PCTs are urging GPs to cut costs by denying HPV jabs to women outside the vaccination programme, GP can reveal.
Of 25 PCTs who responded to a Freedom of Information request, 12 had sent letters to GPs warning them to stick to the programme's limits.
But GPs report that large numbers of women are coming forward for whom the jab is clinically appropriate, and believe it would be unethical to refuse them the vaccine.
Thousands of women who are over 18 but not sexually active, or who are sexually active but have not come into contact with the HPV strains associated with cervical cancer, could benefit.
But the DoH decided the vaccination programme was only cost-effective in women up to 18. GPs can use their clinical judgment to offer the vaccine outside this, but PCTs foot the bill. Jabs under the vaccination programme are paid for centrally.
A complete course of the Cervarix vaccine currently costs a PCT £242 per patient.
Sheffield PCT has urged GPs to keep HPV prescribing outside the programme to an 'absolute minimum' and to resist requests for Gardasil.
In a letter to GPs, Hampshire PCT said that vaccination outside the programme could divert resources from 'more effective NHS activities'.
Worcestershire PCT said it 'strongly discourages HPV vaccine prescribing outside the national programme'. The PCT is monitoring HPV prescribing.
But Cornwall GP Dr Sarah Gray, a GPSI in women's health, said: 'It is unethical to deny patients the vaccine or make them wait until they are included in the programme. This is purely cost driven.'
Dr George Kassianos, RCGP immunisation spokesman and Berkshire GP, said: 'Preventing any case of cancer is cost-effective. Older women should be vaccinated. It is licensed for use up to the age of 25, but has been shown to work up to age 45.'
Dr Sarah Jarvis, RCGP spokeswoman for women's health, added: 'I have had patients who fall outside the programme who have not yet been sexually active and so I have prescribed the jab.'
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