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A SHORT HISTORY OF HPV VACCINATION
The link between HPV and cervical cancer was initially discovered by a German scientist called Harald zur Hausen – working in his laboratory in Germany he worked initially on the link between HPV and cervical cancer. Professor zur Huasen and his team were able to identify the link between HPV strains 16 and 18 and cervical cancer.
This discovery was both ground breaking and somewhat controversial at the time as up until that point most scientists believed the herpes simplex virus was behind cervical cancer. As a result, by 2006 a vaccine had been developed, thanks to the work of Hauser and his team.
Once the link between HPV and cervical cancer was established, work began on creating a vaccine. For the first time in history, scientists had the chance to prevent cancer rather than cure it. The people who discovered the vaccine worked in research facilities from around the world – a truly international effort.
Initially, scientists based at Georgetown Medical Centre (USA) developed a vaccine which protected against two strains of HPV. The vaccine, which was developed by Richard Schlegel, M.D., Ph.D., along with Shin-je Ghim, Ph.D., and Alfred Bennett Jensen, M.D protects against the two strains of HPV that cause 70% of cervical cancers, and shows promise in protection against three other cancer-causing strains.
The next stage in the development of the vaccine was by scientist Ian Frazer. Scottish born and educated, he has for some years lived and worked in Australia at The University of Queensland. Working with his research partner Dr Jian Zhou, they were able to synthesise the particles that could mimic the virus. This lead directly to the development of Gardasil.
TYPES OF VACCINE
There are currently two vaccines licensed for use in the United Kingdom: Gardasil, which is manufactured by Merck and Cervarix, which is manufactured by GlaxoSmithKline. Gardasil is called a quadrivalent vaccine as it protects against 4 high risk strains of HPV: HPV 6, 11, 16 and 18. Cervarix protects against two strains of HPV: HPV 16 and 18.
HPV 16 and 18 can cause cancer and HPV 6 and 11 can cause genital warts and laryngeal papillomas, which are basically warts in the throat. The cost to the United Kingdom’s NHS of treatment for genital warts and laryngeal papillomas is significant at over £50,000,000 every year.
The Gardasil vaccine is currently used by the UK Government for the HPV vaccination programme. Gardasil is currently administered to all girls in the UK aged 12 or 13 unless their parents or their school opt out of the national vaccination programme. Gardasil is used because it protects against 4 of the “high risk”strains that are thought to cause 75% of cervical cancer cases and 90% of genital warts.
GENDER NEUTRAL VACCINATION
The Throat Cancer Foundation believe that the vaccination programme should be extended to include boys – this is called gender neutral vaccination. We believe that there are several reasons why the current UK vaccination policy is inadequate.
The current policy relies on “herd immunity” – the idea being that if 80% of the female population is vaccinated then the rest of the “herd”, in this case males, will be protected. There are some issues that mean this current policy is not effective and is, in fact, discriminating against sections of society leaving them vulnerable to HPV positive infections which can lead to warts, cancer, or even death.
“Herd immunity” by definition means anyone who is outwith the herd is at risk of HPV infection. Men who have sex with men (MSM) are at particular risk and have the highest burden of anal cancers linked to HPV infection. Men in Scotland, Wales and Northern Ireland who have sex with men can already get free HPV vaccination at sexual health clinics in these countries, and the government has confirmed a roll out of vaccination for men aged 45 or under who have sex with men at sexual heath clinics in England and Wales.
The problem with this approach is that vaccination is, or in England and Wales will be, offered when MSM present at a sexual health clinic and make it clear that they have sex with men. As HPV can lay dormant for many years before causing a cancer it may be too late by the time that MSM have a sexual health check-up.
This is not the only flaw in the current programme; should a man have intimate relations with a woman who is not vaccinated he will still be potentially exposed and infected.
Another flaw is that while the HPV vaccine is available privately from pharmacies, the cost of around £300-£450 means that this is not affordable for many people which in our opinion is also discriminatory.
Australia has already implemented a gender neutral vaccination programme and we believe that the UK should follow suit. Our young men should not be exposed to this terrible, debilitating disease which can end lives. A number of other countries offer HPV vaccination to both boys and girls including America, Austria, Canada and New Zealand.
For a society which prides itself on equal rights, we believe that we cannot allow this obvious inequality last any longer and are actively campaigning to change this policy so everyone is protected.
There is lots of help available though and we have compiled a list of useful resources which will guide you through the support that is available to patients and their families.