From the beginning of 2026, all citizens of Serbia under the age of 45 can receive vaccine against human papillomavirus for free. With this, Serbia took an important step forward in the fight against the consequences of this viruses which causes cervical cancer, but also other cancers that affect men. Until then, the vaccine was intended for and freely available to children and young people aged nine to 26.
"For years, we have been trying to explain to people what HPV is and how many lives this virus takes in Serbia," Gordana Plemić, director of the "Roditelj" Association, which deals with informing Serbian citizens about this virus, as well as the vaccine against it, told "Vreme". Just one of those pieces of information is that two women a day in Serbia die as a result of cervical cancer, which is most often caused by the human papillomavirus.
The public, especially through social networks, can hear various unverified and false information about the HPV vaccine and the causes of this virus, sometimes even from doctors who use the Internet to promote their work.
"The doctor's focus should be on the fact that the vaccine protects. Flat and easy statements by individuals that are convenient for likes only fuel ignorance, which is very irresponsible," adds Gordana Plemić. "The profession must take care of what it says, especially if it addresses, as mentioned, such a large number of people who follow it. After all, it is about the public health of the nation."
HAVE WE MADE PROGRESS?
Since the beginning of the year, when free immunization against diseases caused by the human papilloma virus was introduced for those over the age of 26, 335 people received the first dose of the vaccine, and 45 the second.
Gorica Đokić, president of the Citizens' Association for the Fight against Ovarian and Cervical Cancer "Progovori", explains to "Vreme" that for the new category of adult patients it is not enough to just decide that they want to receive the vaccine.
"You need a recommendation from a specialist - gynecologist, urologist, dermatovenerologist, epidemiologist..." says Gorica Đokić. "That's why it's important for people to know that there needs to be some indication."
In practice, this means that people who have had this virus or suffer from the consequences of HPV, as well as everyone else who wants to protect themselves, should ask their specialist doctors about the possibility of receiving the vaccine. If he judges that they belong to the target group, the doctor simply gives them a referral and approves the vaccine, as with other vaccines that are not mandatory, such as the flu or varicella vaccine.
Because it is possible that the patient was exposed to only some types of HPV and not all that are in the vaccine and against which it protects, the HPV vaccine for adults can be useful for those who are already infected with this virus, experts say.
photo: branko lukić...
WHY WAS THE BORDER MOVE?
Gordana Plemić explains how the vaccine was offered free of charge to senior citizens. Bearing in mind that HPV is transmitted sexually, until the beginning of the year, only young people received the free vaccine before entering into sexual relations.
"When we started talking to parents in Serbia about why they should vaccinate their children against HPV, we realized that a large number of them do not know what all the diseases this virus causes - cancer of the cervix, anus, penis", says Gordana Plemić. "Besides them, we noticed another group of parents who are absolutely familiar with the problem. Simply, because they have it. These are parents with HPV, mostly women who had malignant or premalignant changes on the cervix, which is a large number of women in Serbia. They wanted to know more about whether it is possible to protect themselves."
Hence the initiative to make the vaccine free for this group of parents, especially for those who are still of reproductive age. The second fight that the "Progovori" association is leading is to make the vaccine mandatory for all children, and it was supported by the Parliamentary Committee for Health and Family and referred to the Ministry of Health for decision. World studies show that mandatory vaccination of all children is the way to eradicate HPV, and with it the numerous diseases it causes. Without mandatory vaccination, this is practically impossible because the virus will continue to spread. The latest data show that only 9,7 percent of children aged nine to 19 in Serbia have been vaccinated. Of course, the parents decide on the vaccination of minors.
Immunologist Miloš Marković explained in the "Tampon Zone" podcast that parents should not be afraid because this is not a new vaccine that is just being tested or has just come out of the laboratory. "The vaccine against HPV was approved in 2006 and has been given for 16-17 years in some countries," he said.
Countries like Australia, where a large number of citizens have been vaccinated, have practically eradicated cervical cancer. The World Health Organization recommends vaccination against HPV for children aged nine to 14, but also three doses for young people aged 15 to 26.
The WHO strategy called "90-70-90" predicts that by 2030, 90 percent of girls under the age of 15 will be vaccinated against HPV, that 70 percent of women will be screened for the early detection of cervical cancer, and that 90 percent of women with precancerous changes, or cervical cancer, will enter treatment protocols on time.
FIGHT FOR FERTILITY AND MEN
In addition to cervical cancer, this virus can also cause cancer of the anus, penis, neck region, vulva, vagina, oral cavity and pharynx. Also, certain types of HPV are the cause of genital warts, i.e. condyloma.
"It is very important to make people aware that men also have a problem. They are mostly carriers of HPV to their partners. When thinking about offspring, it can endanger the whole family," explains Gordana Plemić. "However, the vaccine also provides numerous other protections that are not being talked about enough."
Also, a small number of studies done around the world show that although they do not directly cause it, some strains of HPV contribute to sterility in men. American studies say that up to 20 percent of infertile men carry human papillomavirus in their semen. Research shows that HPV, especially high-risk strains like HPV 16, binds to sperm and is associated with reduced sperm motility, reduced normal morphology and increased DNA fragmentation, which can affect natural fertility and IVF success.
Male infertility is a factor that contributes to this in approximately 30-40 percent of cases, and one of its etiological causes is sexually transmitted infections. Among sexually transmitted pathogens, HPV can contribute to the failure of spontaneous and assisted reproduction in different ways, acting at different stages of conception, especially early, an Italian study shows.
WHERE ARE WE NOW?
Serbia is in 29th place out of 49 European countries in terms of the number of people infected with the HPV virus, according to the "HPV atlas", prepared by the European Parliamentary Forum. This organization brings together a network of representatives across Europe with headquarters in Brussels. Our country found itself in the company of countries like Lithuania, Andorra, Cyprus, Greece, Georgia, Slovakia, Romania and Spain.
Although we are not at the very top in terms of the number of people suffering from HPV, we are in terms of the number of people suffering from cervical cancer, as well as the number of deaths, which is the most dangerous consequence of the virus. It is indisputable that the health system contributes to this, in which very little work is done on prevention, and cancers are identified and treated only at an advanced stage.
