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Draft decision against giving HPV vaccine to teenage boys sparks disappointment

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A decision by government advisors not to recommend extending routine immunisation against human papillomavirus (HPV) to teenage boys has been met with “disappointment” and “dismay”.

Campaigners in favour of vaccinating adolescent boys as well as girls had noted that HPV was also responsible for anal, penile and head and neck cancers that affected both men and women.

“We hope that the government’s advisory committee reconsider this decision as soon as possible”

Shirley Cramer

But the Joint Committee on Vaccination and Immunisation, which advises ministers on vaccination policy, said that extending the HPV jab to teenage boys was “highly unlikely to be cost effective”.

Its draft decision, published today in a interim statement, follows a meeting in June, where the latest results of review work by Public Health England and the University of Warwick were presented and discussed. The committee has been considering expanding the programme since 2014.

“The analyses considered consistently show that when there is high uptake of HPV vaccine in adolescent girls, considerable herd protection is provided to the male population,” said the report.

“While there are some additional population level health benefits to both males and females by extending the programme to boys, impact and cost-effectiveness modelling indicates that adding boys is highly unlikely to be cost-effective in the UK, where uptake in adolescent girls is consistently high (over 85%),” it added.

“A gender-neutral policy on HPV vaccination is long overdue and would protect boys from cancers”

Ian Green

The JCVI’s interim findings on HPV in adolescent boys are now open for consultation for six weeks until the end of August 2017, after which the committee will publish its final decision.

In response, the Royal Society for Public Health expressed its “disappointment and frustration” at the draft decision, highlighting that HPV was responsible for 5% of all cancers.

While the existing vaccination programme for girls provided a level of “herd protection” to boys, the decision not to extend it meant some 400,000 boys remained at risk of contracting the virus, it said.

A decision to extend the programme today would have brought the UK in-line with 11 other countries that currently offer universal HPV vaccinations, the society added.

RSPH chief executive Shirley Cramer said: “We are deeply disappointed by the JCVI’s decision today, which suggests that fundamental priorities are focused more on saving money than on saving lives.

HPV vaccine

Disappointment over interim ruling against HPV jab for boys

Source: Photohound/Jan Christian

Gardasil vaccine and box

“Such a simple vaccination programme has the potential to make such a big impact on the public’s health on a national scale,” she said. “We hope that the government’s advisory committee reconsider this decision as soon as possible.”

Charities working in the fields of sexual health and cancer also criticised the interim recommendation of the JCVI.

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,” he said. “It is shameful that this is still being denied to them.

“While this is ‘interim’ advice, it is a worrying sign,” he said. “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.”

“Diagnoses of cancer in the UK are rising and our NHS is already at breaking point”

Robert Music

Robert Music, chief executive of Jo’s Cervical Cancer Trust, said: “Diagnoses of cancer in the UK are rising and our NHS is already at breaking point. Extending the current vaccination programme to boys presents an opportunity to reduce diagnoses, and ultimately save lives.

“While today’s interim recommendation is disappointing, it is positive to see that the committee recognises arguments made on the issue of equality and has referred this to the Department of Health for consideration,” he said. “I hope this will lead to a gender-neutral vaccination being made available as soon as possible.”

He added that it was also important to “maintain focus” on increasing uptake of the vaccine among girls, as it has fallen in the last year and significant variation existed across the country.

HPV causes 99.7% of all cervical cancers and the current vaccination programme in the UK offers girls the HPV vaccine in school.

The HPV programme was implemented in September 2008 using the Cervarix vaccine, following a positive recommendation from the JCVI.

The Gardasil vaccine, which is currently used, protects against two high-risk types of HPV (16 and 18) that cause at least 70% of all cervical cancer.

Meanwhile, a pilot scheme to evaluate a service providing HPV vaccination to men who have sex with men, up to and including 45 years of age, is being undertaken in selected clinics across England.

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