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Boys should be given HPV vaccine, says joint committee

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3163 (Published 18 July 2018) Cite this as: BMJ 2018;362:k3163
  1. Zosia Kmietowicz
  1. BMJ

The UK government is considering whether to extend the human papilloma virus (HPV) vaccination programme to boys after an expert committee found that it was cost effective.1

In a report released on 18 July the Joint Committee on Vaccination and Immunisation said that deciding whether to recommend the HPV vaccine for boys was complex. It was only after considering the wider issues of health economics—including the benefits of preventing cancer many years into the future—that it found that including boys in the vaccination programme would be financially viable. This modelling also took account of the years lost from cancer if boys were excluded from vaccination.

The report follows a consultation that the committee launched last year, in which it concluded that HPV vaccination was not cost effective in boys.2 Since then it has taken on the views of stakeholders and asked for additional analyses on cost effectiveness from Public Health England and the University of Warwick.

When it applied the new modelling methods the committee found that having a gender neutral HPV programme would help to compensate for fluctuations in uptake and achieve better control of cancers caused by HPV. It would also lead to future savings in the cervical screening programme and better protection for men who have sex with men.

UK girls aged 12 and 13 have been offered HPV vaccination as part of a school based immunisation programme since 2008. This has been shown to reduce the incidence of cervical cancers.3

As well as being linked to cervical cancer and genital warts, HPV is also associated with penile, anal, oral, vaginal, and vulval cancers.

Cancer Research UK has urged the government to act promptly on the committee’s latest recommendation. Emma Greenwood, the charity’s director of policy, said: “If the government agrees to roll this out, it will help to reduce the risk of HPV infection across the whole population. HPV causes around 2500 cases of cancer in males every year in the UK, including mouth, throat, anal, and penile cancers.”

Parveen Kumar, chair of the BMA board of science, said that current policy to offer vaccinations at sexual health clinics to men aged 16 to 45 who have sex with men is too late to prevent infection, as they are often already sexually active.

“This won't save money for the NHS,” she said. “To properly protect people against HPV infection, this [should] be added to the school immunisation schedule as soon as possible.”

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