Item 11: HPV vaccine for all
Resolution submitted by the RCN United and Homefirst Branch
That this meeting of RCN Congress supports the right of young people to obtain equal access to the HPV vaccine
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Congress voted to support the right of young people to obtain equal access to the HPV (human papilloma virus) vaccine by a majority vote of 98.99%.
The HPV vaccine has been recognised as a major breakthrough in cervical cancer prevention. Kathleen Deeney of the RCN United and Homefirst Branch said that persistent sexually transmitted HPV infections are now recognised as a primary cause of cervical cancer.
Highlighting the vital need for equitable access to the HPV vaccine, Joy Winks of the RCN School Nursing Forum said that some schools have opted in to the national immunisation programme whilst others haven't. She went on to say that young people, including young men, need to be able to access the vaccine in other ways, for example, through GPs or health centres. Sue Haworth, non-voting member, felt that educating of mothers was key to getting the vaccine message across.
Kathleen closed the debate saying that nurses are advocates for the rights of young people and there should be equitable access to this preventative health care programme across all four countries of the UK.
For 391 98.99%
Against 4 1.01%
Abstain 5
PASSED
Background
Persistent sexually transmitted HPV (human papilloma virus) infections are now recognised as a primary cause of cervical cancer (Lowy and Schiller, 2006; Castellsague et al., 2007). Current estimates indicate that more than 3,000 women across the UK are diagnosed with cervical cancer every year (WHO/ICO, 2007).
The HPV vaccine has been hailed as a major breakthrough in the fight against cancer, offering the potential to reduce the risk of cervical cancer by over 70% (HPANI, 2008). To ensure maximum benefit and protection, HPV vaccines need to be administered before the onset of sexual activity, but because of the link made between sexual promiscuity and HPV infection, some sections of society have voiced reluctance regarding HPV vaccination; for example, media coverage has been given to the viewpoint that giving girls HPV vaccinations will encourage under-age sex and promiscuity. However, a survey carried out by Cancer Research UK (2007) found that most mothers (80%) agreed that the appropriate age for vaccination was between 10-14, and that 75% of mothers said they would probably or definitely accept the HPV vaccine for their daughter.
In June 2007 the UK Government, Scottish and Northern Ireland Executives, and the Welsh Assembly, announced they would introduce a national HPV vaccination programme. The national immunisation programme for girls aged 12-13 was rolled out in September 2008, supplemented by catch-up campaigns in all four countries to vaccinate all girls up to the age of 18 years by 2010/11.
The national vaccination campaign needs to be both cost effective and target those sections of the population most likely to benefit from the vaccine. The Department of Health (DH) approach has been to accelerate the national programme, providing the widest population coverage in a shorter time period. However, the DH decision to select an HPV vaccine that does not protect against less common strains of the virus or genital warts has been criticised by some clinicians and professional organisations, and, as the vaccine is licensed for use for women in their early twenties there has been concern that it will not be available to a cohort of young women. There have also been calls that the vaccine should be available to boys in the same national HPV programme.
The Independent Joint Committee on Vaccination and Immunisation advised that HPV vaccination would be most efficiently delivered through schools (NHS, 2007). Nevertheless, if a school elects not to facilitate delivery of the immunisations programme there need to be contingency plans in place to ensure all young people have equal opportunity and access to this important preventative health care programme.
The RCN has supported the HPV programme and young people's access to the vaccination in the press, and worked with the DH to promote awareness among nurses. RCN Scotland has questioned if the Government has allocated sufficient resources to health boards, and if there are sufficient school nurses to enable the immunisation programme. RCN Wales has also raised the issue of additional funding to deliver the programme with the Minister.
References and further reading
Brabin L, Roberts SA, Stretch R, Baxter D, Chambers G, Kitchener H and McCann R (2008) Uptake of first two doses of human papillomavirus vaccine by adolescent girls in Manchester: prospective cohort study, British Medical Journal, 336 (May), pp.1056-1058.
Castellsagué X, de Sanjosé S, Aguado T, Louie KS, Bruni L, Muñoz J, Diaz M, Irwin, K, Gacic M, Beauvais O, Albero G, Ferrer E, Byrne S, Bosch FX (editors), HPV and cervical cancer in the world: 2007 report, Geneva:WHO. Available from the WHO website.
Lowy DR and Schiller JT (2006) Prophylactic human papillomavirus vaccines, Journal of Clinical Investigations, 116(5), pp.1167-1173.