There’s good news in the fight against cervical and other cancers, as an advisory committee has recommended that boys as well as girls should be offered immunisation against HPV
The vaccine against HPV, Human Papilloma Virus, is routinely offered to girls aged 12 to 13 at secondary school and is free up until they turn 18. Take-up rate is more than 85 percent, and the girls' programme has already reduced the prevalence of HPV 16 and 18—the main cancer-causing types—by more than 80 percent, according to data from Public Health England. Hundreds of lives have been saved, but up until now, the same offer has not been routinely extended to boys.
HPV is the name given to a large group of viruses, which can be caught through any kind of sexual contact with another person who already has it. HPV infections can be spread by any skin to skin contact, and are usually found on the fingers, hands, mouth and genitals.
This means the virus can be spread during any kind of sexual activity, including touching.
Most HPV infections cause no symptoms and are dealt with by the body’s immune system, but around a dozen varieties of the virus can lead to a variety of serious problems, including genital warts; cervical cancer for girls; and cancer of the anus, penis, mouth and throat for boys.
Risks and Rewards
Just because men cannot get cervical cancer doesn’t mean they shouldn’t worry about the disease, particularly considering the role they play in spreading the virus that causes it.
Recent studies suggest that around 80 percent of sexually active people will carry HPV at some time in their life, and incidences of head and neck cancer has continued to soar in men across the world. Health experts say that an increase in oral sex is in part responsible for the spread of HPV and for the dramatic jump in neck and head cancers, which tend to have poor long-term survival rates.
In the UK, the HPV vaccine has been offered to girls since 2008 as part of the NHS childhood vaccination programme, with boys being said to benefit through “herd protection”—but of course there is a continued risk of infection for anyone who goes on to have sex with others who have not been vaccinated.
“To be blunt, the case for giving the vaccine to boys as well as girls is now unequivocal as far as I am concerned,” said Professor Mark Lawler, of Queen’s University Belfast. “We have a chance to eradicate both these conditions—cervical as well as neck and head cancers—and we should not be hesitating.”
Campaigners in the UK have been pressing for the vaccine to be offered to boys to further reduce the risk of HPV infection, pointing to the success of similar programmes in other countries. Although there are obvious cost implications, campaigners argue that, in the long term, a ‘gender-neutral’ immunisation programme would be cost effective, and the Joint Committee on Vaccination and Immunisation has now accepted this approach.
The JCVI has advised extending the programme to boys at the same age as girls, and the recommendation has been accepted by the English, Scottish and Welsh governments. The HPV vaccine will be offered to boys aged 12 to 13 in England, said Steve Brine, Parliamentary Under Secretary of State for Public Health and Primary Care.
“The HPV vaccine for girls is already expected to save hundreds of lives every year,” said Brine, “and I am delighted that we will now be protecting even more people from this devastating disease by extending the vaccine to boys.
“Any vaccination programme must be firmly grounded in evidence to ensure that we can get the best outcomes for patients, but as a father to a son, I understand the relief that this will bring to parents."
Other health bodies have welcomed the committee's recommendation, adding that boys had been insufficiently protected against HPV for too long.
Dr Mary Ramsay, head of immunisation at Public Health England (PHE), said: “I'm pleased that adolescent boys will be offered the HPV vaccine.
“Almost all women under 25 have had the HPV vaccine, and we're confident that we will see a similarly high uptake in boys.”
And as Prof Margaret Stanley, from Cambridge University’s pathology department, said, immunising men would also give additional protection to women, as “it takes two to tango”.
The HPV immunisation programme for boys is scheduled to begin in autumn 2019. Ask your school for further details, and if you have questions about HPV in adults, talk to your GP or practice nurse.
This feature was originally published in the summer edition of Healthy Child with Dr Ranj Singh, which you can also read here!
Cervical Cancer Awareness