Our news

Following last week's exciting news from Queen Mary University of London that appears to show the HPV vaccine has all but eliminated cervical cancer deaths in young women in England, Dr Alexandra Lawrence, consultant gynaecological oncologist at The Royal London Hospital, answers some of the most common questions people are asking about the HPV vaccine, and what that means for our communities living in north east London.

What is your reaction to the new study?

I think it's amazing. This is the first time in public health we've ever thought about eliminating a cancer. We've eliminated smallpox and polio in the past, but eliminating a cancer is a whole new ball game, so I think this is a major breakthrough.

We've known for a while that the vaccine was going to be very good at reducing precancerous changes on the cervix, but this is real world evidence that it is working, and working on a national level, and it's incredibly exciting.

What is ‘HPV’ and how do you get it?

HPV (Human papillomavirus) is a very common, sexually acquired infection. It's spread through skin-to-skin contact, so genitals to genitals, genitals to mouth, mouth to genitals, and it's very easy to catch.

There are two types of HPV. There's low-risk HPV, which can cause genital warts. Then there’s the high-risk one, which you wouldn't know you had until you develop an abnormal cervical screen, or symptoms of cancer. HPV can cause cervical, anal, penile, head and neck cancers. It's chance whether you catch the high-risk or low-risk type, or you can get both. There are over 200 different strains of HPV, of which 13 are high risk types with type 16 and 18 being responsible for over 70% of cervical cancers globally.

What is the HPV vaccine and when is it offered?

HPV is a preventable condition, and the vaccine protects against nine different types of HPV, including seven of the high-risk types that cause cancer and the two low-risk types that cause the majority of genital warts.

It's offered to every child, girls and boys, aged 12 to 13, in year 8 at school. The idea is to vaccinate before children have been sexually active, since the younger you have the vaccination, the more likely you are to have enduring immunity. In the UK, girls started receiving the vaccination in 2008, and boys in 2019. If you're home schooled, you can get it through your community vaccination programme instead.

Is the HPV vaccine safe?

The vaccine is safe. It is a vaccine that's been trialled across the whole of the population of England. Girls aged 12 or 13 have been vaccinated for 18 years, so we've got really robust, long-term follow-up data. Apart from the chance of having a sore arm and a headache at the time of vaccination, there are no other risks that have been documented with this vaccine, so we know it's really safe. Eighteen years is a long time to follow people up, so I think we don't need to be worried.

If someone's vaccinated for HPV, do they still need cervical screening?

Absolutely, because no vaccine is 100% effective. Some people are still going to develop HPV even if they've been vaccinated. So if you are one of the unfortunate people that does get HPV, we would be able to pick it up with cervical screening and treat precancerous cells before they ever turn into cancer.

Why are some people hesitant for their children to receive the HPV vaccine?

Nationally, HPV vaccine coverage has fallen since the pandemic, and uptake in London is now the lowest of any region in England. In the most recent data, just 63.8% of girls and 59.7% of boys in year 8 had been vaccinated in London, compared with 71.7% of girls and 67.0% of boys across England as a whole.

In my experience, the main reason parents are hesitant around the HPV vaccination is this belief that, if their children, particularly their girls, are vaccinated, that's saying it's okay for them to go and have sex because they're now protected. There's no evidence to suggest women become any more promiscuous or start having sex earlier if they've been vaccinated. This is a myth and would be really good to dispel. As we observe universally with vaccines, there is a lot of misinformation around safety which means more people are hesitant to take it up.

What is the situation for communities living in north east London?

We've got a very mobile population in north east London that migrate from other places. Some women move to London from countries that don’t offer HPV vaccination or cervical screening, so they're at higher risk of developing cervical cancer. It's even more important that they access cervical screening when they arrive, so we can pick up precancerous changes.

North east London is also a unique region, home to a wonderfully diverse population. We know that some communities are more hesitant to take up vaccines, often because of past experiences of discrimination within healthcare, language barriers, or limited access to clear, trusted information. Vaccine hesitancy isn't unique to any one group, but these barriers can affect some communities more than others. What we've found is that when people are properly supported and the programme is explained clearly, in a way that respects their concerns, they're reassured and happy to go ahead.

What's being done locally to encourage uptake of the HPV vaccine in north east London?

I'm chair of the Gynaecological Expert Reference Group at the North East London Cancer Alliance, and we're running two projects to help boost vaccine uptake here.

The first targets 16 to 25-year-olds who missed the vaccine at school . My colleague Sherrice Weekes has been visiting university freshers' fairs and colleges across the region to encourage young people to request the vaccine from their GP.

The second is aimed at gay, bisexual, and other men who have sex with men up to the age of 45 , who are at higher risk of HPV. We've worked with the charity The LoveTank to develop a webpage and booklet with information about HPV and the vaccine, and we're running a series of "Under the Radar" events, where men can be vaccinated discreetly without needing to attend a sexual health clinic.

Where should people go if they want to receive the vaccine or are seeking more information?

The HPV vaccine is recommended for children aged 12 to 13, usually offered in year 8 at secondary school. If you're 24 or under and have missed it, you can still get it for free by contacting your GP or school nurse. For full advice on the HPV vaccine, including eligibility and how to get it, visit nelcanceralliance.nhs.uk/hpv-vaccine.

The vaccine is also recommended for people at higher risk of HPV, including sex workers, people with HIV, and men who have sex with men. People in these groups, and anyone accessing sexual health services in north east London, can speak to All East ( alleast.nhs.uk ), Barts Health's sexual health service, about vaccination. For gay, bisexual, and other men who have sex with men up to the age of 45, queerhealth.info/hpv has information about the vaccine.

If cervical screening feels difficult because of a previous trauma, including sexual assault, Barts Health's My Body Back clinic ( mybodybackproject.com ) offers trauma-informed cervical screening within our sexual health service, alongside other support tailored to survivors. The clinic has supported survivors in north east London for ten years, and appointments are designed to feel calm, safe, and on the survivor's own terms.