HPV vaccination programme: changes from September 2023 letter
Updated 29 June 2023
Applies to England
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To:
- NHS England regions:
- directors of commissioning
- directors of public health and primary care
- heads of public health commissioning
- heads of primary care
- Integrated care boards:
- clinical leaders
- accountable officers
- GPs
- Local medical committees
- Local authorities:
- chief executives
- directors of public health
- Specialist sexual health services
- HIV clinics
- School aged immunisation service providers
cc:
- Chief pharmacists of NHS trusts
- NHS trusts and foundation trusts
- Royal College of Physicians
- Royal College of GPs
- British Medical Association
- Royal Pharmaceutical Society
- Faculty of Pharmaceutical Medicine
- Royal College of Paediatrics and Child Health
- Faculty of Public Health
- Royal College of Nursing
- Community Practitioners and Health Visitors Association
- Consultants in Communicable Disease Control
- School and Public Health Nurses Association
- British Association for Sexual Health and HIV
- NHS employers
Change in schedule for the routine adolescent HPV programme and eligible men who have sex with men (MSM) under age 25 years
Dear Colleagues,
This letter provides information about forthcoming changes to the human papillomavirus (HPV) vaccination programme.
We are pleased to announce that from 1 September 2023, the HPV vaccine programme will change from a 2 dose to a one dose HPV vaccine schedule for eligible adolescents and men who have sex with men (MSM) aged less than 25 years. This is because the Joint Committee on Vaccination and Immunisation (JCVI) has advised that a one dose HPV vaccine schedule has shown to be just as effective as 2 doses at providing protection from HPV infection.
This letter is aimed at health professionals who are responsible for commissioning and operationally delivering the NHS HPV vaccination programme through school aged immunisation services (SAIS), sexual health services, and general practice. Please share this guidance with all those involved in delivering these programmes in your area.
Change to the programme: main points
Routine adolescent and universal programme
Children who become eligible for the HPV vaccine from the academic year 2023 to 2024 (date of birth between 1 September 2010 to 31 August 2011) onwards will only require one dose and this will continue to be routinely offered to children in school year 8 and those of an equivalent age who are not in mainstream education.
For those children who became eligible for the HPV vaccination programme in the 2022 to 2023 academic year (date of birth between 1 September 2009 to 31 August 2010) the following applies:
- Those who started their HPV vaccination schedule and have already received one dose of the vaccine will be considered fully vaccinated.
- Those who have not yet received any HPV vaccinations will be eligible to receive one dose of the HPV vaccine.
All other cohorts who require catch-up via their SAIS provider or general practice will move to a one dose schedule from 1 September 2023, and remain eligible until their 25th birthday.
In summary:
| Date of birth | Eligible from academic year | Schedule from 1 September 2023 |
|---|---|---|
| 1 September 2010 to 31 August 2011 | 2023 to 2024 | 1 dose HPV schedule |
| 1 September 2009 to 31 August 2010 | 2022 to 2023 | Consider fully vaccinated if received 1 dose of the HPV vaccine |
| Born before 1 Sept 2009 | Various | 1 dose HPV schedule |
MSM programme
Eligible MSM aged less than 25 years will move to a one dose HPV schedule from 1 September 2023. MSM who have already received at least one dose of the HPV vaccine before their 25th birthday can be considered to have completed their vaccination course and do not require further doses.
MSM aged 25 years and older (up to and including 45 years) should continue on the 2 dose HPV vaccination schedule.
In summary:
| Cohort | Schedule from 1 September 2023 |
|---|---|
| MSM under 25 years | 1 dose schedule |
| MSM aged 25 years to 45 years (inclusive) | 2 dose schedule |
Immunosuppressed cohort
Eligible individuals who are known to be immunosuppressed at the time of vaccination and those who are living with HIV, including those on antiretroviral therapy, should continue to be offered a 3 dose schedule as per the HPV and immunisation of individuals with underlying medical conditions Green Book chapters.
Consent
Guidance on informed consent can be found in chapter 2 of the Green Book and a consent form for provider use is also available (see Annexe A). The consent form will be updated to reflect the change to the one dose HPV vaccine schedule.
The currently approved schedule for HPV vaccine is a 2 dose course. Use of a single dose is therefore off-label. In line with advice from the Medicines and Healthcare products Regulatory Agency (MHRA), where authoritative advice and current practice supports the use of a medicine outside the terms of its licence, it is not always necessary to draw attention to this when seeking consent. Please see Annexe A for further useful guidance.
Vaccine supply
As of July 2022, the HPV vaccination programme has transitioned to the Gardasil®9 vaccine.
Vaccine supply to be utilised in the delivery of the NHS HPV programme can be ordered from the UK Health Security Agency (UKHSA) in the usual way.
We would like to take this opportunity to thank everyone involved in commissioning and operationally delivering the NHS HPV vaccination programme.
Yours sincerely,
Deborah Tomalin, Director of Public Health Commissioning and Operations, NHS England
Dr Mary Ramsay CBE, Director of Public Health Programmes (including immunisation), UK Health Security Agency
Annexe A: resources to support the programme
Universal HPV programme resources
HPV vaccination programme collection on GOV.UK.
Health professional resources
Patient group direction (PGD) templates (these will be updated in due course).
The training slide set is available on the main programme collection page.
HPV vaccination guidance for healthcare practitioners.
HPV universal factsheet for health professionals.
HPV cervical cancer factsheet.
Human papillomavirus (HPV): the Green Book, chapter 18a.
Consent: the Green Book, chapter 2.
Human papillomavirus (HPV) vaccination consent form.
Off-label or unlicensed use of medicines: prescribers’ responsibilities.
Off-label vaccines: introductory guide for healthcare professionals.
Off-label vaccines: a guide for parents.
Gardasil 9 suspension for injection, Patient Information Leaflet (PIL) supplied with each vaccine.
The adolescent vaccine coverage: user guidance for submitting vaccine coverage data via ImmForm will be updated.
Patient facing resources
HPV universal vaccination poster.
Universal HPV information leaflet – available in various languages, as an easy-read leaflet, and a British Sign Language (BSL) video.
HPV for MSM programme resources
HPV vaccination programme for men who have sex with men (MSM) collection on GOV.UK.
Human papillomavirus (HPV) vaccine for MSM: PGD template (this will be updated in due course).
HPV vaccination guidance for healthcare practitioners.
The training slide set is available on the main MSM programme collection page.
HPV for MSM patient information leaflet, poster and record card.
All universal and MSM programme patient-facing resources can be ordered free of charge via the Health Publications website.