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HPV vaccination for boys ruled out

By Mark Pownall

An extension to the HPV vaccination programme to cover boys has been effectively ruled out by research finding it would incur huge cost with little benefit.

A new health economics analysis, published online by the BMJ [check], found a sevenfold difference between the cost-effectiveness of vaccinating only girls compared with protecting both girls and boys from HPV infection.

The new analysis, based on a US health economics model, backs the current UK programme, which began in September 2008, of restricting vaccination to girls.

The analysis found the cost per QALY of vaccinating 12-year-old girls who go on to have cervical smears in adulthood was about USD40,310, but for boys was USD290,290 to USD382,860, depending on vaccine efficacy.

A previous analysis by Health Protection Agency economic modellers, published last year, found the UK proposals were cost-effective for girls and came in under the £20,000-£30,000 per QALY threshold (used by both NICE and the JCVI).

But the economists, based at XXXX, said: ‘Vaccination of boys at age 12 years in addition to girls is unlikely to be cost-effective, even if vaccination results in lifelong protection. At 80% coverage it is likely most cervical cancers due to HPV will be prevented so the additional benefit from vaccination of boys is few.'

They said this was particularly true if protection from vaccination was long-lasting, as there would be less HPV infection to avoid.

A Department of Health spokesperson said: ‘We have carefully examined the costs and benefits of this programme and it represents very good value for money. Uptake of the HPV vaccine programme is at world-leading levels – as of August, 78.4% of girls aged 12 – 13 years had received all three doses of vaccine. The high uptake among girls means vaccinating boys would be of very little additional benefit in preventing cervical cancer.'

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