Promising Outlook For National UK HPV Vaccination

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Main Category: Sexual Health / STDs
Also Included In: Infectious Diseases / Bacteria / Viruses;  Public Health;  Women's Health / Gynecology
Article Date: 25 Apr 2008 - 20:00 PDT

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This autumn, reports a recent article published on bmj.com, a £100m national UK vaccination program for the human papillomavirus (HPV) is expected to vaccinate 70% of girls. Two types of HPV - both transmitted through sex and linked to cervical cancer - are prevented by the vaccine. Vaccinations will begin in September 2008 for all schoolgirls in the UK who are in Year 8, between 12 and 13 years old.

Researchers from the University of Manchester conducted a pilot study designed to investigate whether the immunization program will be a success based on the how parents will accept the vaccine. They also sought to analyze the feasibility of such a program to vaccinate adolescent girls. In February 2007, two Primary Care Trusts (PCTs) participated in the study and were charged with making sure girls in all secondary schools in their areas received the vaccine.

There were 2,817 schoolgirls of the target age in 36 secondary schools that were offered the HPV vaccine. Information was adequately disseminated to parents, and they had to consent to the vaccination. Parents were also asked to provide reasons if they refused the vaccination for their daughter.

Although three doses are required at 0, 1, and 6 months in order for the vaccine to be fully effective, the researchers were able to report the number and percentage of girls who received the first dose (1,989 or 70.6%) and the second dose (1,930 or 68.5%). Delivery of the vaccinations proved challenging for many reasons. Schools were very busy at the beginning of the academic year when the first doses needed to be administered, and 16.3% of girls missed the appointment time for the first dose and 23.6% missed the second dose.

Of parents who refused to allow the vaccination, 36% claimed that they did not have sufficient information about the long term safety of the vaccine, 10% were concerned about the age of the girls, and 3% were concerned that the vaccination would influence adolescent sexual behavior.

"These are encouraging results for the forthcoming national HPV vaccine programme but the final criterion for success will be the proportion of girls who receive all three vaccine doses," conclude the researchers.

An accompanying editorial, written by Jo Waller and Jane Wardle (Cancer Research UK), suggest that, "In the wake of the controversy about the measles, mumps, and rubella (MMR) vaccine, work needs to be done to restore public confidence in immunisation." Since 20% of parents in the study refused the vaccine without reason, "More work is therefore needed to understand the motives for refusal and the practical barriers to providing consent."

Uptake of first two doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: prospective cohort study
Loretta Brabin, Stephen A Roberts, Rebecca Stretch, David Baxter, Gloria Chambers, Henry Kitchener, Rosemary McCann
BMJ. (April 2008)
doi:10.1136/bmj.39541.534109.BE
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Written by: Peter M Crosta

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