HPV Action Update

05 March 2019

HPV Action’s Peter Baker has reported that the organisation is proposing a compromise option of a one-year catch-up for boys in 2020/21 that it is limited to boys up to year 11 (16 years old). This would mean that, in 2020/21, boys then in years 10 and 11 would be vaccinated alongside the new year 8s (boys now in year 9 would already have been vaccinated when they were in year 8 in 2019/20). Most of the boys would be under 15 and therefore need only two doses.

HPV Action is suggesting this approach because it addresses the vaccine supply issue (there won’t be enough for a catch-up in 2019/20), reduces the burden on the school nursing workforce, and minimises the cost. It also recognises that uptake among 16-18 year olds is likely to be lower.

The catch-up issue has already been raised in Parliament, most recently by Sharon Hodgson MP. HPV Action wrote about it (again) to Steve Brine MP on 4 March. The Mail on Sunday is also interested in covering the catch-up and may do so soon.

HPV Action recently met the PHE officials involved in implementing boys’ vaccination. The key points were as follows:

1. The ‘indicative’ (PHE’s word) implementation date for vaccinating boys is the 2019/20 school year. Vaccination will go ahead unless there is an unforeseen problem, such as a failure of the vaccine supply chain.
    
2. On the catch-up issue, HPV Action reiterated all the arguments, particularly that the boys who would be in the catch-up are at the same level of risk as boys who will be vaccinated at 12/13 years. The organisation made the following points:
   1. A catch-up would protect many of those boys who will otherwise miss out because JCVI took three years longer than planned to make a decision.
       
   2. It is unfair that wealthier and better-informed parents can effectively pay for a catch-up whereas most parents won’t or can’t.
       
   3. Other countries, notably Australia, have a catch-up for boys.
       
   4. Some individuals and organisations are looking into the option of judicial review.
      
      PHE stuck to the line that the situation is not as it was for girls in 2008 in that there is now some herd immunity for boys and that there are also concerns about workforce capacity.
       
3. PHE has no specific target figures for the number of boys being vaccinated but is aiming for a similar figure to that for girls (currently 83%). They are expecting 100% of boys to be offered the vaccine in 2019/20.
    
4. The plans for producing patient information materials and marketing the new programme are well-advanced.
    
5. PHE expects the MSM HPV vaccination national roll-out to be complete by the end of March but was unaware of delivery problems in specific clinics in central London raised by THT.
    

An important new paper shows that 75% gender-neutral vaccination coverage of adolescents will rapidly eradicate HPV16 (the highest-risk strain) from the general population. More information can be found here.

It has also been suggested that HPV may be implicated in heart disease. In a large-scale study of women in Korea, high-risk HPV infection was significantly associated with an increased risk of developing CVD, especially in obese individuals and those with metabolic syndrome (metabolic syndrome is the medical term for a combination of diabetes, high blood pressure and obesity).

Development work on HPV Action Europe is proceeding well with significant interest from potential members (at this stage, mostly pan-European professional, medical, patient and other groups). HPV Action UK members are very welcome to get involved too – those interested should contact Peter Baker directly, or through the HPV Action website.