WOMEN in Scotland are being left at risk of a killer cancer because of the refusal to fund a preventative vaccine through the NHS, according to a leading medical ethicist.
Females aged 26-45 are currently excluded from the HPV vaccine which protects against cervical cancer and genital warts even though it is offered to men in high-risk groups in the same age category.
Yet women are most at risk for deaths from cancers related to the human papillomavirus (HPV), according to Dr Cristina Richie, a lecturer in ethics at the University of Edinburgh.
However, the only way females aged 26-45 can get the vaccine is by paying almost £600 for it – close to a week’s worth of wages or 1%–2% of an annual salary in the UK.
Research shows the vaccine is more cost effective than treatment for the diseases caused by the virus and Dr Richie is calling for it to be offered to the women who have so far been excluded.
“This policy is harming individual women aged 26 years and over by leaving them unnecessarily at risk of HPV transmission and the development of cervical cancer,” she said.
“As such, it is unethical and policy should be changed. The NHS must close the vaccination gap to align individual and public health and remedy discriminatory policies.”
Although the vaccine started to be rolled out in the UK to females aged 12-25 over a decade ago, many older women are not covered by it, even though research has found it to be both safe and effective for individuals up to the age of 45.
Cervical cancer remains the fourth most common cancer in women, with nearly all cases caused by HPV (99.7%).
After the roll out to younger females, the vaccine was then rolled out to all males in the UK aged 12-25. Men who have sex with men, transmen and transwomen up to the age of 45 are also now eligible as they are all considered to be at high risk of catching the virus.
For females over the age of 25 and up to 64-years-old, the policy is to address the risk of cervical cancer through screening only, even though screening does not stop women contracting the disease.
Said Dr Richie: “The effects of cancer and other symptoms of HPV – like genital warts – are serious enough to expand access to the vaccine based on individual health alone.
“Women are most affected and a lot of it is just down to financial calculations. It is kind of horrible when you are thinking of things like cancer and life threatening diseases that you would just make a determination based on cost, especially when the NHS spends money on things that are not life-saving.
“Even if vaccinations were more expensive than cancer treatment, the terrible burden of a preventable and potentially lethal cancer in the face of a simple preventive strategy should take ethical priority.”
Dr Richie said that many women like herself who are under the age of 45 but over 25 had been told they were too old to get the vaccine because it had initially just been trialled for the younger age group.
At the time, Dr Richie (belwo) was living in the United States, indicating that this is not only a problem in the UK.
Since it was first rolled out in 2012 in the UK, however, more trials have shown it is both safe and effective for women aged 26-45 but she said women are still being told they are too old to receive it with NHS coverage but not told that they can get it at places like Boots.
Others have been told they have “herd immunity” but Dr Richie said that is incorrect because the majority of older men have not had the vaccine.
“What I hear from doctors is that older women would have been exposed to the virus a lot already which is not necessarily true if they were trying to stay safe during sex,” she said.
“There are a lot of women getting this information and it is such a stark contrast that for males in high risk groups the NHS is so willing to provide these vaccines when their rates of cancer are going to be less and their rates of transmission are going to be less. And the consequences will be much more for the females who could die from cervical cancer.”
Dr Richie said that even if the vaccine were to be made available to the female 26-45 age group it would not necessarily mean that women would be queuing up to get it, particularly if they are already in a long term relationship to which they remain committed.
“The benefits of the HPV vaccine are well documented and clinically approved for all adults up to the age of 45,” she said.
Public Health Minister Jenni Minto said: “Scotland’s HPV vaccination programme is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI).
“We continue to work with Public Health Scotland and NHS boards through both the Scottish Vaccination and Immunisation Programme (SVIP) and the Cervical Cancer Elimination Expert Group to address inequalities and build confidence in the HPV vaccine.”
