HP viruses. «With the latest vaccines, it is assumed that up to 90 per cent of all cases of cervical cancer and other diseases caused by HP viruses can be prevented worldwide,» explains Guido Biscontin, Early Detection Specialist at the Swiss Cancer League.
The German Cancer Information Service communicates a similar message in its leaflet on the HPV vaccination: «Studies have shown that the HPV vaccination protects against precancerous lesions on the cervix. As these develop several years before the actual cancer, a reduction in the cancer rate can be expected in the long term. However, definitive study results on this are still lacking.»
A new vaccine approved in Switzerland this year promises a significant improvement in protection against HPV-related diseases, precancerous stages and cancer, which, according to Brigitte Frey, provides additional specific protection against five other high-risk HPV types compared to the previous vaccines. Since January 2019, the costs of this vaccine have been covered as part of the cantonal vaccination programmes. Due to the extended protective effect of the new vaccine, it will be possible in future to «prevent a larger proportion of HPV-associated diseases than before», as can be read in the FOPH's vaccination recommendation from October 2018.

Why women should have regular cancer smear tests ...

Despite these fundamentally positive prognoses, health experts around the world recommend further preventive measures against HPV-triggered diseases. For the Swiss Cancer League, this includes the use of condoms during sexual intercourse, which reduces the risk of HPV transmission. Smoking also increases the risk of cervical cancer. The Swiss Cancer League therefore advises against smoking.
The Swiss Cancer League also recommends that women have regular smear tests and discuss the time between smear tests with their doctor.
The reason: According to the current state of research, none of the vaccines really covers all cancer-causing HP viruses and therefore the vaccination does not offer complete protection against cervical cancer.

HPV vaccination does not protect against all types of virus. This is why women in particular need additional measures to protect against cervical cancer.
HPV vaccination does not protect against all types of virus. This is why women in particular need additional measures to protect against cervical cancer.

This is precisely why Susanne Müller believes it is important to also vaccinate boys against HPV. «At the moment, this seems to me to be the best way to combat cervical cancer.» If something fundamental changes before her children are vaccinated, she would of course reconsider her position. «As with every vaccination, I will take my time to examine the facts and then weigh up all the risks and benefits.»

Katrin Rothist freie Journalistin für diverse Magazine und Bloggerin (
Katrin Roth
is a freelance journalist for various magazines and a blogger(www.sonrisa.ch). She is the mother of an adult daughter.

The most important information about the HPV vaccination at a glance

  • The HPV vaccination is intended to protect against cancer and its precursors. However, as the vaccination does not protect against all types of virus, women in particular need to take additional measures to protect themselves against cervical cancer.
  • The new nine-fold vaccine , which has been authorised in Switzerland since this year, covers five additional cancer-causing HPV types compared to its predecessor and protects against HP viruses that cause benign genital warts.
  • The FOPH and the EKIF recommend the HPV vaccination for all adolescents aged 11 to 14. Because diseases caused by HPV are more common in women than in men, the vaccination is recommended as a basic vaccination for girls and as a supplementary vaccination for boys. The HPV vaccination can also make sense for 15 to 26-year-olds.
  • According to the FOPH, the costs of the HPV vaccination are covered by health insurance for the recommended age groups, provided the vaccination is carried out as part of the cantonal programme.
  • A list of the doctors participating in this programme is available from the cantonal health department.

Human papillomaviruses

According to the FOPH, there are different types of human papillomavirus (HPV). HPV is transmitted through sexual intercourse. Accordingly, an infection usually appears on the skin and mucous membranes in the genital area, but sometimes also in the anal area and throat.
While around two thirds of infections are asymptomatic, high-risk types of HPV can trigger various precancerous stages and diseases. According to the FOPH, the development of cervical cancer is the greatest risk of HPV.

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