JCVI recommends single HPV vaccine dose for under 25s

The Government’s immunisation advisory committee has called for healthcare professionals such as school nurses to use only a single dose of the HPV vaccine.

The Joint Committee on Vaccination and Immunisation (JCVI), the Government’s expert scientific advisory panel on matters of vaccination, introduced the new advice after evidence that a single dose can be just as effective as three doses. This overturns the ‘prime-boost paradigm’, which had assumed that HPV vaccination required at least two doses to be effective.

Its final conclusions advised for a one-dose schedule for the routine adolescent programme and men who have sex with men (MSM) programme before the 25th birthday, a two-dose schedule from age 25 in the MSM programme, and a three-dose schedule for individuals who are immunosuppressed and those known to be HIV-positive.

The earliest date that a potential one-dose programme would be implemented is in the academic year 2023/23, although the change must be agreed by UKHSA, NHS England, the Department of Health and Social Care, and the devolved administrations for Scotland, Wales and Northern Ireland, the JCVI said.

Since 2018, the JCVI has been considering evidence on the use of single dose of HPV vaccine and now can finally advise that the switch to a single dose can be made.

HPV vaccines are normally given to male and female children around 12 or 13 to protect them from cervical  and other cancer later in life. Previous advice recommended the use of two doses: a prime and a boost.

The JCVI did acknowledge that a single dose model creates a higher risk of some people missing out on the vaccination if they have not yet had their first dose, and that it would be important to ‘enhance efforts’ to ensure everyone received a dose.

In another statement, the JCVI has also said that ‘including a dose of MenC-containing vaccine (such as MenACWY) in the infant schedule is not recommended’ after discontinuation of Menitorix, which is used to boost protection against Hib and MenC.

Low levels of the invasive meningococcal disease in the community means that there are a low number of cases to prevent.

Currently, vaccination to protect against MenC is given at 12 months (Hib/MenC) and 14 years (MenACWY), but the JCVI now does not believe that a program of infant immunisation would be cost effective.

For protection against Hib, it noted that Menitorix is the fourth dose of a Hib-containing vaccine given in the childhood immunisation schedule.

However, it found that an additional dose of a multivalent Hib-containing vaccine – such as the hexavalent ‘6 in 1’ (DTaP/IPV/Hib/HepB) or pentavalent (DTaP/IPV/Hib) – is likely to be an appropriate choice going forward.