"HPV vaccine could be given to boys as well as girls in UK," The Guardian reports.
It goes on to say that, "Government advisers are to consider whether the HPV vaccine, routinely offered to girls at the ages of 12 and 13 since 2008 to help protect them against cervical cancer, should also be offered to boys and some men".
The news appears to be based on draft minutes from the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI advises the government on how vaccinations may reduce health problems – and considers the evidence on factors such as the prevalence of diseases, and the safety and effectiveness of vaccines.
The latest draft minutes of the JCVI say that as part of its work on the HPV vaccine it agreed that "further work was required to consider a number of key issues", including vaccinating:
- men who have sex with men, if they attend sexual health services
- adolescent males
Boys are routinely vaccinated against HPV in many other developed nations such as Australia and the US. It's clear that officials in the UK would want to understand whether such a programme would be safe, effective and provide value for taxpayers' money.
Who currently gets the HPV vaccine?
A type of HPV vaccine called Gardasil is routinely offered to secondary school girls aged 12 and 13 as part of the NHS childhood vaccination programme. Gardasil protects against the two types of HPV responsible for more than 70% of cervical cancers in the UK.
Gardasil is not routinely offered to boys. Parents who wish to have their sons vaccinated currently have to pay for the vaccine on a private basis. The complete course of the vaccine requires three doses with each dose costing around £150.
How would boys benefit from the HPV vaccine?
The HPV vaccine should help protect boys against genital warts. Gardasil protects against two strains of HPV that are responsible for 90% of genital warts.
Genital warts are not usually serious but they can be difficult to treat and cause distress.
Some experts have argued that routine vaccination in boys should reduce the number of oral cancer cases.
There has been a sharp rise in oral cancer cases in recent years – from 4,400 a year in 2002 to 6,200 in 2012, according to Cancer Research UK, with two thirds of cases occurring in men.
It is thought that the rise in cases may be associated with high-risk strains of HPV that can be spread during oral sex (in both heterosexual couples and in men who have sex in men).
The link between HPV and oral cancers hit the headlines earlier this year when the actor Michael Douglas allegedly attributed his throat cancer to oral sex.
What is HPV?
The human papilloma virus (HPV) is the name given to a family of viruses. There are more than 100 different types of HPV, with around 40 types that affect the genital area.
Infection with some high-risk types of HPV can cause abnormal tissue growth as well as other cell changes that can lead to cervical cancer.
Infection with other types of HPV may cause:
- genital warts: small growths or skin changes on or around the genital or anal area, these are the most common viral sexually transmitted infection (STI) in the UK
- skin warts and verrucas
- vaginal cancer or vulval cancer (although these types of cancer are rare)
- anal cancer or cancer of the penis
- oral cancers – cancers that develops on the surface of the tongue, mouth, lips or gums
How is HPV infection spread?
The HPV virus is very common and is easily spread by sexual activity. Half the population may be infected at some time in their life. In most cases, the virus doesn't do any harm because your immune system gets rid of the infection. But in some cases, the infection persists and can lead to health problems.
Although most girls don't start having sex until after they're 16 years of age, it's important that they get this protection early enough and a good time is in the teenage years – getting the vaccine as early as possible will protect them in the future.
Using a condom during sex can help to prevent HPV infection. However, as condoms do not cover the entire genital area and are often put on after sexual contact has begun, they are no guarantee against the spread of HPV.
Is the vaccine safe?
The Gardasil vaccine is thought to be extremely safe; much safer than many of the over-the-counter medications available on the market. For example, a 2013 Scandinavian study looked at the effects of vaccination in nearly a million girls and found no evidence of any link to either short or long-term health problems.
Common side effects of Gardasil include:
- pain, redness, bruising and swelling at the site of the injection
- flu-like symptoms, such as a high temperature and joint and muscle pain
These side effects normally pass quickly.
What happens next?
It appears that The Guardian’s story is based on draft minutes from the JCVI.
The JCVI has a reputation for thoroughness so it is unlikely that any changes to the national vaccination schedule will be made soon. Any decision will probably only be made after a careful consideration of the evidence; particularly whether routine vaccination of boys would be a cost-effective use of NHS resources.
Links to the headlines
The Guardian, 29 November 2013
Last updated April 19 2013
BMJ. Published online October 9 2013