Every person in Britain should be given the cancer-fighting HPV jab to prevent a range of deadly tumours and ‘save thousands of lives’, world-renowned medical experts claimed last week.
Until now, most discussion of the vaccine has focused on youngsters, as giving it at an early age offers life-long protection.
But according to the world’s leading HPV researchers, there is now evidence that giving the jab to adults from their 20s into middle age would also bring dramatic health benefits.
If the Government and health chiefs act on their advice, it would bring about the first mass vaccination programme of British working-age adults since the polio campaign of the 1950s.
HPV – the human papilloma virus – is spread by intimate contact and, in some cases, kissing. It is terrifyingly prevalent: without vaccination, about 80 per cent of us will be infected at some point in our lives. In most cases, there will be few, if any symptoms.
The virus lurks in the basal cells beneath the surface of the skin or mucous membranes and in many cases does no damage.
Until now, most discussion of the vaccine has focused on youngsters, as giving it at an early age offers life-long protection (stock image)
But in other cases, it will trigger cancers – which may not emerge for decades.
HPV is known to cause cervical cancer, and a range of other cancers, including tumours of the mouth, tongue, throat, tonsils, penis and anus.
There are more than 4,000 new UK cases of these types of cancer each year and this figure is rising rapidly.
Last year, this newspaper ran a six-month campaign that succeeded in persuading the Government to start offering the HPV jab to all boys aged 12 and 13. Girls have been given it on the NHS since 2008.
The first boys were vaccinated under the new policy earlier this month.
It was believed inoculation was likely to be effective only if given to children before they’d come into contact with the virus. By early adulthood, many people have already been exposed.
But new research suggests the jab can prevent patients who have been infected with the virus from going on to develop cancer. It produces an immune system response so powerful it stops the virus from spreading inside the body.
Currently, HPV vaccination is available only privately to anyone not given it at school – at a cost of £500 for the full course of three.
But the researchers suggest offering it to adults as part of a nationwide programme may be cost effective, due to the huge reduction in incidence of cancer it would bring about.
‘Most people don’t realise that HPV infection is a global epidemic,’ says Cambridge University’s Professor Margaret Stanley, President of the International Papillomavirus Society.
‘And the easiest way to prevent the spread of this virus and the diseases it causes is to give everyone a vaccine shot.’
The new evidence that supports vaccinating older people is summarised in a paper to be published shortly in the International Journal Of Infectious Diseases.
Such a campaign, it says, would stop the virus being transmitted between adults and could reduce the incidence of cancers.
It was believed inoculation was likely to be effective only if given to children before they’d come into contact with the virus (stock image)
Patients who had already suffered an HPV-related cancer could benefit too, as it could reduce the risk of a relapse.
One of the study co-authors is the Barcelona oncologist Xavier Bosch, the scientist who first demonstrated that HPV causes cancer.
He showed more than 20 years ago that HPV is the sole cause of tumours in the cervix, which still afflict some 3,200 women in the UK each year, causing about 850 deaths. It was his work that led to vaccination programmes for adolescent girls.
But he believes that now the time has come to expand the age range.
‘We have an excellent vaccine that certainly does protect girls, but also adults. People have a right to know this,’ he says.
The vaccine, Dr Bosch adds, ‘provides much better protection’ than regular cervical screening.
Giving it to adult women could mean they would only need one or two smears in their lifetimes, instead of every three years.
The first version of the vaccine, Gardasil 4, was developed by the drug company Merck and licensed for use in 2006.
There are more than 100 strains of HPV and, as its name suggests, Gardasil 4 provides protection against four of them, including the two that cause 70 per cent of cancers, and the two that most commonly cause genital warts.
The latest version, Gardasil 9, covers nine strains, and will prevent 85 per cent of cases.
Linked cancers: Desperate Housewives star Marcia Cross and her husband Tom Mahoney
Anti-vaccine campaigners have claimed that the vaccine can cause serious side effects, such as chronic fatigue syndrome.
But the experts who spoke to this newspaper say there is no scientific evidence that this or other adverse conditions are more common in people who have had the vaccine – a conclusion that’s backed by the World Health Organisation.
In America, the Centres for Disease Control has already recommended the vaccine be licensed for men up to the age of 26 and women up to 45.
However, there is already a worldwide vaccine shortage, which would hamper wider use in older people in the short term.
Merck has pledged to remedy this. A firm spokeswoman says it is investing more than £1 billion in new plants and plans to double production from the 2018 level of 170 million doses by the end of next year, and to triple it by 2023.
Among the most striking findings in the new paper by Dr Bosch and his colleagues is that, unlike most vaccines against viruses or bacteria, inoculation for HPV has hugely beneficial effects in patients who have already been infected, as well as those who have managed to avoid the virus.
The threat was hanging over me… but now I’m protected
Elba Aman was 37 when she decided to shell out hundreds of pounds to get the HPV jab
Elba Aman was 37 when she decided to shell out hundreds of pounds to get the HPV jab at a high street chemist.
Three years earlier, the mother-of-one, who lives with her partner in West Hampstead, London, had an abnormal cervical smear test.
She was sent for a colposcopy – a procedure that looks into the cervix – and a large area of cells, highly likely to become cancerous and spread, was discovered. The cause? HPV.
‘It was a worrying time,’ film-maker Elba, now 38, says. ‘I looked up everything around the HPV virus. That was when I discovered that young girls were being vaccinated against it.’
Elba underwent a cone biopsy – an operation to remove a cone-shaped piece of tissue from the cervix – to get rid of the abnormal cells. About six months later, tests showed she was clear of HPV and potentially cancerous cells.
While Elba was told she shouldn’t have problems getting pregnant afterwards, she was warned she may have a premature birth as a result of having the area removed.
But about two years ago she gave birth at 38 weeks to a healthy baby girl. It was afterwards, at a gynaecological check-up, it was suggested that she had the HPV jab.
‘A friend of mine had been vaccinated and it seemed like a good idea for me to do it too,’ she says.
‘Doctors can’t say categorically that the jab will prevent cancer, but I was told it would offer protection.
‘It’s not free on the NHS for people my age, so I had to book an appointment at Boots.
‘I had three separate injections over six months – each costing £165 – but it was well worth the money. I feel much happier knowing I am protected.’
HPV infections are highly localised, and do not trigger a full- blown immune system response – which means the body does not usually produce the antibodies to fight infection.
But the vaccine triggers a ‘high-level immune response’ that is so powerful it effectively neutralises the virus. This means that if those who are carrying the virus get the vaccine, they will no longer transmit HPV to a sexual partner, because their secretions will no longer contain HPV.
Earlier this year, American TV actress Marcia Cross revealed she had been treated for anal cancer – which doctors said was likely to be linked to her husband Tom Mahoney’s throat cancer, which was diagnosed a decade ago. Both tumours were caused by HPV. The Desperate Housewives star and her husband are both now cancer-free. Adult HPV vaccination also means that a mother with HPV can no longer transmit it to their baby – thereby eliminating the risk of respiratory papillomatosis, an agonising, often fatal condition in which warts grow repeatedly inside a child’s bronchial tract, requiring frequent operations to stop them from choking to death.
And, says the paper, the risk of a patient who has already had cervical cancer, and then receives the vaccine suffering a return of their cancer is reduced to a staggering degree – more than 80 per cent.
The evidence also suggests that vaccinating someone already infected with HPV may protect them from ever developing an HPV-related cancer.
Dr Bosch says the jab may prevent the virus advancing from tissues not susceptible to cancer to the cervix, and could work in the same way in the throat ‘by preventing viral particles infecting the soft palate, base of the tongue and tonsils, which are exquisitely susceptible to carcinogenic strains of HPV’.
He adds: ‘As yet, we have little information about this, but we are actively working on it.’
His colleague and co-author, Alex Vorsters, says: ‘We have less data on men, but it’s clear the same principles are at work.’
He said there was no reason to restrict vaccination to people under 45, adding: ‘I don’t see age as an issue. The bigger your vaccine cohort, the more you will reduce cancer.
‘If the price of the vaccine falls, there is no reason not to vaccinate everybody, both men and women.’
Prof Stanley points out that there is a spike in the incidence of HPV cancers when people entered their 60s, because their whole immune systems becomes weaker.
‘HPV breaks the usual rules of vaccination,’ she says.
‘Vaccinating older, infected people will make it less likely that cancers will develop.’
Meanwhile, practising doctors say they have noted huge benefits from vaccinating adult patients.
Sean Cummings, a private GP and sexual health expert who founded Harley Street’s Freedomhealth clinic, cites several cases, including a man in early middle age who was covered from head to foot by painful, disfiguring warts, caused by HPV.
They were in his mouth, on his face, his torso and genitals, and no treatment Dr Cummings tried seemed to work.
Moreover, the man was HIV-positive, so his immune system was already badly compromised.
Finally Dr Cummings prescribed the three-jab course of the HPV vaccine.
The results, Dr Cummings says, were swift and dramatic. ‘I gave him his first dose of the vaccine and a couple of days later, he rang me up in a fury, to say that he’d erupted in a livid rash.
‘But it was gone the next day – and very soon, all the warts had vanished. It was like magic.’
The warts never came back.
Dr Cummings treated several further, similar cases, whose outcomes were equally successful.
He adds: ‘It’s likely that giving the vaccine at any age will interrupt the progression to cancer.’
He said he had noticed that in some patients who did have cancer, the vaccine seemed to make their cancer ‘less aggressive’, as well as preventing the development of a further tumour.
Among thousands of people he had vaccinated, he had never seen anyone develop an adverse reaction: ‘This is a fantastic vaccine. I can’t see any downside.’
The conclusion of the new paper is only slightly more cautious, saying there should be ‘further investigation’ of the benefits of vaccinating people who were already HPV positive.
This, it adds, would provide evidence whether giving the vaccine much more widely would be cost-effective.