Source · Select Committees · Women and Equalities Committee
Recommendation 14
14
Accepted in Part
Paragraph: 62
Increase HPV vaccine uptake, targeting missed children and enabling sexual health services.
Recommendation
The HPV vaccine is a remarkable step forwards in preventing HPV infection and the serious consequences that can result from it. It is a tragedy that not all children are receiving this vaccine. The Government must step up its efforts to increase take up of the HPV vaccine, including as a first step, by targeting the cohort of children who may have missed out on vaccination during the Covid-19 pandemic. Given the significant proportion of children who have not received the vaccine and the potential benefits the vaccine can have in treating HPV, we recommend that sexual health services be able to deliver the vaccine to all those who would benefit from receiving it.
Government Response Summary
The government partially accepts the recommendation. It commits to strengthening efforts to improve HPV vaccine uptake, including targeted outreach, digital enhancements, and local commissioning to meet WHO recommended levels. However, it only accepts that sexual health services should be able to deliver the vaccine to unvaccinated, eligible individuals who attend for other services, rather than all who would benefit.
Paragraph Reference:
62
Government Response
Accepted in Part
HM Government
Accepted in Part
Partially Accept The Government partially accepts this recommendation, in so far as it relates to unvaccinated, eligible individuals who attend SHSs for other services. Our ground–breaking Human Papillomavirus (HPV) vaccination programme is ensuring all young people across the country are better protected from a range of cancers including cervical cancer, regardless of where they live. To achieve our ambition to eliminate cervical cancer by 2040, the NHS needs to ensure as many people as possible are being vaccinated against HPV, which causes up to 99% of cervical cancers. To achieve this, the NHS is supporting health and care professionals to identify those who most need the vaccine, through targeted outreach and offering vaccinations in more convenient settings. The priority for the HPV programme is to vaccinate adolescents before sexual debut. There is good evidence to support the effectiveness of this approach. By 2020, the prevalence of infection with HPV16/18 (the main cancer-causing types) in 16–18 year old females who were offered vaccination at the age 12–13 had reduced to less than 1%, from around 17% before the vaccination programme was introduced. In 2023, the rate of genital warts diagnoses among 15–17–year–old girls was 50% lower compared to 2019 and a decline of 68% was seen in heterosexual boys of the same age over the same period. There have been important changes to the HPV vaccination programme in recent years to maximise opportunities for children and young people to benefit from the vaccine. The extension of the programme to adolescent boys in 2019 has added more resilience to the programme against any short–term fluctuations in vaccine uptake, as occurred during Covid–19 pandemic. A range of activities have been undertaken since the pandemic to recover school aged vaccination services. School aged vaccination teams are working in line with their service specification to offer various catch–up initiatives to target unvaccinated individuals. Following the latest advice from the Joint Committee on Vaccination and Immunisation (JCVI), the NHS recently updated its HPV vaccination programme to single dose instead of two doses for under 25s, except those who are immunosuppressed. Currently, one dose of the vaccine is offered to all those in year 8 (aged 12 or 13 years) via the school aged immunisation service (the universal programme) with catch up opportunities until school leaving age in schools and in community clinic settings. Anyone eligible who has not received their one dose HPV vaccine can catch up until their 25th birthday via their GP practice. SHSs also offer an HPV vaccination programme for at–risk groups including gay, bisexual and other men who have sex with men. In addition, although not a formally commissioned service, clinicians in specialist SHS clinics may use their clinical discretion to vaccinate eligible, unvaccinated individuals using national vaccine stock. This was confirmed in a letter to sexual health clinicians on 5th December 2024 and is in addition to existing routes through which the HPV vaccine is offered. This can help mitigate inequalities in vaccine uptake. Further, NHSE has developed an HPV improvement plan to support regions and their commissioned providers to improve vaccine uptake. The plan will focus on ensuring equitable access, raising professional and public awareness, and enhanced digital capabilities via the implementation of an NHSE–owned digital tool to ensure an equitable offer of HPV vaccination as a school aged vaccination programme, a consistent approach across regions to improve the consent-gaining process, ease of contemporaneous recording, timely data capture and reporting. NHSE’s commitment and ambition to eliminating cervical cancer by 2040 strengthens collective efforts to improve HPV vaccine uptake to reach WHO recommended levels. The expectation is for all regions to achieve 90% HPV vaccine coverage for both males and females and this is supported by the quality standards and requirements of the school age service specification. The NHSE vaccine strategy also sets out initiatives and considerations to improve the way vaccination services are delivered. Digital enhancements are key to support the way people can book appointments, access vaccination services and view their immunisation history via the NHS App. There will also be further developments made by local systems to manage the delivery of vaccination programmes including HPV, focusing on commissioning services to meet the needs of the local population, addressing inequalities and improving access to services. The HPV vaccination programme has so far led to a substantially reduced incidence in cervical cancers for those vaccinated when compared to previous generations.