HPV vaccine to be offered to boys from start of school year in 2019

The Human Papillomavirus (HPV) vaccine is to be offered to teenage boys as well as girls from next year, after the initiative was recommended by the Health Information and Quality Authority (Hiqa).

Funding has been set aside for the vaccine, which Hiqa has declared as safe, Minister for Health Simon Harris indicated. It is understood a vaccination programme will be in place for the beginning of the school year in September.

Hiqa suggested the existing vaccine for 12-13-year-old girls, which protects against four types of HPV, should be replaced by a vaccine giving wider protection against nine types of the virus for both boys and girls.

Infection with HPV is implicated in a number of cancers, including cervical, vaginal, anal and penile cancer, as well as anogenital warts.

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“The efficacy of vaccination is well documented,” Mr Harris said. “The virtual eradication of smallpox and elimination of polio; increased protection for women and girls against cervical cancer; protection of the vulnerable against influenza - all are due to vaccination.”

Speaking from Brussels, where he is attending an EU council meeting on health, the Minister added that there “have been attempts to spread fear and scaremonger” about the HPV vaccine.

“This came to light here in when there was an attempt to link the HPV vaccine with serious side effects. This continues to be a problem for member states.”

Burden

Hiqa said “the burden of HPV-related disease is substantial, with HPV responsible for approximately one in every 20 cases of cancer across the world”.

The current HPV vaccination programme for girls dates from 2010. Uptake was initially above 80 per cent but dropped in the face of a sustained campaign by some parents who claimed, without scientific evidence, that the vaccine was responsible for chronic illness in hundreds of girls.

Uptake has since recovered to over 60 per cent and is expected to improve further over the coming years.

The Hiqa review says the vaccine has been demonstrated across numerous studies to be safe and effective in preventing HPV infection in both girls and boys. It says the cost over five years of rolling out the “gender-neutral nine-talent” vaccine was estimated at €11.66 million.

Hiqa said gender-neutral vaccination would provide protection to vulnerable groups not covered by the current girls-only programme, such as men who have sex with men.

The decision was welcomed by health groups including the Children’s Rights Alliance, the Royal College of Physicians of Ireland and the Irish Cancer Society, which said the number of diagnosed HPV related cases was set to rise in the future.

“It is a source of hope to know that eliminating HPV-caused cancers is now within our grasp,” the society’s chief executive Averil Power said.

Why did Hiqa decided to extend the vaccine?

Hiqa said it had, following a health technology assessment, decided to extend the HPV vaccination programme to include boys because 25 per cent of HPV cancers occur in men.

Dr Máirín Ryan, Hiqa deputy chief executive, said there are about 540 cases of HPV related cancers each year in the State.

“While 75 per cent occur in women, 25 per cent occur in men, that’s over 100 cases of HPV related cancer in men each year,” she said.

“In addition HPV causes anogential warts, there are between 7,000 and 9,500 cases of anogenital warts in both men and women each year so men do have the potential to benefit substantially from HPV vaccination.

“It can cause cancer of the oropharynx area at the back of the throat - it affects both men and women, it can cause penile and anogenital cancer in men as well.”

She went on to explain that as part of the assessment Hiqa carried out there was a “very substantial assessment of the best available evidence on the safety of HPV vaccine”.

“We looked at data that came from 70,000 trial participants and over 20 million individuals who received the vaccination in observational studies. What we found from assessing that evidence base is that there is no increased incidents of serious adverse events associated with the vaccine by comparison with those who received either a placebo or control,” she said.

“There are no indications of serious side effects associated with HPV vaccine…Cervical cancer is a terrible disease, this is safe and effective and needs to be promoted.”