A “targeted” programme of human papillomavirus vaccine for men aged under 45 who have sex with men should take place in England, according to government advisors.
The Joint Committee on Vaccination and Immunisation set out the recommendation to extend the HPV vaccination programme in guidance published today.
“A targeted HPV vaccination programme for men who have sex with men aged up to 45 who attend GUM and HIV clinics should be undertaken”
In 2008, the JCVI recommended the universal HPV vaccination of girls aged 12-13 years of age in schools, along with a catch up programme for girls 13 to under 18 years of age. Since then, the committee said evidence had emerged that HPV immunisation was likely to provide protection against a wider range of HPV-related diseases, including anal, penile and oropharyngeal cancers.
But the JCVI said it was concerned that men who have sex with men were currently a group at high risk of HPV infection and associated disease who received very little indirect health benefit from the adolescent vaccination programme.
As a result, they considered the evidence on the impact and cost-effectiveness of a targeted programme of vaccinating men who have sex with men in the autumn of 2014.
In their report, they said: “Given the evidence available and the modelling work undertaken JCVI advises that a targeted HPV vaccination programme for men who ahve sex with men aged up to 45 who attend GUM and HIV clinics should be undertaken.”
However, the advisors noted that this should subject to procurement of the vaccine and delivery of the programme at a cost-effective price.
“Work is required by the Department of Health, Public Health England, local government and NHS England to identify the commissioning arrangements and potential routes for delivery of any programme to vaccinate men who have sex with men, and JCVI understands that this work may be challenging,” said the report.
“This is an important step in the right direction but it is unfortunately not enough”
It said prisoners who are men who have sex with men should also be able to access the HPV vaccine through prison sexual health services, and transgender women should be eligible.
In addition, the JCVI said it considered that there may be “considerable benefit” in offering the HPV vaccine to some men who have sex with men over 45, sex workers, HIV positive women, and HIV positive men.
“Clinicians are able to offer vaccinations outside of the national programme using individual clinical judgement, and HPV vaccination could therefore be considered for such individuals on a case-by-case basis,” the advisors said.
They added that the Department of Health had agreed to consider their recommendations “from a national perspective” and would report back to the committee at a future date.
A spokesperson for the Department of Health said: “The HPV vaccination programme for girls is really important and expected to prevent hundreds of deaths from cervical cancer every year.
“We welcome this advice on the benefits and complexities of extending the programme to other groups and will consider the JCVI’s advice carefully and confirm our plans in due course,” they said.
The Terrence Higgins Trust welcomed the JCVI’s recommendation, but claimed the vaccine should be made available widely to all boys before they were sexually active.
Dr Shaun Griffin, the charity’s executive director external affairs, said: “This is an important step in the right direction but it is unfortunately not enough.
“We need a gender-neutral vaccination programme so that all boys are covered,” he added.
Meanwhile, the JCVI also published a statement on adult pneumococcal vaccination in the UK, concluding there should be no changes “at this time”.