Department of Health and Social Care
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HPV vaccine recommended for NHS immunisation programme
Government immunisation programme to include routine HPV vaccination of girls aged 12 - 13 years
Health Secretary Alan Johnson today announced the introduction of a human papilloma virus (HPV) immunisation programme to routinely vaccinate girls aged 12 - 13 years of age against cervical cancer, starting from September 2008.
The Health Secretary also confirmed that there would be a two-year catch up campaign starting in Autumn 2009, for girls up to 18 years. The routine programme could cost up to £100m a year and the catch up programme could cost up to £200m in 2009/10 and 20010/11, but the Department of Health aims to negotiate a reduction in vaccine price during the procurement process.
The announcement signalled the Health Secretary's determination to make the NHS a service which prevents ill health and prioritises keeping people well. This means a shift in focus from a sickness service to a wellbeing service - taking action today which may not have immediate effects but will prevent more serious illness and much bigger costs in years to come. This fresh focus for the NHS will be outlined in more detail by the Prime Minister and the Health Secretary over the coming months.
Alan Johnson said:
"As a society we need to do more to prevent disease and not just treat it. Now more than ever before we need to make the NHS a service that prevents ill health and prioritises keeping people well. This means a shift in focus from a sickness service to a wellbeing service.
"Prevention is always better than cure and this vaccine will prevent many women from catching the human papilloma virus in the first place, potentially saving around 400 hundred lives a year."
The highly successful and comprehensive cervical screening programme (smear tests) will continue after the HPV vaccine has been introduced. This is because the vaccine does not protect against all HPV types that may cause cervical cancer.
This decision follows the advice of the Joint Committee on Vaccination and Immunisation (JCVI) which, based on a detailed review of evidence surrounding HPV vaccination,
- Recommended the routine vaccination of girls aged around 12 - 13 years;
- Recommended a catch-up programme of girls under the age of 18 years, and
- acknowledged that the evidence that a catch-up programme for all women aged 18 - 25 years was unlikely to be cost effective but could benefit some individual women. The Department of Health will consider this further.
Primary Care Trusts will plan how to deliver the vaccination programme locally. JCVI have advised that HPV vaccination would be most efficiently delivered through schools.
Director of Immunisation at the Department of Health, Professor David Salisbury said:
"The benefits of introducing this vaccine into the national immunisation programme will be felt by women and their families for generations to come. The vaccine protects against the viruses that cause about 70% of cervical cancers.
"We will work closely with PCTs to ensure the success of this ambitious programme that combines routine and catch-up immunisation and we will consult with all groups who may play a part".
Harpal Kumar, Cancer Research UK's Chief Executive, said:
"This is an exciting step towards preventing cervical cancer in the UK. While the vaccine has the potential to prevent many cases of the disease, the impact of a vaccination programme won't be felt for many years. Cervical screening remains vital in preventing the disease. We urge all women take up the invitation when they receive it.
"The cervical screening programme is very effective. For women between 25 and 49, three yearly screening prevents 84 cervical cancers out of every 100 that would develop without screening.
"Cancer Research UK's Screening Matters campaign encourages people to go for screening when invited, and to encourage friends and family to do the same."
Notes for Editors:
1. The JCVI provides the Department of Health with independent expert advice on all vaccine issues.
2. The JVCI Committee did not make a recommendation about which of the two licensed HPV vaccines should be offered.
3. Human papilloma virus is a sexually transmitted virus that causes 99 per cent of invasive cervical cancer.
4. To ensure maximum benefit and protection from this vaccine, it would be necessary to administer it before the onset of sexual activity.
5. Human Papilloma Viruses cause 99 per cent of invasive cervical cancer. The vaccine protects against the viruses responsible for about 70 per cent of cases.
6. In England there are about 2200 cases of cervical cancer a year, with about 800 deaths.
7. For media enquiries only please call DH Media Centre on telephone: 020 7210 5221.
Notes for Editors:
1. The JCVI provides the Department of Health with independent expert advice on all vaccine issues.
2. The JVCI Committee did not make a recommendation about which of the two licensed HPV vaccines should be offered.
3. Human papilloma virus is a sexually transmitted virus that causes 99 per cent of invasive cervical cancer.
4. To ensure maximum benefit and protection from this vaccine, it would be necessary to administer it before the onset of sexual activity.
5. Human Papilloma Viruses cause 99 per cent of invasive cervical cancer. The vaccine protects against the viruses responsible for about 70 per cent of cases.
6. In England there are about 2200 cases of cervical cancer a year, with about 800 deaths.
Q&A on HPV vaccines:
What is planned?
HPV vaccine will be introduced for girls aged 12-13 years (school year 8) from autumn 2008, and thereafter. A catch-up programme will start in autumn 2009 and will run for two years:
- girls aged 16 to 18 years (school years 12 and 13) will be offered the vaccine from autumn 2009,
- girls aged 15-17 years (school years 11 and 12) will be offered the vaccine from autumn 2010
By the end of this catch-up campaign all girls under 18 years of age will have been offered the HPV vaccine.
What is HPV?
HPV stands for Human Papillomavirus Virus. Some strains of the virus cause cervical cancer and vaccination will offer protection against the two strains that cause 70% of all cervical cancer.
How is HPV infection spread?
By sexual contact, mostly through sexual intercourse, but also through other types of sexual activity.
Is HPV common?
Yes. At some time in their lives, most people will be infected with HPV. In the UK, HPV DNA (indicating current infection) has been found in 40% of 20-24 year old women.
How many women get cervical cancer each year and how many lives will this vaccine save?
2,221 new cases of invasive cervical cancer were diagnosed in England in 2004. This vaccine will save the lives of around 400 women each year.
Why not start vaccination sooner?
Extensive and detailed planning with NHS and other stakeholders is required before the national programme can be introduced. Also ensuring adequate supplies of vaccine will take until next year.
How will the vaccination programme be delivered?
The details of how Primary Care Trusts will deliver the vaccination programme have not been finalised. JCVI have recommended that HPV vaccination would be most efficiently delivered through schools.
Will other women be offered the vaccine?
JCVI have stated that vaccination of all women above the recommended age groups would not be cost-effective in preventing cervical cancer. This is because as soon as a woman has become sexually activity, she is at risk of infection with the virus. However women not covered by the vaccination programme will still be invited to be screened routinely as part of the national cervical screening programme.
What about women older than the recommended groups?
JCVI advice is that it would not be cost effective to run a national vaccination programme for all women over the age of 18. This is because as soon as a woman has started her sexual life she is at risk of catching the virus.. However women not covered by the vaccination programme will still be invited to be screened routinely as part of the national cervical screening programme.
Is it possible to test young women for HPV infection?
Tests for HPV infection exist but these are primarily used for research purposes and are not normally available on the NHS.
Are we vaccinating boys?
No. Protecting boys was discussed by JCVI, who did not consider it to be cost-effective in preventing cervical cancer.
Have the views of girls and their parents been taken in to account? Yes. Research has been carried out and has shown, amongst other findings, that the majority would prefer this vaccine to be offered in secondary school.
Which vaccine will be used?
No decision has yet been made on which of the two licensed vaccines, Gardasil and Cervarix, will be usd.
How many doses of vaccine are needed?
Three doses of the HPV vaccine over a six month period are needed for protection.
Is the vaccine safe?
As with other vaccines, side effects such as a sore arm and a mild temperature, do occur. The vaccines have undergone rigorous safety testing as part of the licensing process. HPV vaccine is given in other countries, including the USA and Australia.
Will the cervical screening programme now be stopped?
No, the national cervical screening programme will continue. Vaccination will not protect against all forms of cervical cancer and women who have not had the vaccine will be unprotected.
The cervical screening programme remains important in reducing the risk of cervical cancer.
