Human papilloma virus vaccination

It has been known for a long time that the human papillomavirus (HPV) which infects the keratinocytes of the skin and mucous membranes is carcinogenic.

There are dozens of strains of HPV. The most important to remember are:

• 6 & 11: causes genital warts
• 16 & 18: linked to a variety of cancers, most notably cervical cancer

HPV infection is linked to:

• over 99.7% of cervical cancers
  • HPV testing is now integral to cervical cancer screening
  • samples are first tested for HPV and only if they are positive is cytology then performed
• anal cancer → about 85% are HPV-related
• oropharyngeal cancers (particularly tonsil and base of tongue) → around 60–70% associated with HPV
• vulval and vaginal cancers → about 50% linked to HPV
• penile cancer → about 40–50% linked to HPV

It should of course be remembered that there are other risk factors important in developing cervical cancer such as smoking, combined oral contraceptive pill use and high parity.

Immunisation

The UK has an HPV immunisation programme that provides protection against both the main oncogenic HPV strains (16 & 18) as well as the strains that commonly cause genital warts (6 & 11). The immunisation programme is aimed primarily at 12-13 years olds, both girls and boys but the vaccine is also offered to gay, bisexual, and other men who have sex with men (GBMSM) to protect against anal, throat and penile cancers.

All 12- and 13-year-olds (girls AND boys) in school Year 8 are offered the human papillomavirus (HPV) vaccine.

• the vaccine is normally given in school
• information given to parents and available on the NHS website make it clear that the child may receive the vaccine against parental wishes
• since September 2023 one dose is now given instead of two. This change followed evidence from large studies that one dose provided equivalent protection

Other groups

• eligible GBMSM under the age of 25 also receive 1-dose, offered through sexual health clinics