HPV Vaccinations for MSM

Paul Beresford Excerpts

Tuesday 7th June 2016 Westminster Hall

[Sir Paul Beresford (Mole Valley) (Con)]

I am delighted to see you in the Chair, Mr Hollobone.

I congratulate my hon. Friend the Member for Finchley and Golders Green (Mike Freer) on securing the debate and on leaving enough time for a few of us to add a few words in a few minutes.

I need to declare a short list of potential interests. I am a small—by which I mean I have a small practice, not that I am small in stature, because I am afraid my overweight problem makes that rather redundant—and very part-time dentist. I am also chair of the all-party parliamentary groups for dentistry and oral health, and on skin, both of which have a link to and provide an interest in the debate.

My hon. Friend has explained all the disasters related to this ghastly virus, and what it does. I am more interested in head and neck cancers, for obvious reasons, which he touched on. The statistics on head and neck cancer related to HPV make for hideous reading. Up to 70% of oropharyngeal cancers are caused by HPV. In addition, recent research has found HPV in nearly 20% of large periapical dental abscesses—not as the cause, but probably as a co-contributor to the infection.

Treatment of head and neck cancers are often debilitating, disfiguring and destructive of the patients and their self-esteem. Unless the cancer is caught very early, most frequently radiology and/or surgery is required, involving the face, the jaw and teeth, the neck, the tongue, the pharynx, the larynx, the oesophagus, or combinations of them. Only think of that and we can think how debilitating it is for the patient. Physical disfigurement is common, and speech and eating can be significantly impaired. In the global ranking of cancer deaths, head and neck cancers rank fifth. Furthermore, the prevalence of head and neck cancer is higher in males than in females—a ratio of approximately 2:1.

The cost to the NHS of treatment is astronomical. The latest figure I am aware of is from 2011, when it was costing us £310 million. Since the growth in the frequency of head and neck cancer is one of the fastest of all cancers in the UK, the cost must be considerably higher now—I am sure the Minister will correct me and give the ghastly figure, if the opportunity arises.

Vaccination programmes can eliminate, or virtually eliminate, certain diseases. The anti-polio campaign is such an example. The aim in such programmes is to produce what is called herd immunity. The success of the HPV vaccination programme for adolescent girls in the United Kingdom is progressing and becoming evident, but it is not producing herd immunity. Not every teenage girl participates in the programme, let alone completes the programme. Furthermore, given that today’s debate features men who have sex with men, they are obviously outside any herd immunity that might arise from the inoculations.

I also contend that heterosexual men—quite a proportion of us are left in the community—[Hon. Members: “Hear, hear!”]. I thank hon. Members for the support. We are also vulnerable. Not every girl has the inoculation, as I said, and not every girl completes the programme—I believe the estimate is that 10% of girls do not get full vaccination cover. So if, as some research has suggested—I am not sure whose research this was—an estimated 20% of 16 to 24-year-old men have had 10 or more partners, that means, statistically, one of those partners has not been vaccinated, although it could be more or less.

I fully support vaccination for men who have sex with men. However, vaccination programmes for boys and girls would lead to herd immunity and in time pick up that group as well. I understand that that would cost about another £22 million per year more than the cost now for girls. That is small beer when set against the £58 million spent on treating genital warts and is well below the £300 million spent on head and neck cancer treatment—and we must add in the pain and suffering of cancer victims. As I said to the Minister in July 2014,

“it is not fair, ethical or socially responsible to have a public health policy that leaves 50% of the population vulnerable”—[Official Report, 1 July 2014; Vol. 583, c. 866.]

to HPV and the dreadful diseases that so often relate to it.

What is important is not who is having sex with whom but the fact that we need herd immunity for the whole population. If Australia, Austria, Canada, Israel, Switzerland and the USA—and I suspect also New Zealand, but I have not asked—can achieve herd immunity across the board with excellent results, so can we.