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DH advisers consider HPV vaccination for gay men

GPs could be tasked with administering HPV vaccines to gay men, as Department of Health advisers have decided to evaluate an expansion of the current female-only vaccination strategy.

Minutes published earlier this month reveal the Joint Committee on Immunisation and Vaccination (JCVI) has recommended a review of the current immunisation programme – which vaccinates all girls aged between 12 and 13 years of age – as it does not protect gay men, who may suffer high rates of HPV-related disease.

The JCVI was presented with evidence suggesting that the immunisation programme in England is lowering the number of HPV-16 and -18 infections in girls in the age group who were eligible for vaccination.

The draft minutes of the June meeting said: ‘Given that there may be a higher burden of HPV-related disease in men who have sex with men and that they are likely to get less direct protection from the vaccination of girls, vaccination strategies to protect [these individuals] should be evaluated.'

The committee has asked the Health Protection Agency (HPA) to model the impact and cost-effectiveness of the vaccine being administered by GPs or at genitourinary medicine clinics to gay men.

It was acknowledged that data on the prevalence of HPV infections in gay men was very limited, though research on the issue is under way at University College London.

The JCVI noted it would be important to understand the rates of HPV-related disease and the influence of HPV on HIV infection.

Following a review of submissions provided by the vaccine manufacturers, the HPA was also asked to assess the impact of a two-dose schedule – already the norm in Switzerland and a number of Canadian provinces – and to assess the higher valency HPV vaccines that are currently in development.

Dr Richard Ma, a GP in North London and a member of the RCGP's Sex, Drugs and HIV task group, said it was 'good news' they are extending the programme and that GPs should be at the forefront of offering the vaccine.

He said: 'There's value in GPs offering the vaccine because they have wider access.

'There might be men who wouldn't go to GUM clinics who would benefit from the vaccine and so it's good that they should get it from their GP. Even if the modelling shows GPs to be more expensive, we shouldn't discount the value of the wider access they offer.'