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DH announces switch to Gardasil for HPV vaccination programme

The vaccine used for the HPV immunisation programme will be replaced from the beginning of the next school year, after the Department of Health reviewed the evidence for the alternative to Cervarix.

Gardasil will replace Cervarix as the HPV vaccine used routinely in the programme to prevent cervical cancer in girls aged 12 to 13 from next year.

Both Gardasil and Cervarix protect against the two types of HPV virus that cause more than 70% of cervical cancer in England, but only Gardasil protects against two types of HPV virus that cause 90% of genital warts.

In 2008, NHS recommended the use of the Cervarix vaccine when the HPV immunisation programme was rolled out, controversially going against recommendations from the BMA and the Joint Committee on Vaccination and Immunisation that the Government used Gardasil.

Professor David Salisbury, the Government's director of immunisation, said: ‘We have one of the best HPV vaccination programmes in the world and we want that success to continue. It will be tremendous to see rates of cervical cancer falling. The number of women getting abnormal results from HPV screening will also fall. Many women will no longer have to live through the worry and stress of follow-up after screening, including treatment for precancerous lesions.'

He added: ‘It's not unusual for the NHS to change vaccines or other medicines – it can happen following competitive tendering exercises or when new research findings come to light.'

In 2010, research showed that Gardasil prevents 95.7% of HPV-type-related infections, cervical pre-cancers, genital lesions and genital warts, according to results from a four-year follow-up study of 4,000 women. Another study in September this year found that Cervarix would have to be £19 to £35 cheaper per dose to be as cost-effective as Gardasil, mainly due to a lack of protection against genital warts.

Sexual health specialists argue that it costs £23m to treat the 100,000 cases of genital warts that occur in the UK every year, and that preventing them at the same time would be cost effective.

An Australian study in 2008 showed that, after the country started vaccinating with Gardasil in 2007, the number of cases of genital warts in young women attending a large sexual health centre fell by 25%.

Since 2008 the HPV vaccine has been offered routinely in the UK to girls aged 12 to 13, with catch up programmes available for girls up to 18. Since then, 1.5 million young women and girls have been protected.

Dr Colm O'Mahony, consultant in genitourinary medicine at Countess of Chester Hospital and a member of the British Association for Sexual Health and HIV, said: ‘I wrote for years to Alan Johnson and Dawn Primarolo pleading with them to choose Gardasil instead of Cervarix, but to no avail. Finally common sense has prevailed and we now will have the same benefit given to our young men and women that almost all other developing countries have already achieved'.

GlaxoSmithKline, the producer of Cervarix, told Pulse they chose not to compete in the tendering process for the HPV vaccination programme. A spokesman for GSK said the company ‘will not participate in tenders where the specifications mean that it cannot effectively compete without undermining the value of our vaccines'

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