Background Info

Throat Cancer Foundation is a UK based charity which is dedicated to the support of all people affected by throat cancer and works to prevent future cases of throat and oral cancers. Our work includes developing on-line and print resources for patients and carers, establishing best practice in the treatment and care for cancer patients, advocating and funding research into the treatment and prevention of throat cancers and building a network of patients, carers and medics who have a vested interest in improving services and resources for cancer patients. As part of our commitment to reducing cases of throat cancer we are campaigning to introduce gender nuetral vaccination to protect all children from the Human Papillomavirus.We believe that vaccinating females only is an inadequate approach. Gender-neutral vaccination will reduce the impact of the most dangerous strains of Human Papillomavirus, preventing a great many cases of Cervical, Oropharyngeal, Oral, Anal, Penile and Vulvar cancers. By taking action now, we can reduce needless suffering and death, as well as cutting the economic burden of treatment for cancer and genital warts. The current Human Papillomavirus vaccination programme is discriminatory and leaves too many at risk of preventable cancers. We urge immediate action.

The Human Papillomavirus is a highly contagious virus which lives on the skin. There are well over a hundred strains of Human Papillomavirus which are transferred from person to person by skin to skin contact. The virus is extremely contagious and it is estimated that 80% of the population will have an Human Papillomavirus infection at some point in their lifetime. For the majority of people Human Papillomavirus will not cause any serious health issues, their immune system will clear the virus and people might not even know that they have had Human Papillomavirus. For some people though Human Papillomavirus can lead to other more serious diseases including fatal cancers.  It is thought that Human Papillomavirus can cause cervical, anal, penile, vulval, vaginal and throat cancers. Human Papillomavirus is known to cause about 5% of all cancer cases worldwide. Human Papillomavirus also is the cause of genital warts and laryngeal papillomas (a childhood condition which is warts on the vocal cords).

The current UK wide Human Papillomavirus vaccination policy is adminstered by the NHS through the school system. Cancer Research UK has this information about the current policy "in the UK, girls in year 8 at school (aged 12 to 13) are offered the Human Papillomavirus vaccine. Girls have three injections over 6 months. A letter about the vaccine and a consent form is sent to the parents of the girl before she has the vaccine. It is up to her whether she has the vaccine.". The vaccination policy is UK wide and is the same in Scotland. We want this same service being offered to males in the UK with the same method of delivery and consent.

There is a motion in the Scottish Parliament to highlight the broader burden of Human Papillomavirus in Scotland. The name of the motion is S4M-05613 Nanette Milne: Human Papilloma Virus in Scotland;That the Parliament notes with concern the broader burden of the Human papilloma virus (HPV) in Scotland, which, it understands, is thought to be associated with 5% of all cancers; believes that 80% of women will have an HPV infection at some point in their lives; accepts that such infections are common in the genitals and oral cavities of men and women, and are evident in penile, vulval and vaginal, anal, head and neck and cervical cancers; notes with concern that HPV-related diseases are on the increase, specifically head and neck cancers in men; applauds the Australian, United States and German governments on, it understands, recently extending provision of the HPV vaccine to cover boys as well as girls; believes that this is a major step toward addressing equality issues surrounding female-only HPV vaccination programmes, and urges the Joint Committee on Vaccination and Immunisation to consider these examples during the current review of the UKs position.]

While we welcome this awareness raising motion we believe it does not go far enough in calling for the introduction of gender nuetral vaccination in Scotland and the inequity of the current vaccination programme cannot be allowed to continue.

The current policy excludes males because of the assumption that "herd immunity" will protect the male population.  "Herd immunity" means by vaccinating females this will stop the virus being transmitted to boys. (which is an 80% uptake of the vaccine amongst females will protect  the herd from Human Papillomavirus). Herd immunity is a flawed and discriminatory policy which must be addressed as a matter of urgency. By the very nature of herd immunity , if a person is outwith the herd then they will not be protected. This means men who have sex with men (MSM) are excluded and not protected from Human Papillomavirus cancers. This is particularly significant as as MSM have the highest burden of anal cancers, which the BMA advises can be prevented with Human Papillomavirus vaccination. 

It is not only MSM who are not being protected at the moment. We live in an era where there is a highly mobile population. There are mass movements of population around the globe. While Scotland’s “herd” does have good levels of vaccination for our females , the same cannot be said for other countries around the world. Some countries have a vaccine uptake of far less than the 80% required for even herd immunity. By relying on herd immunity we are leaving males vulnerable to Human Papillomavirus.  Finally, herd immunity has been seen to be flawed before: rubella inoculation was female only when introduced and it was only after the introduction of gender neutral vaccination did it become effective and fit for purpose.

The precise costs are hard to obtain because commerical confidentiality prohibits the pharmacutical companies from divulging the costs for the vaccine in the UK. Figures which we obtained from Norway put the cost per vaccination (3 doses) at £45. There are 27,000 12 year old boys in Scotland so costs for the extension on the programme are around £1,215,000 for the vaccinations and the additional administration costs to implement this extension of the programme. 

Australia has started to vaccinate it’s young men and the vaccine is being recommended in the USA and Canada for young men. Scotland should take this opportunity to be at the vanguard of the global Human Papillomavirus epidemic and start protecting all of it’s citizens as a matter of urgency. The more time we spend procastinating , the more lives we are putting in danger.

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