Extending HPV vaccination to men who have sex with men

In November 2014 the JCVI (Joint Committee on Vaccination and Immunisation) recommended that HPV vaccination should be offered to all 16-40 year old men who have sex with men, as long as the vaccination programme can operate at a cost-effective price.

In 2009 the HPV vaccine was introduced into the UK schedule for all girls aged 12-13. There was also a catch-up programme for 13-18 year old girls. The main aim of this programme was to prevent cervical cancer. Over 99% of cervical cancers are caused by HPV (human papillomavirus) infection, and the disease kills about 1000 women in the UK every year. Two high-risk types, HPV 16 and HPV 18, are responsible for over 70% of all cervical cancers in Europe.

Currently the JCVI is also considering whether it would be cost-effective to vaccinate boys as well, but modelling data are not yet available. The girls’ HPV vaccine programme is extremely effective and induces herd immunity, which provides substantial protection to boys as long as there is high vaccine coverage in girls. Since 2009 the HPV vaccination programme in the UK has proved highly successful, with over 86% of teenage girls fully vaccinated in the last three academic years.

However, there were concerns that men who have sex with men would remain at higher risk and would not benefit from herd protection from the teenage girls’ programme. Since 2008 more evidence has emerged to show that the HPV vaccine is likely to offer protection against other types of cancer that affect men as well as women (including cancers of the anus, neck and head). HPV infection also causes a large proportion of cases of genital warts. Some studies carried out with groups of men who have sex with men showed that there was a high level of willingness to be vaccinated against HPV. In a small pilot study in clinics in North London, 80% of those offered the vaccine took it up.

As a result the JCVI has recommended a targeted programme of HPV vaccination for 16-40 year old men who have sex with men. As long as the programme can be delivered at a cost-effective price, it will be offered through GUM (genito-urinary medicine) and HIV clinics in the UK, using the same vaccine that is used for teenage girls. This vaccine protects against four types of HPV infection: types 16 and 18 that cause a range of cancers, and types 6 and 11 which cause about 90% of cases of genital warts.

If HPV vaccination goes ahead with men who have sex with men, the programme will be closely monitored to see how successful it is.

Read the full JCVI statement

More information about HPV infection and the HPV vaccine