In the UK, the government has chosen the vaccine Cervarix for their human papillomavirus (HPV) vaccination program.

But actual UK doctors choose Gardisal for their own children, says Phil Hammond, general practitioner, writer, and broadcaster, on bmj.com today.

The reason has nothing to do with the effectiveness of either vaccine, but rather with genital warts.    "You’d be mad not to protect your daughter against genital warts if you can afford to." he quotes Peter Greenhouse, a sexual health consultant, as saying.   

The genital warts lobby is largely undercover, he says, "but if it was breast cancer, there would doubtless be an industry supported march on Downing Street…There are no letters to the Times, and warts have never made it to the cover of the Mail."

Both vaccines are equally effective against the strains of HPV that result in 70 percent of cervical cancers .   Gardisal also protects against 90% of genital warts.

With 100 000 new cases of genital warts in England each year and condoms only reducing transmission by up to 50%, the far safer option is to vaccinate with Gardisal, argues Hammond.  But, although Gardasil is available privately to parents, at a cost of £350 to £400, most will not be able to afford it.

According to Hammond, with the current cost of treating genital warts estimated to be £23 million in the UK, the government's decision may be a false economy. Within three or four years the use of Gardasil would have begun to have a considerable financial payback. 

The government's cheap deal for Cervarix only applies to the vaccination program. The fact is that most doctors would recommend Gardasil because of the extra protection it offers, he writes.  And since they can afford it, they vote with their wallets.

In addition, he argues that there has been a glaring lack of patient choice. Having chosen one vaccine for patients, the government has failed to provide information on the other vaccine, which is given no mention on the NHS Choices website or on the NHS vaccination site.

He believes that for any licensed treatment, the public should be given quick and easy access to unbiased information on efficacy and safety.