- 97% of dentists and 94% of GPs would have their own sons vaccinated against the Human Papillomavirus (HPV), in a new survey published ahead of World Immunisation Week 24th-28th April.
- 97% of dentists and 94% of GPs believe that the national HPV vaccination programme should cover both boys and girls.
BRITISH MEDICAL ASSOCIATION
Dr Andrew Green, a member of the BMA’s General Practitioners Committee (GPC), said: “If we want to see an end to some of the most aggressive and hard to treat cancers such as throat, head, neck and anal cancer, boys as well as girls must be given the HPV vaccination. It is ridiculous that people are still dying from these cancers when their life could have easily been saved by a simple injection.”
BRITISH DENTAL ASSOCIATION
Mick Armstrong, Chair of the BDA's Principal Executive Committee, said: “HPV is the leading cause of oro-pharyngeal cancers and men are just as likely to develop it as women so where is the logic – or fairness – in targeting protection to one section of the population? It is morally indefensible to allow people to contract cancer when prevention – the new NHS mantra – could be so cheap and easy. Cancers affecting the mouth and throat have a huge impact on the quality of people’s lives, so it’s frustrating for dentists, who are often the first to detect them, knowing how easily they could have been prevented."
LETTER TO JEREMY HUNT
Parliamentarians from all parties have signed an open letter to the Health Secretary, Jeremy Hunt MP, urging him to ensure that the UK doesn’t miss this opportunity to eradicate some of the fastest rising cancers in the developed world.
Up to 80% of sexually active people will be infected by HPV at some point in their lives. 5% of all cancers are caused by HPV and some of these, notably oral cancers, are now rising sharply in incidence. HPV-related cancers such as anal cancer are also among the hardest to diagnose and treat.
THE COST-EFFECTIVE ARGUMENT
Many doctors, dentists, scientists and professional and patient organisations who support the vaccination of both sexes are concerned that the JCVI will reject universal coverage on the grounds of cost despite the vaccination’s ability to protect against 5% of all cancers and the huge cost of treating HPV-related cancers and other diseases caused by HPV (genital warts and recurrent respiratory papillomatosis).
It is estimated that vaccinating boys would cost £20-22m a year at most – a figure that is dwarfed by the cost of treating HPV-related cancers and warts. An estimated £57.1 million is spent treating head and neck cancer (in England), almost £7 million on treating men with anal cancer and an estimated £58.44 million a year treating anogenital warts.
Newly-published research by Favato G, Easton T, Vecchiato R, Noikokyris E. “Ecological validity of cost-effectiveness models of universal HPV vaccination: a systematic literature review” casts doubt on hitherto published cost-effectiveness modelling and highlights the uncertainties in the process.
The authors comment: “Our findings indicate that the selective immunisation of prepubertal girls is likely to fail to achieve the expected level of herd immunity at population level. A relatively small (15–20%) overestimation of QALY-gained with selective immunisation programmes could induce a significant error in the estimate of the cost-effectiveness of universal immunisation, making the option of vaccinating boys [wrongly appear to be] cost-ineffective.”
WHY GIRLS NOT BOYS?
As well as cost, the main argument deployed against vaccinating boys is that the girls’ programme indirectly protects boys. However, this has been widely dismissed because it fails to take into account men who have sex with unvaccinated women (from the UK and other countries) or men who have sex with men.
One of the key voices in the campaign, Tristan Almada, HPV & Anal Cancer Foundation, said: “The UK government cannot ignore the overwhelming support from GPs, dentists and MPs who want boys to have the HPV vaccination. With every year that passes, almost 400,000 more boys go unvaccinated and are therefore at
risk of developing a HPV-related cancer later in life. The government must roll out gender-neutral vaccination nationally as soon as possible.”
THE GLOBAL VIEW
Australia, USA, Brazil, Bermuda, New Zealand, Austria, Israel, Italy, Switzerland and Canada all recommend that boys are vaccinated as well as girls.
Peter Baker, HPV Action Campaign Director, said: “HPV affects men and women equally and both sexes therefore deserve equal protection though a national vaccination programme. It is now time for the Government’s vaccination advisory committee to look up from its financial spreadsheets and act to end the suffering of those men and women affected by easily-preventable diseases caused by HPV.”
The survey was carried out by HPV Action with the support of the HPV and Anal Cancer Foundation and its other members. HPV Action is asking people, especially the parents of boys, to sign an online petition demanding gender-neutral vaccination: http://bit.ly/2nHaUul and will be calling on all political parties to commit themselves to gender-neutral HPV vaccination during the forthcoming General Election campaign.
For further information including interviews with HPV-related cancers survivors please contact: firstname.lastname@example.org 0203 701 7510 / 07973 316 818.
Notes to Editors
- World Immunisation Week runs from April 24th – 30th. This year’s theme is: #VaccinesWork http://bit.ly/2nNJpjn
- The Survey was carried out using Survey Monkey by HPV Action from 12 March-14 April 2017 and valid responses were received from 1,667 GPs and dentists. 995 GPs (60%) and 672 dentists (40%) replied.
- The survey was sent to members of the British Dental Association, the British Medical Association (GPs) and the Faculty of General Dental Practice.
- The HPV vaccination prevents 5% of HPV related cancers including oral, cervical, anal, penial, vaginal and vulval. HPV also causes anogenital warts and recurrent respiratory papillomatosis.
- HPV awareness is still relatively low and research is ongoing. In 2008, Professor Harald zur Hausen received the Nobel Prize for medicine for his work on the link between HPV and cancer. The Professor is an advocate for the vaccination of boys against HPV.
- The JCVI began to consider gender-neutral vaccination in 2013. Even if the JCVI this year recommends the vaccination of boys, implementation is unlikely to begin before 2020.
- The letter to the Health Secretary Jeremy Hunt MP has been signed by: John Baron MP (Conservative), The Baroness Elizabeth Barker (Liberal Democrat), Danny Kinahan MP (Ulster Unionist), Caroline Lucas MP (Green Party), Grahame Morris MP (Labour), Jim Shannon MP (Democratic Unionist). John Baron is the chair of the All Party Parliamentary Group on Cancer and Jim Shanon is the Vice Chair. Danny Kinahan and Grahame Morris are also members. Baroness Barker is Vice Chair of the APG on HIV and AIDS and Caroline Lucas and Grahame Morris are also members of this Group.
- In the UK, girls aged 12/13 have been offered the vaccine since 2008.
- Favato G, Easton T, Vecchiato R, Noikokyris E. Ecological validity of cost-effectiveness models of universal HPV vaccination: a systematic literature review. Vaccine. Article in press. Available at: http://ac.elscdn.com/S0264410X17304450/1-s2.0-S0264410X17304450-main.pdf?_tid=f80902e8-1ea2-11e7-8d7a-00000aab0f6b&acdnat=1491907275_81a18d4b2d6eab6ba9d80d6ef080b43b
- The costs for head and neck cancer hospitalizations in England were taken from the Journal of the International Society for Pharmacoeconomics and Outcomes Research: http://bit.ly/2o6jTc5
- Other cost examples where taken from Jabs for the Boys: The case for gender-neutral vaccination: http://bit.ly/217EvNo
- NOMAN: In July two teams will row 200 miles across the Mediterranean from Ibiza to Barcelona to raise awareness and £200,000 for the HPV & Anal Cancer Charity Foundation.
- The endurance event symbolizes the race to end the 5% of HPV-related cancers and the isolation and fear that HPV-related cancer patients feel.
- HPV & Anal Cancer Foundation is a charity dedicated to educate the public about anal cancer, to provide support for patients, to improve preventative care and to fund therapeutic research. For more information visit www.analcancerfoundation.org.
- HPV Action is a collaborative partnership of 45 patient and professional organisations that advocates HPV vaccination for both boys and girls. Its members are: British Association for Sexual Health and HIV, British Association of Dental Therapists, British Dental Association, British Federation against Sexually Transmitted Infections, British Society for Immunology, British Society of Dental Hygiene and Therapy, Brook, Cancer Focus Northern Ireland, Children’s HIV Association of the UK & Ireland (CHIVA), ENT UK, European Men’s Health Forum, Faculty of General Dental Practice (UK), Faculty of Public Health, Faculty of Sexual and Reproductive Healthcare, Family Planning Association, GMFA (Gay Men’s Health Charity), Herpes Viruses Association, HPV and Anal Cancer Foundation, Let’s Talk About Mouth Cancer, London Cancer Alliance, London Friend, Men’s Health Forum (GB), Men’s Health Forum Ireland, Mouth Cancer Foundation, National Aids Manual, National Association of Laryngectomee Clubs (NALC), National Union of Students, Northern Head and Neck Cancer Fund, Oral Cancer Foundation (USA), Oral Health Foundation, Primary Care Urology Society, Rainbow Project, Reproductive Health Matters, Royal College of Obstetricians and Gynaecologists, Royal Society for Public Health, The School and Public Health Nurses Association, Sexpression:UK, Society of Sexual Health Advisers, Stonewall, The Swallows Head and Neck Cancer Support Group, Tenovus, Terrence Higgins Trust, Throat Cancer Foundation, The Urology Foundation, Wellbeing of Women. http://www.hpvaction.org