New UK vaccine schedule for HPV depends on HIV status
1 August 2023. Related: Guidelines, Coinfections and complications, Cancer and HIV.
Simon Collins, HIV i-Base
On 29 June 2023, UKHSA announced new guidelines on the HPV vaccine schedule.
From 1 September 2023, the HPV vaccine programme will change from a two dose to a one dose HPV vaccine schedule for adolescents and men who have sex with men (MSM) aged less than 25 years.
However, the schedule will continue to use three doses for people living with HIV.
The vaccine is also available for all gay and bisexual men up to the age of 45, ‘regardless of risk, behaviour or [HIV] status’.
This raises the important practical issue of routinely including HIV testing before giving the HPV vaccine, though this is not included in the related papers or recommendations.
The change in policy is based on a recommendation from the Joint Committee on Vaccination and Immunisation (JCVI) nearly a year ago. [3]
comment
The simplified vaccine schedule for many people is welcomed and should improve vaccine coverage.
However, people need to know their HIV status in order to access the appropriate HPV vaccine schedule.
Although the HPV vaccine for gay and bisexual men is only available from specialist sexual health services (SHSs) and HIV clinics, it might be good for the guidelines to include that HIV testing would be good practice, without making this a barrier to the HPV vaccine. Some people attending these clinics will not have had an HIV test and the default assumption might be that they are negative.
Without HIV testing, people who are not yet diagnosed will not receive the three-dose schedule. Based on the latest statistics from England, people aged 16 to 25 still account for nearly a third (230/794) of new HIV diagnoses. [4]
As mentioned earlier in reports from IAS 2023, one of the three official pre-meetings was an international workshop on HPV infection, which included a call for global health targets for all HPV-related cancers, not just cervical cancer. [5]
References
- UKHSA. HPV vaccination programme: changes from September 2023 letter. (29 June 2023).
https://www.gov.uk/government/publications/hpv-vaccination-programme-changes-from-september-2023-letter - UKHSA. Change in schedule for the routine adolescent HPV programme and eligible men who have sex with men (MSM) under age 25 years 29 June 2023).
https://www.gov.uk/government/publications/hpv-vaccination-programme-changes-from-september-2023-letter/hpv-vaccination-programme-changes-from-september-2023-letter - JCVI. JCVI statement on a one-dose schedule for the routine HPV immunisation programme (05 August 2022).
https://www.gov.uk/government/publications/single-dose-of-hpv-vaccine-jcvi-concluding-advice/jcvi-statement-on-a-one-dose-schedule-for-the-routine-hpv-immunisation-programme - UK HSA. UK surveillance statistics (2022). National HIV surveillance data tables. Table 1a.
https://www.gov.uk/government/statistics/hiv-annual-data-tables -
IAS 2023 premeeting. Putting people first in the prevention, treatment and care of HPV-related cancers among people living with HIV. (22 July 2023).
https://www.iasociety.org/conferences/ias2023/programme/pre-meetings/putting-people-first-prevention-treatment-and-care-hpv-related-cancers-people