Doubt on HPV jabs for schoolgirls

Mass vaccination of secondary school girls against HPV could result in long-term side-effects, warn US researchers.

The first vaccine against HPV, Gardasil, was granted a licence by the European Medicines Agency in September, permitting its use in females aged 9–25 years.

But the Joint Committee on Vaccination and Immunisation’s HPV subgroup has yet to make a decision on whether the cervical jabs will be available on the NHS.

In an editorial in the journal JAMA, the researchers said that the HPV vaccine was supported by ‘limited efficacy and safety data’.

‘Clinical trials have thus far involved a relatively small population, less than 12,000 participants, for a limited period of follow-up: five years,’ they said.

Although the vaccine would be administered to girls aged 11–12, it has yet to be evaluated for efficacy among this age group.

It would therefore be unwise to require a young girl with a low lifetime risk of cervical cancer to be vaccinated, the researchers said.

Research is also needed to show how long the HPV vaccination protection would last and to assess whether there would be any side-effects from the jab.

Additionally, the researchers suggested that boys might also need to be vaccinated because ‘studies have shown that men can have at least as high a prevalence of HPV infection as women’.

But west London GP Dr Sarah Jarvis, RCGP spokeswoman on women’s health, said that, although there was not any long-term evidence to show the safety of the HPV vaccination, five-year studies had proved the vaccination to be safe.

‘It would be ideal to do 10-year studies but we only have data from five-year ones. We have seen a fall-off in vaccination after five years,’ she said.

‘We have to take a leap of faith that the vaccination will be safe.’

There is no need to vaccinate boys against HPV, because you need a certain amount of HPV to circulate. There needs to be a low enough level of herd immunity, added Dr Jarvis.

Dr Jarvis added that introducing the vaccination would be very cost-effective for the NHS.

‘The vaccination offers protection against genital warts, which cost the NHS £25 million to treat each year,’ she said. ‘Vaccination would also help to reduce the pressure on colposcopy services.’

It is likely that the JCVI’s HPV subgroup will introduce the vaccination in the school year beginning September 2008, Dr Jarvis added.

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