521929
research-article2014
RSH0010.1177/1757913914521929Letter To The EditorLetter To The Editor
Letter To The Editor
Dear Editor, It was good to see a discussion on the option of including boys in the human papillomavirus (HPV) vaccination programme in Michelle Russell et al.’s article in the November issue of Perspectives.1 But the authors’ conclusions about this were too cautious in light of the mounting evidence for vaccinating both sexes. This evidence has led to the advocacy of vaccination of boys by the 22 patient and professional organisations, including the Royal Society for Public Health, that have joined together as HPV Action, as well as by Cancer Research UK, the Faculty of Public Health and the British Dental Association. Boys are now being routinely vaccinated in Australia and two Canadian provinces, and vaccination is also recommended by the Centers for Disease Control in the United States and the World Medical Association. Vaccinating boys would increase the protection of females from cervical, vaginal and vulval cancers (especially in communities where vaccination rates are relatively low), of males from penile cancer and of both sexes from head, neck and anal cancers, genital warts and recurrent respiratory papillomatosis. Vaccination is particularly important for men who have sex with men (MSM), for whom anal cancer is a rapidly increasing problem because they do not benefit from the ‘herd protection’ created by a female-only vaccination programme. Men with HPV are also more likely to become infected with HIV. But it is not feasible to vaccinate just MSM because a programme would be unlikely to reach most of this population and, more importantly, because optimal protection occurs only if vaccination is administered before sexual debut. It would be both practically and ethically impossible to target MSM at the age of 12 or 13. Recent research on the impact of female HPV vaccination on the incidence of genital warts also suggests that the
benefits of herd protection for men who have sex with women may have been exaggerated in countries, like the United Kingdom, where many men have sexual relationships with unvaccinated women from elsewhere.2 HPV Action believes that the additional short-term costs of vaccinating boys will be outweighed by the longer term savings in the treatment of cancers and genital warts, as well as in the fields of welfare benefits, social care budgets and employers’ costs. The cost-effectiveness of vaccinating boys, even when the uptake of vaccination by girls is at levels similar to the United Kingdom, was confirmed by the Pharmaceutical Benefits Advisory Committee in Australia. The costs of vaccination may in any event be significantly reduced if it is established that a two-dose vaccination programme is as effective as the three doses currently administered in the United Kingdom. HPV Action does not believe that the decision to introduce gender-neutral vaccination should be made primarily on a financial basis; however, the opportunities for improving public health, tackling inequalities and reducing suffering provide, on their own, an overwhelming and decisive argument.3 Peter Baker, FRSPH Campaign Director, HPV Action
References 1. Russell M, Raheja V, Jaiyesimi R. Human papillomavirus vaccination in adolescence. Perspectives in Public Health 2013; 133(6): 320–4. 2. Baandrup L, Blomberg M, Dehlendorff C, Sand C, Andersen KK, Kjaer SK. Significant decrease in the incidence of genital warts in young Danish women after implementation of a national human papillomavirus vaccination program. Sexually Transmitted Diseases 2013; 40(2): 130–5. 3. HPV Action. It’s Time to Vaccinate Boys Too: The Case for Gender-Neutral HPV Vaccination. November 2013. Available online at: http://www.hpvaction. org/uploads/1/7/8/5/17850843/hpv_action.case_for_action.pdf (Last accessed 13th December 2013).
Unemployed young face mental health risk A new The Prince’s Trust Macquarie Youth Index report has revealed that more than 750,000 young people out of work are experiencing mental health symptoms including panic attacks, feelings of self-loathing and believing there is nothing to live for, as a direct impact of unemployment. The report also revealed that long-term unemployed people were more than twice as likely to have been prescribed antidepressants in the past than their working counterparts, with 32% having contemplated suicide in the past and 72% saying that they don’t have anyone to confide in. As a result, The Prince’s Trust is now calling on the government, health agencies and employers to help contribute to the work they do to help these young people who are trying to cope with mental illnesses, and they hope to help more people into work in the future. Three out of every four people that The Prince’s Trust is able to help move into education, training or work afterwards. Martina Milburn, Chief Executive of The Prince’s Trust, stated that “more than 430,000 young people are facing long-term unemployment, and it is these young people that urgently need our help. If we fail to act, there is a real danger that these young people will become hopeless, as well as jobless”. With research such as this now available, youth unemployment is becoming a public health issue and is one that experts are calling for to be solved sooner rather than later. For more information: www.princes-trust.org.uk/youthindex
62 Perspectives in Public Health l March 2014 Vol 134 No 2 Downloaded from rsh.sagepub.com at UNIV CALIFORNIA SANTA BARBARA on July 1, 2015
research-article2014
RSH0010.1177/1757913914521929Letter To The EditorLetter To The Editor
Letter To The Editor
Dear Editor, It was good to see a discussion on the option of including boys in the human papillomavirus (HPV) vaccination programme in Michelle Russell et al.’s article in the November issue of Perspectives.1 But the authors’ conclusions about this were too cautious in light of the mounting evidence for vaccinating both sexes. This evidence has led to the advocacy of vaccination of boys by the 22 patient and professional organisations, including the Royal Society for Public Health, that have joined together as HPV Action, as well as by Cancer Research UK, the Faculty of Public Health and the British Dental Association. Boys are now being routinely vaccinated in Australia and two Canadian provinces, and vaccination is also recommended by the Centers for Disease Control in the United States and the World Medical Association. Vaccinating boys would increase the protection of females from cervical, vaginal and vulval cancers (especially in communities where vaccination rates are relatively low), of males from penile cancer and of both sexes from head, neck and anal cancers, genital warts and recurrent respiratory papillomatosis. Vaccination is particularly important for men who have sex with men (MSM), for whom anal cancer is a rapidly increasing problem because they do not benefit from the ‘herd protection’ created by a female-only vaccination programme. Men with HPV are also more likely to become infected with HIV. But it is not feasible to vaccinate just MSM because a programme would be unlikely to reach most of this population and, more importantly, because optimal protection occurs only if vaccination is administered before sexual debut. It would be both practically and ethically impossible to target MSM at the age of 12 or 13. Recent research on the impact of female HPV vaccination on the incidence of genital warts also suggests that the
benefits of herd protection for men who have sex with women may have been exaggerated in countries, like the United Kingdom, where many men have sexual relationships with unvaccinated women from elsewhere.2 HPV Action believes that the additional short-term costs of vaccinating boys will be outweighed by the longer term savings in the treatment of cancers and genital warts, as well as in the fields of welfare benefits, social care budgets and employers’ costs. The cost-effectiveness of vaccinating boys, even when the uptake of vaccination by girls is at levels similar to the United Kingdom, was confirmed by the Pharmaceutical Benefits Advisory Committee in Australia. The costs of vaccination may in any event be significantly reduced if it is established that a two-dose vaccination programme is as effective as the three doses currently administered in the United Kingdom. HPV Action does not believe that the decision to introduce gender-neutral vaccination should be made primarily on a financial basis; however, the opportunities for improving public health, tackling inequalities and reducing suffering provide, on their own, an overwhelming and decisive argument.3 Peter Baker, FRSPH Campaign Director, HPV Action
References 1. Russell M, Raheja V, Jaiyesimi R. Human papillomavirus vaccination in adolescence. Perspectives in Public Health 2013; 133(6): 320–4. 2. Baandrup L, Blomberg M, Dehlendorff C, Sand C, Andersen KK, Kjaer SK. Significant decrease in the incidence of genital warts in young Danish women after implementation of a national human papillomavirus vaccination program. Sexually Transmitted Diseases 2013; 40(2): 130–5. 3. HPV Action. It’s Time to Vaccinate Boys Too: The Case for Gender-Neutral HPV Vaccination. November 2013. Available online at: http://www.hpvaction. org/uploads/1/7/8/5/17850843/hpv_action.case_for_action.pdf (Last accessed 13th December 2013).
Unemployed young face mental health risk A new The Prince’s Trust Macquarie Youth Index report has revealed that more than 750,000 young people out of work are experiencing mental health symptoms including panic attacks, feelings of self-loathing and believing there is nothing to live for, as a direct impact of unemployment. The report also revealed that long-term unemployed people were more than twice as likely to have been prescribed antidepressants in the past than their working counterparts, with 32% having contemplated suicide in the past and 72% saying that they don’t have anyone to confide in. As a result, The Prince’s Trust is now calling on the government, health agencies and employers to help contribute to the work they do to help these young people who are trying to cope with mental illnesses, and they hope to help more people into work in the future. Three out of every four people that The Prince’s Trust is able to help move into education, training or work afterwards. Martina Milburn, Chief Executive of The Prince’s Trust, stated that “more than 430,000 young people are facing long-term unemployment, and it is these young people that urgently need our help. If we fail to act, there is a real danger that these young people will become hopeless, as well as jobless”. With research such as this now available, youth unemployment is becoming a public health issue and is one that experts are calling for to be solved sooner rather than later. For more information: www.princes-trust.org.uk/youthindex
62 Perspectives in Public Health l March 2014 Vol 134 No 2 Downloaded from rsh.sagepub.com at UNIV CALIFORNIA SANTA BARBARA on July 1, 2015
