HPV vaccine: Thousands of girls did not get full dose

One in three girls in some parts of the UK did not have their full vaccination at school against HPV, the virus that can cause cervical cancer, in 2017-18.

While the national target of immunising 80% of girls is being met, the rate varied between local authority areas.

In total 57,048 girls did not receive the two doses required for the vaccine to be effective.

Public Health England (PHE) said the vaccine programme was "stable and consistent".

Charity Jo's Cervical Cancer Trust said educating parents and young people about the Human Papilloma Virus vaccine was "essential".

PHE statistics showed vaccination rates ranged from about two thirds of year nine girls in some parts of London to more than nine out of 10 in other areas, such as North Yorkshire, Tameside and Portsmouth.

Cervical cancer remains the most common cancer in women under 35 and kills about 850 a year.

The NHS said the vaccine was "effective at stopping girls from getting the types of HPV that cause most cervical cancers" but it was "important to have both doses to be properly protected".

Girls who did not receive a vaccine at school were encouraged to speak to their GP and arrange an appointment as they are entitled to it until they are 18.

'The best protection'

Emmeline Collin survived cervical cancer and is keen for daughter Lucy to receive the HPV vaccine

Having had cervical cancer herself, Emmeline Collin has explained to her daughter Lucy how the HPV vaccine could save her life.

The 47-year-old, who lives near Peterborough, says it is "the best protection" for girls.

Mrs Collin was diagnosed in 2009 with a tumour in her cervix after a routine smear test, despite having never shown symptoms previously.

The mother of two has been clear of cancer for nearly 10 years, and is now keen that 13-year-old Lucy receives her first HPV vaccine dose.

"I have personal experience in how potentially devastating cervical cancer can be," she said. "I was very lucky I was treated early."

Mrs Collin said talking about the vaccine was "difficult to address with children" as it was connected with "sexual activity".

"I've spoken to mothers who don't want their daughters to have it because they say it encourages 'promiscuity' but that's quite a naive approach to take with this vaccine," she said.

School administrator Mrs Collin said girls needed to know the vaccine would protect them in the future.

Parents, she said, should not be "frightened" of a "safe vaccine" or having conversations about it with their children.

How many girls were not vaccinated?

Girls aged 12 to 13 years are routinely offered the first HPV vaccination when they are in school year eight, with a second dose normally offered six to 12 months later.

Across the UK 354,658 girls born between September 2003 and August 2004 were eligible to have been vaccinated by the end of the 2017-18 school year.

Official figures showed 57,048 - about one in six - had not had the full two doses, while 38,172 of them - just over one in 10 - had not had the first dose either.

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Millions missing smear tests

Between September 2017 and August 2018 a total of 83.8% of girls in year nine in England had received both doses of the vaccinations, according to PHE.

In Scotland 86.6% of girls aged 13 to 14 had been fully vaccinated and in Wales it was 80.3%. In Northern Ireland, where girls are immunised in year 10, the rate was 84.7%.

PHE says vaccinating 80% of girls is the "minimum target" needed to help control HPV in the whole population.

Data for England shows vaccination rates ranged from just under two in three eligible girls in Hammersmith and Fulham to more than nine out of 10 in North Yorkshire.

What is behind the different take-up rates?

Robert Music, chief executive of Jo's Cervical Cancer Trust said there was "wide variation" across England, and although up-take was generally high, authorities should not become "complacent".

He said "cultural barriers and myths" about HPV and the vaccine could contribute to areas having lower up-take rates.

"Connotations that the vaccine encourages or effectively gives permission for children to be sexually active once they are given it can affect parents' intention to vaccinate their daughter," he said.

He said concerns over the safety of the vaccine can have "a very damaging impact".

NHS teams in Brent and Hammersmith and Fulham said language barriers and religious reasons were among reasons for a lower up-take than in other parts of England.

A spokesman for Central and North West NHS Foundation Trust said the areas had a large population of "non-white residents who have different cultural and religious beliefs" and there were "more refusals in these groups of parents".

"If children are not given the second vaccine within the timescale due to absenteeism or sickness we still offer it to them in a later school year but they will not be captured in the figures," the trust said.

He said in some cases parents had refused second doses and children had then left the schools and moved to other areas.

What is the Human Papilloma Virus (HPV)?

•HPV is the name given to a common group of viruses; there are more than 100 types of HPV

•Many women will be with infected with HPV over the course of their lifetime without any ill-effect

•In the vast majority of cases, there will be no symptoms and the infection will clear on its own, but in some cases persistent infection can lead to cervical disease

•Some types of HPV are high risk because they are linked to the development of some cancers

•Other lower risk HPV types can lead to genital warts

•Nearly all cervical cancers (99.7%) are caused by infection from a high risk HPV

•The HPV vaccine protects against four types of HPV which cause around 80% of cervical cancer and the vast majority of genital warts

Source: NHS Choices

Lois Alderson, clinical lead of childhood immunisations for North Yorkshire and York, said some concern was "normal" from parents.

She said health teams ask for consent by post, using online forms and by speaking directly with girls eligible for the vaccine.

Dr Mary Ramsay, head of immunisations at PHE said: "Girls who missed either of their HPV vaccines should speak to their school nurse or GP and arrange to get the vaccine as soon as possible as they remain eligible until their 18th birthday."

PHE intends to extend vaccinations to boys in the same age group.