Call for boys to get cervical cancer jab

Published on Saturday 11 April 2009 20:13

EVERY schoolboy in Scotland should be vaccinated against the virus that causes most cases of cervical cancer to stop them passing the infection to girls, leading experts demanded last night.

The Royal College of Obstetricians and Gynaecologists, the Royal College of Nursing in Scotland, Cancer Research UK and a number of senior doctors want boys vaccinated before they become sexually active.

Schoolgirls are already receiving jabs that prevent them being infected by the Human Papilloma Virus (HPV). The Scottish Government is currently refusing to back an extension of the vaccination programme to boys, saying such a move would not be "cost effective".

Ministers are spending 64m on the immunisation programme, which it is hoped will save up to 100 lives a year. Around 30,000 girls over 12 are being vaccinated by school nurses.

But Henry Annan, spokesman for the Royal College of Obstetricians and Gynaecologists, said the refusal to extend the programme to boys was "defeatist".

Annan, a consultant obstetrician and gynaecologist, said: "Scientifically it makes sense that if you want to vaccinate young girls then boys should also be vaccinated, otherwise it's a bit defeatist, because they will still have HPV. It is sensible and it's a question of whether the Government wants to take it up."

His concerns were echoed by Ellen Hudson, associate director of the Royal College of Nursing in Scotland.

She said: "The HPV vaccination programme is extremely important in the battle against cervical cancer.

"Eradication of cervical cancer should be our goal, and to achieve this the vaccination programme should be extended to boys."

So far, 92% of Scottish schoolgirls had the first of the three required doses. But there are serious concerns that uptake is far lower among school leavers.

Plans to immunise up to 120,000 older girls over the next three years in a 1.7m "catch-up" campaign are in doubt because plans for all family doctors to provide the cervical cancer jab collapsed.

Instead school leavers are being invited to attend makeshift clinics and it is unclear whether this is proving successful.

The only NHS board to have released uptake figures for school leavers is NHS Dumfries and Galloway, where they are just 67%.

Sarah Woolnough, head of policy at Cancer Research UK, said: "The more girls who are vaccinated against HPV, the more effective the programme will be.

"If take-up is low amongst girls who have left the school system, the Government must do more to publicise the benefits of vaccination and ensure that girls can have the vaccine easily, close to where they live.

"Vaccinating boys against HPV could be helpful in achieving population-wide immunity."

Dr Anne Szarewski, a clinical consultant at the Wolfson Institute of Preventive Medicine, said the move was necessary to create "herd immunity", where the vaccination of the vast majority of the population ensures that the few who are not vaccinated are protected.

She said: "It is extremely unlikely that uptake in girls will hit the 100% level.

"In order to get herd immunity we need to vaccinate boys as well."

The vaccine can also prevent some rare cancers in men.

Dr Sheila Graham, an HPV microbiologist at Glasgow University, warned that boys are not being immunised because the move would draw the Government into a moral debate.

She said: "If the Government was going to immunise boys as well as girls it would become clear to the general public that this vaccine is not against cervical cancer per se, but against a sexually transmitted disease."

Labour health spokesman Dr Richard Simpson said: "I understand the cost implications in the current climate but it should not be ruled out in the long term." However, yesterday a Scottish Government spokesperson said: "The priority for HPV immunisation is directly to protect girls against their future risk of cervical cancer.

"The question of whether to immunise boys against HPV was considered by the UK Joint Committee for Vaccination and Immunisation.

"The JCVI did not consider immunising boys to be a cost-effective way to prevent cervical cancer in girls."

Should we vaccinate boys against the cervical cancer virus?

YES

Mark Ward, national co-ordinator of Men's Health Forum Scotland

In an ideal world I would totally support the vaccine made available to boys and men for the sake of their own health, but also for the impact that they can then have on cervical cancer in their partners.

It would empower men to have control over their own health and help them to share responsibility, which is very important in sexual health.

In particular communities of men, such as gay men, there's evidence to suggest the vaccine can have benefits in preventing penile and anal cancer which are very relevant issues. There's quite a lobby that says this vaccine should be made available to gay men. However politically there would be an uphill struggle to do that.

NO

Dr Martin Donaghy, Medical Director, Health Protection Scotland

The Human Papilloma Virus (HPV) immunisation programme protects young women against two strains of the virus which cause 70% of cervical cancer, which kills around 100 women in Scotland annually.

By vaccinating enough girls, the chances of boys coming into contact with girls carrying either of these strains will be greatly lowered. Over time, the strains will become far less widespread in the population. The immunisation experts who advise the Government considered evidence showing that if 70%-90% of girls were vaccinated, it was not cost effective to vaccinate boys to help prevent cervical cancer. They therefore did not recommend it.