Guest blog post from Julie Bentley (Chief Executive, FPA)

The Guardian reported yesterday that some schools in England have opted out of the human papilloma virus (HPV) cervical cancer vaccination programme for girls on religious grounds. To add insult to injury, most of them are not informing their local GP of this decision, putting another barrier between their female pupils and this potentially life saving vaccination.


Since the introduction of the vaccination programme in late 2008, critics have been wrongly convinced that because HPV is linked to sexual activity, providing a vaccine will promote promiscuity. Rubbish! That's like suggesting cookery classes promote obesity. The vaccine can certainly play an important role in aiding discussion about being sexually responsible, but it can also be given without discussion of HPV transmission at all. When we had our Bacillus Calmette-Guérin BCG vaccinations as teenagers, how many of us were told just how TB is spread?

Some of the schools gave more detail to the media about their reasons behind their decision. One said, “It is not in keeping with the school ethos" though it is apparently in keeping with the ethos to expose girls to pointless and unnecessary health risks. Another school said, “Pupils follow strict Christian principles, marry within their own community and so do not practice sex outside of marriage."

While it may be that the schools hope their pupils won’t have sex outside of marriage, evidence would suggest it is often not the case in real life. As children grow up they develop their own set of beliefs and establish their own moral compasses. That may be to follow the religious path laid down for them, but it may not. To refuse to offer a vaccine that would protect girls from a life threatening illness is at best spectacularly thoughtless, at worst wilfully dangerous. It does not recognise that HPV can be passed on through non penetrative sexual acts such as intimate touching and petting. Neither does this position allow for a young person's independent growth or development. Very importantly it fails to recognise the more sinister circumstances of HPV transmission such as rape or sexual assault. And let’s not forget that it is possible to have sex with just one person, but to still be infected if that one person has the HPV virus – their husband for example.

It cannot be that the deeply held and adhered to religious principles of these schools are so fragile that a simple vaccine could jeopardise them. My experience is that most people of faith are not so blinkered. They want to protect their children physically, through vaccination, and emotionally by bringing them up within their own faith or moral framework. The two are not incompatible.

There is a high likelihood that as girls becomes women some of them will, at some point in their future, be exposed to the HPV virus that puts them at risk of cervical cancer. Is it morally right that they are denied an evidenced based vaccination against a life threatening disease simply because when they were girls, the adults with authority over them didn't feel comfortable with it?

Maybe the expressed conviction that the vaccine is not needed by these young people is actually a fear that offering them it may suggest an alternative perspective on their sexual identity and the relationships they may have in the future. Suddenly it is less about religion or ethos and more about a desire to control women's sexual behaviour.

Whatever the reason, denying girls this vaccination is wrong. Intellectually wrong. Emotionally wrong. Morally wrong.

Why waste the chance?

Last week Brook was extremely disappointed government wasted a significant opportunity to maximise the protection available through the new HPV vaccine programme.  A vaccine offering less protection than another on the market was chosen for a national vaccination programme. Whatever the 'pre determined criteria' the spokesperson for department of health referred to in defence of their decision, young women have been let down with this decision.

We also saw increases in rates of abortion for the first quarter of 2007. Who knows the reasons behind this, hopefully quicker access and better referrals. Both are needed. In February government announced increased investment in contraception. Three months into the financial year professionals are telling me the money isn't reaching contraceptive services in many areas. Didn't we see this with the Choosing Health money for sexual health a few years ago? 

We must not let it happen again. Young people need and deserve good quality support and investment in their sexual health. Chances to make a significant improvements to young people's sexual health cannot be allowed to slip away without those making decisions know we are bothered.

Human Papilloma Virus - the case for a vaccination programme

Yesterday the Health Protection Agency announced new findings that at least 10% of young women have the human papillomavirus by the age of 16. HPV leads to increased risk of cervical cancer in women. We now have a vaccination for HPV which saves lives.

We urge government must urgently implement a vaccination programme for girls and boys before they become sexually active and ensure suffficient resource is available to do so. A key human resource is of course the school nurse, part of our workforce so badly affected by the NHS deficit and a service seriously underfunded.

Most times I speak to school nurses, they are compassionate, passionate about public health and desperate to do more, to have more opportunities to build genuine relationships with children and young people, rather than a snatched moment here and there as they rush from duty to duty, school to school. Dialogue about implementing a HPV vaccination programme will necessarily involve dialogue about how to ensure there are enough school nurses, with enough resource to do the job. And I sincerely hope the opportunity will be taken to ensure serious conversation about the wider role of the school nurse in promoting children and young people's public health as well.

Finally, a vaccination programme is not a universal panacea, it is only part of the solution. It must be backed up with proper education about sex and relationships, opportunties for children and young people to develop skills, hopes and aspirations and a change in culture so young people expect much from the relationships and sex they choose to have.

The case for vaccinating girls against HPV

A new study published in the Lancet today has strengthened the already convincing evidence that vaccinating girls and young women against the human papilloma virus that causes cervical cancer is important. The combined results of four trials across the world show the vaccine is 99% effective for girls who have never had sex.

So, we have a vaccine that saves lives. This vaccine is a major scientific breakthrough and it is much more effective if we vaccinate young women before they become sexually active. No arguments then - ensuring universal access to the vaccination is scientifically and morally the right thing to do. My guess is most people would agree. Despite this there is a minority voice that argues vaccinating children is likely to encourage earlier sexual activity. This assertion is no more rooted in fact or evidence than the well refuted claim that sex and relationships education does the same.

Like sex and relationships education however, the vaccination is not a universal panacea. It must be administered in a macro and micro cultural context where emotional literacy and competence is developed, sex and relationships are talked about honestly; where young people learn that trust within relationships is important and they have rights to make choices about the sex they do or don’t choose to have.