HPV Vaccine

Debate between Pamela Nash and Anna Soubry

Tuesday 2nd July 2013 Commons Chamber

[Anna Soubry]

I am going to struggle, because that is another good point. I always try to be honest when I come to the Dispatch Box and when hon. Members make good points—points that were made not only by my hon. Friend, but by the hon. Member for Airdrie and Shotts (Pamela Nash).

The point raised by the right hon. Member for Wolverhampton South East (Mr McFadden) is related to the actual vaccine, and I am more than happy to discuss that case, or any other adverse reactions of young women to the vaccine, with him. I am very sorry for his constituent, and I am more than happy to have that discussion with him and help in any way I can. He raises an important point.

As we have heard, in June 2012 the JCVI was presented with data on HPV infections and it noted that there is early evidence to suggest that the HPV immunisation programme in England is lowering the number of HPV 16 and 18 infections—the strains of HPV that are linked to these unpleasant cancers—in females in birth cohorts that have been eligible for vaccination.

I accept that the data are very limited on the prevalence of HPV infections among men who have sex with men, but we hope that research under way at University College London will provide more data and an age profile of HPV prevalence. HPVs, particularly types 16 and 18, are associated with the majority of anal cancers as well as cervical cancers, and to a lesser degree with penile, vaginal, vulval and head and neck cancers, but HPV types 16 and 18 predominate in cancers at those sites that are HPV-related. Data on the impact of HPV vaccination on infection at some of these non-cervical sites are limited.

The JCVI noted that the potential impact of HPV vaccination on non-cervical cancers would make the current HPV immunisation programme even more cost-effective, but it would remain the case that, given the expected effects of immunisation on HPV transmission and the indirect protection of boys that accrues from high coverage of HPV vaccination in girls, vaccination of boys in addition to girls was unlikely to be cost-effective. That argument, which we know is advanced, is combated by all that has been said by my hon. Friends the Members for Sherwood (Mr Spencer) and for Finchley and Golders Green, who urge us to consider the cost of treating someone who has one of these cancers.

Evidence for indirect protection would continue to be evaluated by the ongoing HPV surveillance programme at the former Health Protection Agency, now part of Public Health England, but the JCVI agreed that there may be little indirect protection of men who have sex with men from the current immunisation programme. Therefore, the impact and cost-effectiveness of vaccination strategies for men who have sex with men, with the offer of vaccination through general practice and/or at genito-urinary medicine clinics, needed to be assessed. In addition, data on the prevalence by age of HPV infections in men who have sex with men and in the settings where vaccination could be offered to them were needed to determine the potential effectiveness and cost-effectiveness of HPV vaccination of men who have sex with men. It would also be important to understand better the rates of HPV-related disease in men who have sex with men and the influence of HPV on HIV infection.

As we have heard, in August 2012, the JCVI issued a call for evidence from interested parties, including for information to inform a study on the impact and cost-effectiveness of HPV vaccination of men who have sex with men. Any new proposals for the vaccination of additional groups will require supporting evidence to show that this would be a cost-effective use of resources. The JCVI also asked the HPA, now part of PHE, to undertake that study. The study is under way and, once completed, will be considered by the JCVI, at the earliest in 2014. The Department will consider carefully the advice from JCVI, once the committee has completed its assessment.

[Pamela Nash]

May I reiterate the point the hon. Member for Strangford (Jim Shannon) made about the need to have conversations with ministerial colleagues in Scotland, Wales and Northern Ireland? As the hon. Member for Finchley and Golders Green (Mike Freer) argued powerfully, this is about homosexual men and men who have sex with men, but also about men who have sex with women who have not been vaccinated. It is important to have those conversations with the other nations.

[Anna Soubry]

I am grateful for that intervention. I was about to conclude by saying that it is only fair and right to acknowledge the powerful arguments that have been advanced by a number of hon. Members this evening. They have certainly caused me to take the view that I will not hesitate to contact the JCVI, as a matter of urgency, to raise all these important points with them. The committee is an independent expert body, and when it gives its advice to the Government, the Government are—quite rightly—bound to accept that advice.