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Expanded HPV vaccination program for boys and adolescents to launch in Estonia starting next February

09.12.2023 | 17:43

The Immunoprophylaxis Expert Committee operating under the Ministry of Social Affairs has made a significant decision, recommending vaccination against Human Papillomavirus (HPV) for boys as well. Additionally, all 15-18-year-olds are offered the opportunity for free catch-up vaccination. As a result, starting February of the next year, young individuals in Estonia aged 12-18 who are interested will have access to free vaccination against HPV. Furthermore, the committee recommends changing the current HPV vaccination schedule from a two-dose to a one-dose scheme.
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All European countries offer state-sponsored HPV vaccinations for both girls and boys, with the exceptions of Bulgaria and, until now, Estonia. Enabling HPV vaccination for boys will help reduce the risk of anal, penile, and head and neck cancers. Since HPV is a contact infection, vaccinating boys also contributes to the prevention of cervical, vaginal, and vulvar cancers.

According to family doctor and member of the Immunoprophylaxis Expert Committee, Dr. Piret Rospu, beyond healthy lifestyles, there are few options for cancer prevention. “Vaccinating against cancer-causing viruses is a simple, effective, and safe way to reduce the risk of various malignancies. Scientists predict that if 80% of boys and girls are vaccinated against HPV, it could practically eliminate the circulation of high cancer-risk papillomaviruses in the population,” she says. “Although vaccination will continue to be preferably done at the age of 12-14, from next year, it will be possible to vaccinate for free up to the age of 18. We see that vaccination coverage is higher among 14-year-olds than 12-year-olds. However, many families become interested in vaccination only when their children turn 15-16, when previously the vaccination was chargeable. Extending the age range for national vaccination allows for the protection of a larger group of young people,” explains Dr. Rospu.

Gynaecologist Dr. Piret Veerus noted that increasing vaccination coverage is particularly important, as Estonia ranks high in Europe for cervical cancer incidence. “Over 300 different site cancers caused by HPV are diagnosed in Estonia each year. This is in addition to precancerous conditions and genital warts,” Dr. Veerus exemplifies, adding: “Since the one-dose vaccination course has shown sufficient effectiveness, the decision was made to continue primarily with one dose. In other words, the new strategy is to reach more young people, and now boys can also protect themselves and future partners against the cancer-causing virus.”

For children with immunodeficiency, the recommended HPV vaccination schedule is three doses. This is vital as they are more susceptible to infections and receive weaker protection from the standard schedule.

HPV vaccination, where the state covers both the cost of the vaccines and the associated vaccination expenses, will be available to all up to the age of 18 (inclusive) starting from February 1, 2024. For those aged 19 and older, it remains chargeable according to the vaccinator’s price list.

In 2021, the prevalence of high cancer-risk HPV among women aged 30-65 was 8.8%, meaning nearly one in ten women in this age group was infected with a potentially cancer-causing virus. The estimated treatment cost for HPV-caused diseases is 6.8 million euros per year, of which 81% is for cancer treatment. The transition to a one-dose vaccination schedule is supported by the World Health Organization.

The Immunoprophylaxis Expert Committeeis an advisory body to the Ministry of Social Affairs on the immunization plan and other vaccination-related issues, comprising representatives from allergologists-immunologists, infectious disease specialists, virologists, family doctors, paediatricians, nurses, the Health Board, the State Agency of Medicines, the Health Insurance Fund, and the Ministry of Social Affairs.

Neeme Raidvere