School age boys in the UK should be offered vaccination against the cancer causing human papillomavirus (HPV), according to government advisors.
The Joint Committee on Vaccination and Immunisation (JCVI) yesterday recommended that a combined girls’ and boys’ programme was “highly likely to be cost-effective”.
“Gender-neutral HPV vaccination is highly likely to be cost-effective”
The virus is thought to cause around 2,500 cases of cancer in males every year in the UK, including mouth, throat, anal and penile cancers.
The expert group’s 13-page statement was shortly followed by announcements from the Scottish and Welsh governments that they would be extending HPV vaccination to boys, as a result.
However, the Department of Health and Social Care said it was still considering the JCVI’s report and would respond shortly.
HPV vaccination is currently offered to girls aged 12 and 13 in a free school-based immunisation programme, which began in 2008 to reduce cervical cancers.
The JCVI has been reviewing the evidence for vaccinating boys since 2013. It issued an interim statement this time last year, saying it could not recommend extending the national programme.
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However, on Wednesday, the JCVI published documents from their latest meeting where the committee reviewed evidence from a consultation on extending the vaccine to boys.
In this meeting, which took place in June, members of the committee decided to alter their view and recommend that the programme should be extended.
“We urge the government to give the green light on this recommendation without delay”
This was on the grounds that modelling suggested that a gender-neutral programme would be cost-effective, and that vaccinating boys as well as girls would further reduce HPV infection in the population compared to vaccinating girls alone.
Boys have not previously been included in the immunisation schedule, despite also being susceptible to HPV-related illnesses, because it was thought that herd immunity would protect them.
However, this protection did not extend to men who have sex with men (MSM), who have a particularly high incidence of anal cancer, because they fall outside of the “herd”.
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While more recent policies extended the HPV vaccine to MSM who present at sexual health clinics on an opportunistic basis, this policy was deemed insufficient to ensure high uptake.
In addition, in several areas of the UK, uptake of the vaccine for girls was insufficiently high to ensure herd immunity in the community in general.
Furthermore, men in the UK were seen as still at risk of acquiring HPV from sexual contact with women from countries without a vaccination programme against HPV.
“Boys have been left insufficiently protected against HPV for too long”
In response, Scotland’s public health minister, Joe FitzPatrick, said: “I am pleased to announce that the Scottish government will implement a HPV vaccination programme for adolescent boys.
“Work to develop the programme will now begin, in conjunction with Health Protection Scotland and NHS Scotland, to be rolled out as soon as is practicable,” he said.
Vaughan Gething, health secretary for Wales, said: “I am pleased to announce that I have decided that the HPV vaccination programme in Wales will be extended to include adolescent boys.
“We will now work with NHS Wales on the implementation of the new programme for roll out as soon as practicable,” he added.
The JVI’s recommendation has been widely welcomed by charities and professional groups, which called on the government in England to also take action.
Emma Greenwood, Cancer Research UK’s director of policy, said: “We welcome the recommendation to extend the HPV vaccination programme to boys.
“If the government agrees to roll this out, it will help to reduce the risk of HPV infection across the whole population.
Disappointment over interim ruling against HPV jab for boys
Source: Photohound/Jan Christian
“We urge the government to give the green light on this recommendation without delay so that no one is excluded and we can help protect all young people against HPV-linked cancers,” she said.
Shirley Cramer, chief executive of Royal Society for Public Health, said: “The JCVI’s decision to advocate for a gender-neutral vaccination programme against HPV is a victory for the public’s health.
“Boys have been left insufficiently protected against HPV for too long and it is good news that the UK is following in the footsteps of the other 20 countries already vaccinating boys against HPV,” she said.
“It is estimated that HPV causes up to 5% of all cancers and, with the NHS under pressure, the value of the prevention of ill-health is only increasing,” noted Ms Cramer.
She added: “The government and vaccine manufacturers should aim to roll the immunisation programme out to all boys as soon as possible.”