It’s only taken ten years, but the NHS has decided to extend the HPV vaccination to boys. Here, Alexander Marshall reports
This week the NHS decided to extend the HPV vaccine to boys aged 12-13, bringing them in line with the policy for girls, in an attempt to reduce HPV-related cancers. Controversy has surrounded the vaccination policy since its inception a decade ago, with criticism aimed at the gendered approach to its distribution.
The family of viruses known as human papillomaviruses (HPV) are transmitted through sexual contact, and are so common that nearly every individual who engages in sexual activity will be exposed within their lifetime. While most cases will clear up without incidence, the HPV16 and HPC18 viruses have been associated with a wide range of cancers, especially carcinomas, which develop from the skin or internal linings of the cervix, throat, penis or anus.
How these viruses contribute to the development of cancer isn’t entirely clear; however, the impact of HPV seems to be increasingly important, with HPV-positive cancers even forming their own subgroups in terms of treatability and survival.
The NHS had originally intended for the vaccine to be given to girls, with the primary objective being a reduction in cervical cancer, while simultaneously enabling the elimination of the virus in the general population, and therefore eventually protecting men too. The concept had merit; 43.5% of HPV-related cancers are cervical cancers, and cervical cancers are the second most common type of cancer in women. While HPV may be involved in various cancers, it has been debated whether the substantial cost of expanding the policy was worthwhile, with cervical cancers occurring about nine times more frequently than anal cancer – the other type of cancer with a significant association to HPV.
From its conception, this policy has been called flawed and accused of abandoning the gay and bisexual community, men who have sex with women from non-immunised locations, and men who have sex with older women. Campaigners have been pushing for the roll-out of the vaccine ever since it was put in place, arguing that these communities were put at risk by the NHS’s policy, given that gay or bisexual men are especially at risk of anal cancer, and that 80% of anal cancer cases have been linked to HPV infection.
Since April, at-risk gay and bisexual men have theoretically been able to receive the vaccine from sexual health clinics across the country as part of a regular check-up. However, with increasing demands on NHS funding, local sexual health clinics have been put under pressure, and the slow roll-out, coupled with the need to actively attend sexual health clinics, poor awareness and questionable effectiveness for late-in-life use, leaves men who have sex with men vulnerable.
However, it is hoped that this expansion of the programme will help to further reduce the prevalence of the virus in all communities within the UK, and make HPV a thing of the past.
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