Curt Falk

Dear Mr Britten, The Joint Committee on Vaccination and Immunisation (JCVI) is an independent Departmental Expert Committee and a statutory body, constituted for the purpose of advising the Secretary of State on the provision of vaccination and immunisation services. JCVI’s advice and recommendations are based on consideration of scientific evidence from different sources including clinical trials epidemiological reports and impact and cost-effectiveness studies. In order to form a recommendation for a new national programme or changes to an existing national programme the Committee must ensure that this represents the best use of NHS resources by demonstrating cost-effectiveness. The aim of the UK’s current HPV vaccination programme is to prevent HPV related cervical cancers. The programme was introduced in 2008 following the advice of the JCVI which carried out a detailed review of evidence surrounding HPV vaccination including the cost effectiveness of routine and catch-up programmes. At that time JCVI did not recommend vaccination of boys because the evidence indicated vaccinating boys was unlikely to be cost-effective, as vaccine efficacy was high, and high coverage in girls would provide herd protection for boys, meaning that a programme which included boys would provide little additional benefit. The coverage of the HPV programme is high. In the last three years, coverage of the routine programme for the full three-dose course has been consistently above 86%. JCVI keeps the eligibility criteria of all vaccination programmes under review. In October 2013 JCVI recommended a HPV sub-committee be formed to consider a number of issues including vaccinating men who have sex with men (MSM) and the potential extension of the programme to include adolescent boys, because of new and emerging evidence on the association of HPV vaccine types with non-cervical cancers. JCVI subsequently requested that modelling be undertaken by Public Health England (PHE) to re-examine the impact and cost-effectiveness of extending the

HPV vaccination programme to adolescent boys. It is anticipated that PHE will submit the work on the cost-effectiveness of extending the HPV vaccination programme to adolescent boys to JCVI by early 2017. Modeling work on vaccinating MSM was already underway as this was considered a priority because this is a group that receives very little indirect benefit from the girls programme. In November 2015 JCVI issued a statement advising that a targeted HPV vaccination programme for MSM aged up to 45 who attend GUM and HIV clinics should be undertaken subject to procurement of the vaccine and delivery of the programme at a cost-effective price. For more information I recommend you access the JCVI webpage which has the latest minutes and statements from JCVI meetings. I have attached the JCVI code of practice which gives details about the Committee and provided links below to the relevant JCVI documents concerning the subject of HPV vaccination.

JCVI web page: https://www.gov.uk/government/groups/joint-committee-on- vaccination-and-immunisation#terms-of-reference JCVI 2008 statement on HPV vaccines to protect against cervical cancer:

od_consum_dh/groups/dh_digitalassets/@dh/@ab/documents/digitalasset/dh_0947
39.pdf Minutes of the JCVI HPV Subcommittee:

JCVI statement on HPV vaccination of men who have sex with men:

men-who-have-sex-with-men

Kind regards

Scientific Secretariat to the Joint Committee on Vaccination and Immunisation Public Health England, Wellington House, 133-155 Waterloo Road London SE1 8UG Email: jcvi@phe.gov.uk

Chair of JCVI HPV Subcommittee