Cost… this is the cold deciding factor that ultimately influences whether individuals are protected from illness, or not. Whether patients receive lifesaving treatment, or not.
Right now the Human Papillomavirus Vaccination (HPV Vaccine) for Boys remains an issue of debate in this respect – an ongoing question of benefits versus expense. The most recent word seems to point to the vaccine being an inefficient expense. Let’s explore where we are currently – with context as to the advantages that boys may be missing out on, and why charities and medics are standing united to condemn this move.
What Is The Human Papillomavirus (HPV?)
The Human Papillomavirus is the overarching name for a family of viruses, of which there are more than 100, with 40 strains that affect the genital region.
Infections from HPV can result in:
- Genital Warts
- Skin Warts And Verrucas
- Vaginal Cancer Or Vulval Cancer
- Anal Cancer Or Cancer Of The Penis
- Oral Cancers
Staggeringly eight of 10 people will be affected by HPV during their lifetimes, with HPV also linked to one in 20 cancer cases in the UK.
A Promising Start
The year was 2013 – and it seemed promising that the HPV vaccine could soon be rolled out to include boys, as well as girls (who’d benefited from the vaccine for half a decade at this point.
“HPV vaccine could be given to boys as well as girls in UK…
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”.
This would mark the start of three years of boys being considered for the scheme, and there were many good reasons for exploring this option. At the forefront of which was the protection the vaccine could offer boys against genital warts – providing a complete defence against 90% of all forms of genital warts. Notably however whilst uncomfortable, difficult to treat and potentially distressing, genital warts aren’t considered a serious condition.
However on an altogether graver a note the HPV vaccine can also drive down the risks of certain cancers. Oral cancer in particular is rising significantly, surging from 4,400 cases in 2002 to 6,200 cases as of 2012 – and of these figures men account for two thirds of all patients.
Where We Are Today – A Gloomy Outlook
“Highly unlikely to be cost-effective” – those were the words of The Joint Committee on Vaccination and Immunisation (JCVI). 400,000 – that’s the figure of school-age boys who’ll remain at risk should the NHS be confirmed as not going ahead with the HPV vaccine for boys. However we know that U-turns by the JCVI are not unheard of; perhaps most infamous of which was the change of heart to offer free meningitis B vaccinations. Similarly to the HPV vaccine, this decision had also been previously noted as “not cost effective”.
“FSRH aims to improve women’s sexual and reproductive health, especially access to contraception. However, HPV affects not only women, but also men, and FSRH firmly believes that men and boys are vital in contributing to secure women’s reproductive health and rights. We support boys’ and men’s right to access high-quality [sexual and reproductive healthcare] services and live a life free of sexually transmitted infections such as HPV”.
It’s also worth mentioning that support for the HPV vaccine is unprecedented, with a recent survey finding that 94% of GPs back the programme, while a higher figure – 97% – of dentists say the same.
“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”.
Where Next?
The JCVI say that they remain in their consultative phases, and we should emphasise that their decision is far from set in stone as yet. Any interim statements that have been released have made a point of avoiding an official recommendation, however the latest did state that “while there are some additional population-level benefits”, the scheme was unlikely to be cost-effective.
Eventually however the decision will rest with ministers, who’ll have the last word on whether or not the current programme is extended. We can but hope that the right choice will be made, for the sake of 400,000 boys who’ll otherwise face heightened health risks.
I want to make it clear as a medical professional, I whole-heartedly support the vaccine.