HPV Vaccinations for MSM

Mike Freer Excerpts

Tuesday 7th June 2016 Westminster Hall

[Mike Freer (Finchley and Golders Green) (Con)]

I beg to move,

That this House has considered HPV vaccinations for men who have sex with men.

Thank you for chairing this debate, Mr Hollobone; it is always a pleasure to serve under your chairmanship. This debate is a continuation of those that we have had over the past few years. The extension of the human papilloma virus vaccination programme to men who have sex with men—MSM—has been three years to the day in the making.

I first raised this issue in an Adjournment debate on 2 July 2013. I thank the then Minister for Public Health, my right hon. Friend the Member for Broxtowe (Anna Soubry), who, in responding to that debate, said that the issue could no longer be ignored. However, I reserve my heartiest thanks for the Under-Secretary of State for Health, my hon. Friend for Battersea (Jane Ellison), who is in her place today, for her unswerving support to ensure that HPV vaccinations are finally available for MSM. I have no doubt that without her personal support and her forbearance of my cajoling on a regular basis the new programme may not have happened.

Before turning to issues relating to the pilot of the new vaccination programme, it is worth reminding ourselves why such a programme is needed. I make no apology for raising yet again what some might regard as unsavoury issues—sometimes we do not like to talk about sexual health. HPV is responsible for nine out of 10 cases of genital warts, and men are six times more likely than women to have an oral HPV-related infection, which increases the risk of cancers of the mouth, throat, neck and head. Then there is HPV-related penile and anal cancer. HPV is associated with 80% to 85% of all anal cancer in men. In 2009, just after the general HPV vaccination programme started, there were more than 6,500 cases of these cancers. Some 47% of penile cancers and 16% of head and neck cancers are thought to be HPV related. The latest incidence data show that in 2010 there were 437 incidences of anal cancer, 5,637 incidences of oropharyngeal cancer, 515 incidences of penile cancer and 90,000 incidences of genital warts. Rates of some HPV-related cancers are on the increase in the UK and throat cancer has overtaken cervical cancer as the leading HPV-related cancer.

It is worth looking at the costs incurred in treating these cancers, which could now be avoided. Each HPV vaccination for the three-dose programme costs an estimated £260 on the open market—I appreciate that the NHS will, I hope, have negotiated a lower price. That compares with the £13,000 cost of treating anal cancer, the £11,500 cost of treating penile cancer, the £15,000 cost of treating oropharyngeal cancer or the £13,600 cost of treating vulva and vaginal cancer transmitted by an infected male. In 2010, the cost of treating genital warts was £52.4 million. The clinical and financial reasons are self-evident. That is why we started this debate three years ago, and today we have a pilot for making vaccinations available for MSM through sexual health clinics.

I will not detain hon. Members for long; this is really an update request. I have several questions for the Minister. How long will the pilot be for? Who exactly will the pilot vaccination programme be available to? Is it to men identifying as MSM or men identifying as MSM who request the vaccine? What if a man who does not identify as MSM asks for the vaccine? Will it be available to heterosexual males?

How will the pilot be evaluated? For example, will it simply be from the take-up of MSM patients registered, or will it measure the adherence rate, because the programme requires three doses, and for all three to be taken, to be effective? So will the evaluation include adherence to the dosage requirements? Is there a timescale to measure the impact on HPV-related cancers and genital warts? Will the results and any mid-pilot indicators be reported to the Minister and, eventually, made public?

I must also ask whether the vaccination programme will include adolescent boys if they turn up at a sexual health clinic. They might not technically or legally be men, but if they are at risk and go to a sexual health clinic, will the HPV vaccination be available to them because they are at risk, and if a clinician deems it necessary? Finally, I cannot miss the opportunity to nudge the Minister on whether we may have an update on when HPV vaccinations will be widely available to all boys in the UK.

[Several hon. Members rose—]

--- Later in debate ---

[Mike Freer]

First, I would like to put it on the record that this pilot is a success. Hon. Members need only go back and read the previous debates to see how the JCVI had simply set its face against extending HPV vaccinations to boys and MSM. It was implacably opposed, and it took a lot of badgering from Members of this House and from Ministers to get the JCVI to change its terms of reference. It has taken us three years to get to this point, but I welcome the pilot and I welcome the Minister’s explanation of the complexities and why we have to ensure that the pilot is robustly monitored before we can take the extension of the vaccinations any further.

I finish by thanking colleagues for joining the debate today and for the broad cross-party support. We covered all perspectives, including MSM, boys, the minority known as heterosexual men and dental health practitioners—have I missed anyone out? Men are notoriously bad at seeking help with their health, especially sexual health. Vaccination is the way forward. I welcome this positive step forward and thank colleagues for their attendance today.

Question put and agreed to.

Resolved,

That this House has considered HPV vaccinations for men who have sex with men.