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Human Papillomavirus (HPV) vaccine - Information for health professionals

Currently being updated for 2023-24

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Background

There are approximately 100 types of the Human papillomavirus (HPV). HPV is a double stranded DNA virus that infects squamous epithelia including the skin and mucosae of the upper respiratory and anogenital tracts. Although most infections are asymptomatic and self-limiting, genital infection by HPV is associated with genital warts and anogenital cancers in both men and women. HPV viruses are classified as either ‘high-risk’ or ‘low-risk’ types depending on their association with the development of cancer.

Since 2018 the Joint Committee on Vaccination and Immunisation (JCVI) has been reviewing in detail the evidence about protection from a single dose of HPV vaccine. JCVI considers that the evidence is now very strong that one dose provides similar protection to that induced by two doses.

See the JCVI statement in full here: JCVI statement on a one-dose schedule for the routine HPV immunisation programme - GOV.UK (www.gov.uk)

In England and Wales from 1 September 2023 there is now a one-dose schedule for HPV vaccinations for the routine adolescent programme and gay, bisexual and other men who have sex with men (GBMSM) under 25. Further details are provided in the Welsh Health Circular WHC/2023/016 (see Guidance section below).

One-dose of the HPV vaccine is recommended for:

  • All immunocompetent adolescents (boys and girls)*. The HPV vaccine is offered in schools to pupils in Year 8 (usually aged 12 to 13). Males and females in cohorts eligible for vaccination in the national programme remain so until their 25th birthday - see Green Book for details.
  • GBMSM up to 25 years of age attending Specialist Sexual Health Services and/or HIV clinics.*

A two-dose schedule of the HPV vaccination is recommended for:

  • GBMSM who are aged 25-45 years old. *

Note: individuals eligible for HPV vaccination who are immunosuppressed or HIV-positive should be offered 3 doses of the HPV vaccine.

Gardasil has been the vaccine used in the NHS since 2012. In 2022 Gardasil 9 was introduced into the NHS HPV vaccination programme. It is now the main HPV vaccine given in Wales.

Gardasil 9 provides protection against HPV types (6, 11, 16, 18, 31, 33, 45, 52 and 58). HPV types: 16 and 18 are high risk HPV types that can lead to cancer; 6 and 11 are HPV types that cause approximately 90% of all anogenital warts in males and females.

Gardasil 9 offers protection against 5 additional types of HPV (31, 33, 45, 52, 58) which, although less common than types 16 and 18, are also considered high-risk. Gardasil 9 protects against the majority of cervical, vaginal and vulvar cancers and premalignant lesions, as well as genital warts associated with HPV.

 

Summary of product characteristics

The Complete Routine Immunisation Schedule includes information about routine and non-routine vaccinations.

 

Guidance

Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy can be found at the links below.

Joint Committee on Vaccination and Immunisation - GOV.UK (read JCVI publications and statements; search e.g. HPV)

 

Welsh Health Circulars and Welsh Government letters

WHC: HPV immunisation programme update. Implementing the move to one dose of the HPV vaccine in Wales. (WHC/2023/016) May 2023

Changes to the vaccine for the HPV immunisation programme (WHC/2022/023) September 2022

Changing to a two-dose NHS Human Papillomavirus (HPV) vaccination schedule for eligible adolescents and adults starting the course after they turn 15 years old, including men who have sex with men (MSM) (2022)

JCVI interim advice on a one-dose schedule for the human papillomavirus (HPV) immunisation programme February 2022

WHC: Changes to the Human Papillomavirus (HPV) immunisation programme from the academic school year starting September 2019 (WHC/2019/020) June 2019

HPV vaccine for adolescent boys (2018)

HPV vaccination for men who have sex with men (2017)

Chief Nursing Officer letter to Local Authority Directors of Education & School Governor Officers (sharepoint.com) February 2021 

Joint CMO/Chief Nursing Officer/ Director Education Directorate letter to headteachers - Maintaining school-based vaccination programmes during COVID-19 (2020)

 

Training resources and events

Online courses and training materials about a number of vaccines and diseases can be accessed via the E-learning page.

Further immunisation training information and resources are provided on the Training Resources and Events page.

 

Clinical resources and information

 

Patient group directions (PGDs) and protocols

 

Further clinical resources and information

 

Other resources

Cervical Screening Wales is responsible for the NHS cervical screening programme in Wales.

 

Data and surveillance