NOMAN are proud to continue to support the HPV Action campaign in 2019.
Whilst UK boys in Year 8 have begun to receive the HPV vaccination, there is an opportunity which at present is unfulfilled : protecting a significant number of boys who will otherwise be left at risk of HPV-related cancers.
There are approximately 400,000 boys in each school year in the UK. This means that, if a catch-up programme for boys up to 18 year of age had been introduced in the 2019/20 school year, about two million more boys would have been eligible for vaccination
As per HPV Action's case of action we believe that the decision not to implement a HPV catch-up programme for boys is flawed for the following reasons:
- The JCVI has judged HPV vaccinations to be necessary for 12/13 year olds (11/12 years in Scotland); it appears illogical to withhold vaccination from a boy who is just slightly older, at identical risk and equally deserving of protection.
- Boys who are eligible for HPV vaccination but who miss it are entitled to receive the vaccine until they are 25. This policy, which is very welcome, is an implicit acceptance of the case for vaccinating older boys. If the level of herd protection created by the vaccination of girls really was sufficient for older boys, there would be no need to maintain their eligibility for vaccination.
- HPV Action accepts that boys will derive some protection from the vaccination of girls. Clearly, a boy or man who has sex only with vaccinated girls or women is not at risk of HPV infection. But those boys and men who could have been vaccinated through a catch-up programme will remain at risk if they have sex with a girl or woman who was not vaccinated in the UK or another country or if they have sex with another man. The vaccination programme targeted specifically at men who have sex with men (MSM), while important, does not reduce their risk to a level equal to that achieved by vaccination in adolescence.
- The CDC recently revised its recommendations on HPV vaccination. It now recommends catch-up vaccination for males and females up to the age of 26. Other countries, including Australia, Austria, Germany and Liechtenstein, introduced a catch-up for boys when their HPV programmes became universal.
- The current policy of offering HPV vaccination to boys who were eligible but who missed out but not to provide a catch-up to older boys will be confusing for boys and their parents and will, rightly, be perceived as unfair, particularly by parents with two school-age sons one of whom is eligible for vaccination while the other is not.
- Health inequalities could be exacerbated if, as seems highly likely, more affluent or informed parents decide to pay for the private vaccination of their sons in the absence of a catch-up programme. The result could be that a small but significant group of boys from higher-income backgrounds would be protected from HPV-caused diseases while those from lower-income backgrounds would remain at risk.
- Many of the boys who would benefit from a catch-up would have been eligible for routine HPV vaccination had the JCVI made its decision on the vaccination of boys as originally scheduled in 2015. The long delay in decision-making – until 2018 – has meant that over one million boys who could have benefited from routine vaccination have not done so. A catch-up programme would help to mitigate this problem.