HPV Vaccination: A Real Opportunity to Reduce Cervical and Head & Neck Cancers in Wales
This January, Public Health Wales is launching a new campaign to encourage the uptake of HPV vaccination in Year 8 schoolchildren, for the future prevention of HPV-related cancers.
HPV is a common virus that infects around 8 out of 10 people during their lifetime. The HPV virus, which lives on skin, is usually harmless and can be easily eradicated by the immune system in most people who are infected.
However, for reasons not totally known, the virus can persist in some people. Over time, this can lead to malignant changes that cause cervical, penile, anal, vaginal and vulval cancers, as well as certain types of head and neck cancer.
Over 100 Different Strains of HPV
There are over 100 different strains of HPV, only some of which are ‘high-risk’ and have the potential to cause cancer. The main ones that can lead to cancer are HPV 16 and HPV 18.
The good news is that the current HPV vaccines also protect against 'low-risk' strains HPV 6 and 11. These strains cause genital warts, the most common sexually transmitted disease in the UK, which can be difficult to treat and are often physically and psychologically distressing for sufferers.
Over 95% of all cervical cancers are caused by HPV. Since 2008, all schoolgirls in Wales have been offered the HPV vaccination from the age of 12 - since 2019 this has also been extended to include boys in year 8. The HPV vaccine is highly effective and numerous studies, that have followed the first cohorts to be vaccinated, have shown a reduction in HPV-related cervical cancers and pre-cancerous changes of up to 90%.
All young women up to the age of 25 and young men born on or after 1/9/2006 are eligible for the immunisation against HPV if they have not already received the vaccine.
Dramatic Increase in HPV-Related Head & Neck Cancers in the Last 25 Years
Head & neck cancers caused by HPV, medically known as oropharyngeal cancer, mainly affect the soft palate at the back of the mouth, throat and base of the tongue. The incidence of HPV-related oropharyngeal cancer has grown steadily over recent decades.
An important study, funded by Cancer Research Wales and conducted by clinicians and scientists in Cardiff, was the first to show the impact of HPV on rates of head & neck cancers in the UK. The study found that rates of head & neck cancer caused by HPV had trebled in the last 25 years. These cases mainly affected younger men, between the ages of 30 and 60, with no previous history of common risk factors such as heavy drinking and smoking.
This study was presented to policymakers and the UK Government Joint Committee on Vaccination and Immunisation (JCVI), contributing critical evidence towards the decision to provide the HPV vaccine to boys as well as girls for the prevention of cancer.
Following the Covid-19 pandemic, NHS Wales worked tirelessly to restart vaccination programmes in schools for new pupils, as well as for those that missed out due to the disruption caused by the lockdowns. Further coverage was provided by additional out of school catch-up clinics.
This hard work paid off as the uptake of the first dose was 66%, 61% and 75% for pupils in Years 8, 9, and 10 respectively. Despite these credible efforts there is still room for improvement - uptake of the HPV vaccine lags behind other immunisations for childhood infections, such PCV for prevention of pneumococcal disease, which has around 95% uptake.
For schoolchildren the HPV vaccines were typically administered as a two-dose schedule, with the first dose given in Year 8 or 9 followed by a second dose a year later. Recent evidence indicates that one dose is sufficient to provide up to 93% protection against the HPV strains that cause more than 70% of all cases of cervical and head and neck cancers.
From September 1st 2023, the national HPV vaccination programme in the UK follows the updated recommendation of the JCVI and uses a single vaccine dose for everyone under the age of 25, including those who may have missed the opportunity of receiving the vaccine first time around.
For gay and bisexual men, and men who have sex with men, over the age of 25, a two-dose schedule of the HPV vaccine is still recommended. People who have weakened immune systems (immunosuppressed), or are HIV positive, are recommended to have 3 doses of the HPV vaccine, as currently there is not enough evidence that less than 3 doses gives sufficient protection against HPV in these groups.
Over 50 million HPV Vaccines Administered Worldwide
The HPV vaccine is very safe, with over 50 million people worldwide having received at least one dose and close monitoring having been undertaken for over 15 years. There are minor side effects that are typical for many vaccines, such as sore arm, and some less common side effects like headache, high temperature and nausea, which usually subside within a few days – however, serious side effects are very rare.
Around 500 HPV-related cancers occur in Wales each year. Since the HPV virus can cause penile, anal and vulval cancers as well as cervical and head & neck cancers, getting vaccinated is a simple, safe and effective way of massively reducing the devastating impact these cancers can have.