Vaccine update: issue 339, June 2023 - HPV special
Published 28 June 2023
Applies to England
© Crown copyright 2023
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Changes to the HPV vaccination programmes
We are delighted to announce that from 1 September 2023, the universal and gay, bisexual and other men who have sex with men (GBMSM) human papillomavirus (HPV) vaccination programmes will change from a 2-dose to a one-dose HPV vaccine schedule for eligible adolescents and GBMSM aged under 25 years.
The Joint Committee on Vaccination and Immunisation (JCVI) regularly reviews all vaccination programmes and considers new evidence as it emerges. The Committee has been considering the potential decision for several years and now considers that there is strong evidence in favour of moving to one dose. This view aligns with recent advice from the World Health Organization’s Scientific Advisory Group for Emergencies (SAGE) committee. The HPV programme in the UK targets girls and boys aged 12 to 13 and is currently given as a 2-dose course. Under the new advice, all young people will be eligible for one dose as part of the routine adolescent programme.
Dr Vanessa Saliba, Immunisation Consultant Epidemiologist at the UK Health Security Agency (UKHSA), said:
The HPV vaccination programme is one of the most successful in the world and has dramatically lowered the rates of cervical cancer and harmful infections in both women and men – preventing many cancers and saving lives. The latest evidence shows that one dose provides protection as robust as 2 doses. This is excellent news for young people. If you missed your HPV vaccine, it is vital you get protected. Contact your school nurse, school immunisation team or GP practice to arrange an appointment – you remain eligible to receive the vaccine until your 25th birthday.
National Director for Screening and Vaccinations Steve Russell said:
This is another step forward for our world-leading HPV vaccination programme, which saves lives by significantly reducing the risk of cervical cancer. With one quick HPV jab now making it simpler than ever to reduce your risk of cancers caused by the virus, it’s so important that people come forward when invited. Along with getting your HPV vaccine, it is also still vital to book in for your cervical screening appointment, which checks for high-risk HPV and remains one of the best ways to protect yourself from cervical cancer.
The NHS HPV vaccination programme in England has been shown to have dramatically lowered HPV infections and rates of cervical cancer in vaccine-eligible women, with the strongest effects seen in those offered vaccination at younger ages. HPV vaccination also protects men and women against genital warts and other cancers of the genital areas and anus, as well as some mouth and throat (head and neck) cancers. Reductions in diagnoses of genital warts to the end of 2022 have been recently reported by UKHSA.
A study published in The Lancet in 2021 found that cervical cancer rates were 87% lower in young women who had been eligible for HPV vaccination when they were aged 12 to 13 years, compared to young women who had not been offered vaccination, providing strong evidence the programme is preventing cervical cancers.
Overall, the study estimated that the HPV programme had prevented about 450 cancers and 17,200 pre-cancers up to mid-2019. The latest UKHSA report published in December 2022 on the routine adolescent HPV vaccination programme for 2021 to 2022, which is primarily delivered in schools, shows that coverage in year 8 and year 9 pupils is yet to return to pre-pandemic levels.
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 school-age immunisation services (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 |
| Born before 1 September 2009 | Various | 1 dose of the HPV vaccine |
UKHSA National HPV programme resources
Guidance for healthcare practitioners about the HPV universal programme for adolescents and the HPV GBMSM programme is available. It includes information on eligibility, scheduling and vaccine administration. There are 2 slide sets and 2 guidance documents which should be used together to plan and implement the programme. Please make sure you order the national programme consent resources (leaflets, record cards and posters) listed in the section below:
- HPV adolescent programme slide set
- HPV universal programme guidance
- HPV for GBMSM programme training slide set
For more information see the letter published on Tuesday 20 June 2023.
New HPV for All resources
| Version | Product code |
|---|---|
| HPV universal leaflet | HPVU1L |
| HPV universal record card | HPVU1RC |
| HPV universal poster | HPVU1POS |
| HPV universal consent form | HPVU1CF |
| HPV universal healthcare worker factsheet | HPVU1HCF |
| HPV universal leaflet: translations | |
| Albanian | HPVU1L-AL |
| Arabic | HPVU1L-AR |
| Bengali | HPVU1L-BEN |
| Brazilian Portuguese | HPVU1L-BRP |
| Bulgarian | HPVU1L-BUL |
| Chinese (simplified) | HPVU1L-CHS |
| Chinese (traditional) | HPVU1L-CHT |
| Spanish | HPVU1L-ES |
| Estonian | HPVU1L-EST |
| Farsi | HPVU1L-FAR |
| Fijian | HPVU1L-FI |
| Greek | HPVU1L-GR |
| Gujarati | HPVU1L-GU |
| Hindi | HPVU1L-HI |
| Kurdish Sorani | HPVU1L-KS |
| Latvian | HPVU1L-LA |
| Lithuanian | HPVU1L-LI |
| Nepali | HPVU1L-NE |
| Panjabi | HPVU1L-PAN |
| Pashto | HPVU1L-PAS |
| Polish | HPVU1L-POL |
| Romany | HPVU1L-RMY |
| Romanian | HPVU1L-ROM |
| Russian | HPVU1L-RU |
| Somali | HPVU1L-SOM |
| Tagalog | HPVU1L-TAG |
| Turkish | HPVU1L-TUR |
| Twi | HPVU1L-TWI |
| Tigrinya | HPVU1L-TIG |
| Ukrainian | HPVU1L-UK |
| Urdu | HPVU1L-UR |
| Yiddish | HPVU1L-YI |
| Yoruba | HPVU1L-YO |
| HPV universal leaflet: accessible versions | |
| Audio | HPVU1L-AU |
| Braille | HPVU1L-BRL |
| BSL | HPVU1L-BSL |
| Easy read | HPVU1L-ER |
Changes to the GBMSM programme
In addition to the routine adolescent programme, there is also a separate HPV vaccination programme for GBMSM aged up to 45 years, which is delivered through sexual health clinics.
The advice from JCVI on the move to one dose applies to everyone aged under 25, including GBMSM. From September, GBMSM under 25 will only need to receive one dose of the HPV vaccine instead of 2 to be fully vaccinated. Any GBMSM aged 25 or over will continue to be offered 2 doses. Individuals living with HIV will be offered 3 doses, irrespective of their age.
The vaccine helps to prevent HPV infection which can cause genital warts and HPV associated cancers such as cervical cancer, some other cancers of the genital areas and anus and some cancers of the head and neck.
Those who are eligible for the HPV vaccine can get it free from NHS services up until their 25th birthday. In August 2022, JCVI, which regularly reviews all vaccination programmes, advised that the single-dose schedule could be extended to adults up to 25 as the evidence showed even a single dose of Gardasil 9 offers good protection in older individuals.
New resources for HPV for GBMSM programme from September 2023
- record card – product code C23HPVM1
- leaflet – product code C23HPVM2
- poster – product code C23HPVM3
Ordering HPV resources
Please make sure you order enough stock to give every eligible person their vaccination leaflet, record card and have stocks of the translated posters available to display in all school settings.
Health publications orderline
Immunisation Publications
UK Health Security Agency, 61 Colindale Avenue, Colindale
London
NW9 5EQ
Contact form https://www.healthpubl...
Telephone: 0300 123 1002
Copies of printed publications and the full range of digital resources to support the immunisation programmes can now be ordered and downloaded online. Log in to register and place your order.
Vaccine supply
Routine vaccination programme
Change in schedule for the routine adolescent HPV programme and eligible GBMSM under 25 years
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 GBMSM aged less than 25 years; please see the UKHSA and NHSEI bipartite letter for details.
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’ chapter 18a and ‘Immunisation of individuals with underlying medical conditions’ chapter 7 of the Green Book. HPV vaccine will continue to be available to order through ImmForm in the usual way. However, please consider the schedule change when placing orders for HPV vaccine, and do not order more than 2 weeks’ worth of stock to minimise wastage due to holding excess stock, or fridge failures.
DTaP/IPV/Hib/HepB vaccine ordering
Supplies of DTaP/IPV/Hib/HepB vaccines Infanrix hexa® and Vaxelis® are available for the routine infant primary immunisations programme. Orders for Infanrix hexa® remain unrestricted. Customers in England and Wales may order up to 20 packs of Vaxelis® per ImmForm account per week – this will vary for customers taking part in the Oxford Vaccine Group trial. Customers in Scotland should refer to their local ordering restrictions. Providers should not order more than 2 weeks’ worth of stock to minimise wastage due to fridge failures. For assistance, please contact the ImmForm Helpdesk at helpdesk@immform.org.uk
Update to Bexsero Patient Information Leaflet
Every pack of Bexsero (Meningitis B vaccine; 10 doses) issued via ImmForm in Great Britain (England, Scotland and Wales), is supplied with a pad of 10 Patient Information Leaflets (PILs), as well as there being a single PIL inside each Bexsero pack. Since September 2020, an updated version of the PIL pad has been distributed with Bexsero orders. Please dispose of the single PIL from inside the pack and issue the updated PIL.
Registering for a new or updating your existing ImmForm vaccine ordering account
When you register for or update an existing ImmForm account, UKHSA as a wholesaler of vaccines needs to verify the requesting customer.
Please ensure you have your professional regulatory body registration number or Wholesaler Dealer Licence and an organisation code which can be verified when requesting updates or requesting a new vaccine ordering account.
For more information please see the ImmForm Helpsheet – How to register
The EU Falsified Medicines Directive (FMD) and Delegated Regulation as applicable to UKHSA-supplied vaccines for the national immunisation programme
The EU Falsified Medicines Directive 2011/62/EU (FMD) and Delegated Regulation impose legal obligations on the EU medicines supply chain to prevent entry of falsified medicinal products into the supply chain. The Delegated Regulation was implemented in all EU member states on 9 February 2019. Following the UK’s departure from the EU, the Delegated Regulation ceased to apply in Great Britain from 31 December 2020, but continues to apply in Northern Ireland.
Information for customers in Northern Ireland
FMD-barcoded packs of routine immunisation programme vaccines that are centrally supplied by UKHSA continue to be supplied with active FMD serialisation, and should be decommissioned by end users in Northern Ireland. Customers in Northern Ireland who access centrally supplied vaccines are encouraged to review local guidance on implementation of the EU Falsified Medicines Directive.
MMR vaccine ordering
To rebalance central supplies of both MMR vaccines please consider ordering M-M-RvaxPRO® as your first choice, which is available without restriction. Customers in England and Wales who require Priorix®, for example because you serve communities that do not accept vaccines containing porcine gelatine, may order up to 6 packs of Priorix® per ImmForm account per week. For assistance please contact the ImmForm Helpdesk at helpdesk@immform.org.uk. Customers in Scotland should refer to their local ordering restrictions.
Non-routine vaccine supply
Hepatitis A vaccine
Adult:
- GSK: supply of Havrix Adult PFS singles and packs of 10 are currently available
- Sanofi Pasteur: Avaxim PFS singles and packs of 10 are currently available
- MSD: VAQTA Adult is available
Paediatric:
- GSK: supply of Havrix Paediatric singles and packs of 10 are currently available
- MSD: VAQTA Paediatric is available
- Sanofi Pasteur: Avaxim Junior singles are currently available
Hepatitis B vaccine
Adult:
- GSK: Engerix B PFS singles and packs of 10 are currently available
- GSK: supply of Fendrix is currently available
- MSD: HBVAXPRO 10 micrograms is available (limited supply until July 2023)
- MSD: HBVAXPRO 40 micrograms is available
Paediatric:
- GSK: supply of Engerix B Paediatric singles is currently available
- MSD: HBVAXPRO 5 micrograms is available
Combined hepatitis A and B vaccine
- GSK: Twinrix Adult singles and packs of 10 are available
- GSK: Twinrix Paediatric is currently available
- GSK: Ambirix is available
Combined hepatitis A and Typhoid vaccine
Sanofi Pasteur: Viatim is now a discontinued product and no longer available for sale.
Typhoid vaccine
- Sanofi Pasteur: Typhim singles and packs of 10 are available
- Patientric: Vivotif is available
Rabies vaccine
- Valneva: Rabipur is available – due to high demand, orders are capped to maximum of 9 doses per order, per week (restrictions are anticipated to remain in place until August)
- Sanofi Pasteur: Rabies BP is now a discontinued product and no longer available for sale
Pneumococcal polysaccharide vaccine (PPV)
MSD: supply of Pneumovax 23 (PPV23) PFS is available.
Pneumococcal polysaccharide conjugate vaccine (PCV)
Pfizer: Prevenar 13 is currently available.
Varicella zoster vaccine
- GSK: VARILRIX is currently available
- MSD: VARIVAX is available
- MSD: ZOSTAVAX is now a discontinued product
Diphtheria, tetanus, pertussis (inactivated) vaccine
Sanofi Pasteur: Revaxis is available.
Diphtheria, tetanus, pertussis (acellular) and poliomyelitis (inactivated) vaccine
- GSK: supply of Boostrix-IPV is currently unavailable – recovery expected early May 2023
- Sanofi Pasteur: Repevax is currently available
MMR
- MSD: MMR Vaxpro is currently available
- GSK: Priorix is currently available
Meningitis ACWY vaccine
- GSK: Menveo is currently available
- Pfizer: Nimenrix is currently available
- Sanofi Pasteur: MenQuadfi is available
Yellow fever
Sanofi Pasteur: Stamaril is available.
Human papillomavirus (HPV) vaccine
- MSD: Gardasil 9 is currently available
- GSK: Cervarix has been discontinued
Cholera vaccine
- Valneva: Dukoral is available
- Patientric: Vaxchora is available
Japanese encephalitis vaccine
Valneva: Ixiaro is available.