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Teenage boys shouldn’t be given HPV vaccine, says joint committee

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3523 (Published 20 July 2017) Cite this as: BMJ 2017;358:j3523

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Re: Teenage boys shouldn’t be given HPV vaccine, says joint committee

You quote Professor Jonathan Ball as saying:

“Unfortunately, it isn’t a question of science—it’s one of cost—and at the moment the Joint Committee on Vaccination and Immunisation doesn’t consider that the benefits are worth the investment.”

I think he has misunderstood the role of the committee.

The government, acting on behalf of the population and, cognisant that its their taxes that fund such decisions, sets thresholds of cost and benefit.

The role of the scientific committee - using the best available science - is to advise whether benefits are likely to be available at a cost that which is below the threshold set by the treasury. This is a scientific decision, extending beyond studies of efficacy and into health economics.

A decision that a treatment does not meet the cost-efficacy threshold does not mean that the science has failed to prove that there are (in this instance) likely benefits from vaccinating boys: The benefits Ball describes are real. And the decision does not mean that the committee per se "doesn’t consider that the benefits are worth the investment”. Simply that the benefits are below the threshold set by the treasury.

In principle, at least, it is entirely appropriate for a democratically elected government to set such thresholds.

One could, of course, argue about whether the UK does, in fact, have a democratically elected government, and whether the emphasis on health issues in elections is such that it reflects the views of the electorate. But that's a different matter altogether. The JCVI was simply doing the job it is tasked with and – in my opinion – doing it, as usual, very well.

Competing interests: No competing interests

21 July 2017
Peter Mark English
Public Health Physician
N/A - this is a personal response
Epsom