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"9. HPV 

The committee was informed that DH had announced that PCTs were 

encouraged to accelerate the HPV catch-up programme in England.  This 

acceleration will enable the girls already identified for the catch-up programme to 

be offered protection earlier.  At the end of January, the Department had 

provided further details to PCTs on this acceleration of the HPV programme.  DH 

will be providing additional assistance to PCTs to support the extra work involved 

in accelerating the catch-up programme. 

The committee was provided with an update on vaccine uptake. 

Vaccine uptake in England 

Vaccine uptake information is supplied by each of the 152 PCTs and provisional 

data is submitted monthly using the Health Protection Informatics (HPI) website.  

Annual coverage data will be collected in September 2009.

Approximately 83% of 12 to 13 year olds received their first dose of vaccine by 

the end of January; approximately 73% of 12 to 13 year olds in those PCTs have 

also received a second dose. 

Approximately 32% of 17-18 year olds received their first dose.   

The total number of doses administered so far is around 656,000. 

46 PCTs achieved a first dose uptake of over 90% of 12 to 13 year olds, with a 

further 62 achieving over 80%.  This means that 71% of PCTs have achieved 

over 80% first dose uptake amongst 12 to 13 year olds by the end of December 

2008.   

Vaccine uptake for first dose of HPV is expected to rise as the last of the PCTs 

finish their first dose cohorts. 

The Department continues to support the HPV programme through a national 

advertising campaign. The next wave of advertising and PR will run in April and 

May this year and aims to remind girls and their mothers that the programme 

comprises of three doses and that all three vaccinations are needed for full 

protection.  Post campaign research recently conducted among parents and girls 

suggests that both have been very positive about their HPV vaccination 

experience.  There was evidence that some girls aged 17-18 years were delaying 

their vaccination with common reasons being low awareness of cervical cancer 

and the importance of HPV vaccination, concern about needles and the 

vaccination itself and the effort required to book an appointment. 

Vaccine uptake in Scotland 

The committee was informed that provisional first dose HPV vaccine uptake in 

Scotland was 92.5% and second dose uptake was 81.8% for girls aged 12 to 13 

years (school year S2 in Scotland).  Uptake for the other two school years (S5 

and S6) for girls aged 15 to 17 years old is in the high 80%s and for the second 

dose is mid to high 70%s.  Alternative community models are being used to 

target girls who are in the eligible cohorts and are out of the school system. 

Vaccine uptake in Wales 

The committee was informed that uptake for the first dose of HPV vaccines in 

girls in school year eight was 87.9%.  Over half of all local health boards have a 

first dose uptake of over 90%.  Provisional uptake of the second dose of HPV 

vaccine was 74.4%; because immunisation sessions and data entry are still in 

progress at the time of the meeting, this figure is expected to rise. 

Vaccine uptake in Northern Ireland 

The committee was informed that vaccine uptake at 30 November 2008 for 

Northern Ireland was 89% for the first dose and 67% for the second dose. 

Vaccine safety 

The MHRA provided an update on the proactive pharmacovigilance plan in place 

in the UK for Cervarix vaccine.  The MHRA study yellow card reports on a daily 

basis in order to assess the seriousness of each case and determine if follow-up 

is required.  The findings are published each week on their website: 

http://www.mhra.gov.uk/hpvvaccine 

MHRA is working closely with colleagues in the Health Protection Agency in 

compiling information on reported serious adverse reactions and comparing them 

to expected background incidence rates (stratified by age, gender and season) 

using the general practice research database (GPRD).  The data provide 

information on whether there is an increase in any adverse reaction over and 

above what would be expected within the population for that age group. 

Using these background rates and estimates of vaccine exposure provided by 

DH, MHRA is performing observed versus expected analyses of any reported 

‘events of interest’ on a continuous weekly basis.  

Individual cases of adverse reactions are placed into one of five categories; i.e. 

injection-site reactions; allergic reactions; ‘psychogenic’ events; ‘other 

recognised’ reactions; and ‘suspected adverse reactions not currently 

recognised’.  There have been several clusters of convulsions, loss of diabetic 

control and lymphadenopathy.  There have also been two cases of Guillain Barré 

syndrome and one case of Bell’s Palsy.  Taking into account the number of 

vaccine doses that have been administered so far these cases are not likely to be 

linked to the vaccination as they fall within expected rates for these conditions. 

The MHRA noted that, to date, no significant new safety issues have been 

identified during worldwide use of Cervarix and no new undesirable effects have 

been added to the Summary of Product Characteristics (SPC) since licensure. 

The committee felt that this process was open, helpful, and balanced and would 

help to reassure people that the safety aspects were being carefully monitored. "