This week, the Joint Committee on Vaccination and Immunisation (JCVI) made an incredibly disappointing interim decision to deny boys the Human Papilloma Virus (HPV) vaccination.
Infection by high-risk HPV is the cause of 99% of all cases of cervical cancer - the second most common cancer affecting women worldwide. There are more than 100 different types of the HPV virus, but you can get infected with genital HPV through skin-to-skin contact, which means you can get it through sexual activity. Condoms help protect against HPV infection, but because condoms don't cover all of the genital area you may not be completely protected.
The current HPV vaccination programme means that all girls aged 12-13 are offered the vaccine as part of the NHS's childhood vaccination programme. Although the vaccine is most widely known for protecting against 70% of cervical cancers, it's important to recognise that HPV is also responsible for the fastest increasing cancers among men in the UK today.
Because of the high rate of girls completing the two-course dose of the vaccine (over 85% in 2015-16), the theory is that boys will also be protected through sexual contact. But this does nothing to help men who have sex with men, and men who have sexual contact with unvaccinated women.
This risk is recognised by healthcare professionals. In a survey for HPV Action during this year's World Immunisation Week in April, 97% of dentists and 94% of GPs said that the national HPV vaccination programme should cover both boys and girls. As Dr Andrew Green, a member of the British Medical Association's General Practitioners Committee, said: "If we want to see an end to some of the most aggressive and hard to treat cancers such as throat, head, neck and anal cancer, boys as well as girls must be given the HPV vaccination. It is ridiculous that people are still dying from these cancers when their life could have easily been saved by a simple injection."
Data is already showing that girls and women are benefiting from being vaccinated where boys and men aren't. In 2015 there was an 8% drop in the number of recorded cases of genital warts among young women - 90% of which are caused by HPV types six and eleven. In comparison, the drop was 2% less among men.
Following JCVI advice, there are plans to offer HPV vaccinations to men who have sex with men up to the age of 45 via sexual health and HIV clinics. But this is not enough. Not all men who have sex with men attend clinics, and the men who do are highly likely to already be sexually active. For the vaccine to be most effective, boys should be vaccinated before they first have sex. And since asking 12 and 13-year-old boys about their sexuality would be unethical and simply ineffective, this should be all boys.
The JCVI's announcement denies boys their right to live a life free from HPV-related illness. By placing the burden on girls and women to provide protection for the whole population, it also contributes to the stereotype that women should have sole responsibility for sexual health. As Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Health, says: "The interim decision to deny boys the HPV vaccination is a huge missed opportunity for improving long-term SRH [sexual and reproductive health] outcomes and tackling gender inequality."
HPV-related cancers can have devastating effects. Following the news from the JCVI, Tristan Almada, co-founder of the HPV & Anal Cancer Foundation, spoke out about the devastating impacts of HPV for his mother, Paulette, who passed away from Stage IV HPV-related anal cancer aged 53. He also pointed out that countries including the United States, Canada, and Australia offer gender-neutral vaccination programmes, saying: "UK boys deserve the same...right to have access to this life-saving vaccine."
Thankfully, the announcement this week made it clear that this decision is an interim one, and they will make their final decision in October. In the meantime they've asked the public to let them know their thoughts. So if you want to help organisations like FPA and HPV Action challenge this decision, you can contact the JCVI by emailing jcvi-consultation@phe.gov.uk. Let them know your concerns by using some of the arguments above, or the great resources on HPV Action's website. This consultation is open until the end of August 2017.
If they haven't reversed their recommendation by October, we will continue to work with our partners to call on politicians to ensure a vaccination programme that offers protection to everyone from HPV.
The consequences of not including boys are too serious to ignore.