What happened with HPV vaccine uptake in the UK?

The UK has maintained a comprehensive and effective vaccine strategy to combat HPV for many years. However, recent evidence indicates that the uptake of this vaccine has slowed, raising questions about the country’s future response to cervical cancer.

But what’s going on? Keep reading to find out more.

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What is the HPV vaccine?

HPV is the most common STI in the world; it’s so common, in fact, that the vast majority of sexually active people will contract it at some point in their lives.

Most HPV infections are completely harmless. These infections typically don’t cause any symptoms and are resolved by your immune system without incident.

Some strains of HPV cause genital warts, which are harmless fleshy protuberances that appear around the genital area. Most cases of genital warts resolve within a couple of years, but they can also be treated with topical creams or removed surgically.

However, HPV isn’t completely harmless. A couple of strains of HPV (HPV 16 and HPV 18) cause around 99.7% of all cervical cancers. High risk strains are also responsible for causing a large number of other cancers, like penile, mouth, vaginal, vulval, and anal cancers.

To combat the rising incidence of cervical cancer, the UK government launched a vaccination program in 2008, utilising the Gardasil 9 vaccine, which protects against nine types of HPV associated with various cancers.

When do people get it?

All children in year 8 (around 12-13 years old) are routinely offered the HPV vaccine. Initially, the vaccine was only available to girls. In 2019, the vaccine was also made available to boys.

The NHS also encourages other groups to get vaccinated. In particular, men aged 45 and under who have sex with men, people under the age of 25 who missed earlier vaccinations, and other at-risk groups, such as sex workers and individuals with HIV, are also encouraged to get the vaccine.

Why has uptake declined?

The answer to this question is a bit complicated.

In 2023, the UK Health Security Agency reported a concerning increase in new STI infections. In response, the Women and Equalities Committee (WEC) produced its own report, focusing on the prevalence of STIs among young people and other high-risk groups.

One of the main areas of concern was the drop in HPV vaccine uptake during the COVID-19 pandemic. While levels of uptake appear to be stabilising, they remain significantly below 2019 levels.

In 2022-2023, 71.3% of year 8 females received dose 1 of the vaccine, 16.7% lower than pre-pandemic levels. Since the WEC published its report, figures for 2023-2024 have been released, indicating further decreases in uptake. Post-pandemic catch-up activity has been completed in only 62% of local authorities.

Catch-up vaccinations are recommended. Although they are not as effective when administered in later years, the vaccine still provides a degree of protection against HPV. Some evidence also suggests that vaccination may benefit people who have already been infected with the virus.

However, it remains unclear why these levels have dropped off.

One reason provided by School Age Immunisation Services (SAIS) is the increase in the number of consent forms that were declined or not returned. This may indicate a lack of engagement, potentially influenced by vaccine hesitancy or fatigue from a large vaccination program rolled out during the pandemic.

Staffing shortages also hinder follow-ups with non-consenting students. The disruption of the HPV vaccination programme during the pandemic continues to affect coverage in some cohorts in year 10.

The disruption of the vaccination program will likely hinder the Government’s target of achieving 90% coverage by 2040.

On the 7^th of May, the Government published a response to the WEC report, in which it responded to concerns about declines in the vaccination rate: “A range of activities have been undertaken since the pandemic to recover school aged vaccination services. School aged vaccination teams are working in line with their service specification to offer various catch-up initiatives to target unvaccinated individuals.”

What does this mean for the future?

The Government’s response to the decline in vaccine uptake highlighted its ongoing commitment to eliminating cervical cancer in the UK by 2040: “The expectation is for all regions to achieve 90% HPV vaccine coverage for both males and females, and this is supported by the quality standards and requirements of the school-age service specification.”

Important changes to the vaccination program have been undertaken to make it more effective, including offering a single dose instead of two doses. The plan also encourages clinicians to “use their clinical discretion to vaccinate eligible, unvaccinated individuals using national vaccine stock.” NHS England has created a plan to “support regions and their commissioned providers to improve vaccine uptake,” focusing on “equitable access, raising professional and public awareness, and enhanced digital capabilities via the implementation of an NHSE-owned digital tool.”

Final thoughts

While the HPV vaccination program in the UK has been effective, gaps still exist. If you’re worried about HPV, and want to get tested, click the button below to book an STI test at a sexual health clinic near you today.

Don’t leave your sexual health to chance. Book your appointment at a sexual health clinic near you.

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