HPV vaccination not recommended to be extended to boys

Expanding HPV vaccine to teenage boys is not cost effective, says the Joint Committee on Vaccination and Immunisation in interim advice, as cancer campaigners and clinicians oppose the decision.

Boy receives human papilloma virus (HPV) vaccination

A decision not to extend the human papilloma virus (HPV) vaccine to boys has been greeted with dismay by clinicians and campaigners.

The Joint Committee on Vaccination and Immunisation (JCVI) has published interim advice that does not recommend extending the HPV vaccination to adolescent boys.

HPV is thought to cause around 80% of cervical cancers, as well as other forms of the disease, including anal cancer. All girls aged 12–13 in the UK have been offered HPV vaccination as part of the NHS childhood vaccination programme since 2008.

Since then, studies have shown that the number of men contracting cancer from the HPV virus could outstrip women, and many countries, including the United States and Australia, have introduced vaccinations for men. A parliamentary campaign called for the vaccination to be extended to teenage boys and men who have sex with men.

The JCVI said the high uptake of the vaccination seen in the UK will have a substantial effect on HPV-related disease indirectly among men and boys, as well as among females. It concluded that any extra benefits from extending the programme to adolescent boys “would be small”.

It added that although vaccinating adolescent males would provide them 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.

“Therefore, most of the benefit in boys can be achieved through achieving high uptake in a girls-only vaccination programme.”

But Tristan Almada, co-founder of the HPV and Anal Cancer Foundation, said the decision will put more than 400,000 boys a year at unnecessary risk of contracting HPV.

HPV causing cancer in men

“Although the public is familiar with the HPV vaccine as the ‘cervical cancer jab’, HPV is responsible for the fastest increasing cancers in UK men today,” he said.

“Recognising the HPV vaccine as our best opportunity to prevent cancer since smoking cessation, 11 countries, including the United States, Canada and Australia, are now vaccinating their boys against a virus that causes cancer in both genders. UK boys deserve the same.”

Campaign director at HPV Action, Peter Baker, said it would call on ministers to “make the right decision if the JCVI continues along its current path”.

“There may also be grounds for a legal challenge of the decision to leave boys and men at risk as breaching equality law.”

Chief executive at the Royal Society for Public Health, Shirley Cramer, said she was ‘aggrieved’ by the decision, which appeared to prioritise saving money over saving lives.

“Such a simple vaccination programme has the potential to make such a big impact to health on a national scale,” she said.

“We hope that the government’s advisory committee will reconsider this decision as soon as possible and put human health and wellbeing before cost saving.”

This interim decision will now go out to consultation, and a final JCVI decision is expected in October.

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Last updated
Citation
The Pharmaceutical Journal, July 2017;Online:DOI:10.1211/PJ.2017.20203231