‘Shameful’ decision on HPV vaccine leaves men at risk
The HPV vaccine should not be routinely offered to teenage boys, the Joint Committee on Vaccination and Immunisation has said.
A vaccination programme began in 2008 among school-age girls in the UK to tackle the human papilloma virus, which spreads through genital or oral contact and can cause a number of cancers.
Only girls are vaccinated on the grounds that men who only have sex with women are also protected from transmission through ‘herd immunity’.
However, the initial ‘herd immunity’ plan left gay men vulnerable. As unvaccinated men have sex with other unvaccinated men, they are effectively left without any protection – and HPV has continued to spread through the gay community.
The government has recently commissioned limited trial schemes offering the vaccine to men who have sex with men – but critics say that by targeting adult gay men through sexual health clinics, the schemes do not intervene early enough or aggressively enough to tackle HPV.
One further proposal would have seen teenage boys routinely vaccinated as well as girls – but in a decision today, the Joint Committee on Vaccination and Immunisation recommended against such an action.
The JCVI found that the proposal would have been too costly, and would not have as large an impact as the initial HPV vaccine rollout.
Ian Green, Chief Executive of Terrence Higgins Trust, said: “We are deeply disappointed by this short-sighted recommendation to deny teenage boys the potentially life-saving HPV vaccine. Girls aged 12 and 13 have been given the vaccine since 2008, but boys have had no protection.
“A gender neutral policy on HPV vaccination is long overdue and would protect boys from cancers caused by untreated HPV, including penile, anal and some types of head and neck cancer. It is shameful that this is still being denied to them.
“To eradicate HPV and protect people from related cancers, we need protection for boys and girls before they become sexually active. While this is ‘interim’ advice, it is a worrying sign.
“Before a final decision is taken, we strongly urge the government to listen to the campaigners, experts, charities, parents and young people who have campaigned so passionately for equal access to the vaccine, and to do the right thing.”
The JCVI recommendation says: “The Committee is mindful that the argument for gender equality has been put forward to justify the need for a gender neutral programme.
“Ultimately JCVI’s role is to consider the scientific, clinical and economic evidence when formulating its advice.
“Much of this indicates that while there is a disparity between males and females in terms of protection from HPV, the strong herd effects of the programme provide substantial benefit to males.
“The Committee has recognised that MSM are disproportionately affected by HPV infection and disease compared to other men and as a result has advised a targeted programme for MSM which is already being piloted.”
It noted the pilot scheme for adult gay men that is in place, adding: “The pilot has been very well received and informal early feedback indicates that the programme is proving a success both within the clinical community and among MSM themselves”.
However, the JCVI added: “The additional benefits gained from extending the programme to adolescent boys would be small, relative to the impact of the girls programme.
“The findings of both cost-effectiveness analyses provided specifically to the committee predict that extending the HPV programme to adolescent boys would not be a cost-effective use of health service resources in the UK setting.”
It noted that there would be “while it is clear that a programme to vaccinate adolescent males would provide those vaccinated with direct protection against HPV infection, and associated disease, all the evidence suggests that the risk of infection in males has already been dramatically reduced by the girls programme and that these herd effects will continue to have a substantial impact.”
