HPV Vaccine

Debate between Mark Spencer and Mike Freer

Tuesday 2nd July 2013 Commons Chamber

[Mike Freer (Finchley and Golders Green) (Con)]

I am grateful to Mr. Speaker for granting me this debate on vaccinations against the human papillomavirus, otherwise known as HPV. My main aim is to raise the issue of the inherent inequality of the vaccination programme, which excludes men.

Discussing this issue involves raising topics that people often do not want to talk about, but such discussion is easier than having to deal with the illnesses and diseases that arise from not vaccinating. Embarrassment is preferable to the many cancers that are associated with HPV.

Let me begin by saying that it is important to acknowledge the success of the programme. Since its launch in 2008-09, it has successfully screened and vaccinated more than 80% of applicable girls. Last year the original HPV vaccine was replaced with the quadrivalent HPV vaccine, which provides protection against the two strains of HPV that cause at least nine in 10 cases of genital warts. Of course this added protection is above the primary purpose of the vaccination programme—to bring down rates of cervical and vaginal cancer in women. Men are, however, up to six times more likely than women to have oral HPV infection, thereby increasing the risk of cancers of the throat, neck and head.

[Mr Mark Spencer (Sherwood) (Con)]

I am pleased to hear my hon. Friend mention throat cancers in men. Will he address how much the treatment of such diseases would cost compared with the cost of the vaccine?

[Mike Freer]

Yes, I will raise the cost-effectiveness of the vaccine as compared with the treatment costs of many cancers, including oral or pharyngeal cancer, which is throat cancer.

In 2009, just after the HPV vaccination programme started, there were over 6,500 cases of these cancers, with 47% of penile cancers and 16% of head and neck cancers thought to be HPV-related. Today, however, overall rates of HPV-related cancer and warts should—should, I stress—subsequently come down in heterosexual men, because of so-called herd immunity.

Herd immunity is where men have sex with vaccinated women and thereby get protection against warts, as well as other cancers including penile, anal, oral and pharyngeal cancers. However, they get such protection only if they have sexual contact with UK-born women who have been vaccinated, or with Australian women or those of the very few countries that have had a mass vaccination programme.

--- Later in debate ---

[Mike Freer]

I am grateful to the right hon. Gentleman for intervening on me to ask the Minister a question and I am sure that she will answer it in due course. He makes a valuable point, however. I, too, have a constituent who had an adverse reaction to the vaccine and who is believed to have myalgic encephalomyelitis as a result. Statistically, such reactions might only be small in number compared with the benefits of the widespread vaccination programme, but he makes a good point in that it is important that the Department of Health tracks them to see whether a pattern emerges over time.

[Mr Spencer]

My hon. Friend is being very generous with his time. Is screening available on the NHS to prove whether someone is a carrier of HPV? If I presented myself to my local GP and asked to be screened, would such screening be readily available?

[Mike Freer]

To be honest, I am not sure that I can answer the question. I suspect, however, that if my hon. Friend presented at a sexual health clinic, the staff might be able to advise on what screening or tests were available to identify whether he is a carrier of HPV. It is quite common in men, so in all probability he is. He might want to visit a sexual health clinic tomorrow—if I have not frightened him too much.

I understand that the JCVI inquiry is limited to considering cervical cancer, which restricts the review to women and girls. I press my hon. Friend the Minister to confirm that the JCVI’s scope will be extended to include all HPV cancers so that we can look at how best to vaccinate boys, girls, women and men. The Department of Health must redefine the formal aim of the programme, because if it does not it will be compounding inequality and cost-ineffectiveness.

Males must be protected against the four strains of HPV. The herd immunity that will potentially result from the current programme is often used as a defence for not vaccinating boys, but that implicit intention of excluding men who have sex with men or men who have sex with women who are not vaccinated is simply not sustainable.

The inequality of health protection is obvious and so are the cost savings that I have identified. I know that the Minister will be as concerned as I am that that cost-ineffectiveness and inequality cannot be allowed to continue, and I look forward to hearing her confirmation that the scope of the review will be widened.