Warts and all at last: HPV vaccination

Health campaigning, like much of public health, can be a slow, repetitive business. The media will break a big story once and then tend to lose interest unless a fresh scandal surfaces. But to change culture, opinion, or behaviour the same message may have to be drip fed over many years. And if the story doesn’t lend itself to a cute front page photo the chance of success is remote. Genital warts will never make the headlines in the Daily Mail or indeed any other newspaper—which makes the government’s decision to switch to a multipurpose vaccine against human papillomavirus all the more remarkable.1

The Lancet kicked off the campaign in October 2006, with an editorial titled “Should HPV vaccines be mandatory for all adolescents?”2 It argued that Gardasil, which protects against HPV types 6, 11, 16, and 18, could dramatically reduce not just the incidence of cervical cancer but unpleasant conditions such as genital warts, anal cancer, and other malignancies affecting both sexes. It concluded, “EU member states should lead by making the vaccinations mandatory for …