To not make my son have his vaccine?

Honestly HPV in a boy I would be tempted to leave it.
I am very much in favour of universal HPV vaccination but one reason universal vaccination coverage is important is to protect those that can't be vaccinated.
In a few years hopefully HPV will be at very low levels and his risk will be low.

The only issue is setting a precedent and making it harder for any future jabs

Provide as much appropriate information as you can.
Ask the GP if they have anyone available to talk with him that understands autism.
Look into what could be stopping him. Is it physical touch, is it the unknown, is it a communication or understanding thing. Don’t assume and don’t put words into his mouth.

Is there anything you can bribe him with?

Even if that were to be true (which someone else has addressed), it still leaves women at risk if a male is having unprotected intimate moments.

We get a prescription for those numbing plasters before he has an appointment. I also schedule it for the day when he has his most disliked subjects at school. Then I tell him he needs to have it done and why, remind him of other vaccinations he's had and that it went ok. Then he tries to bargain that if he has it done he gets the day of school. I answer that we'll discuss that afterwards and that he needs to be brave and let the doctor give it to him without making a fuss. If he doesn't let the doctor do it, he's got to go straight back to school. Then once it's done, I let him have the rest of the day off.

Same age as your DS, has been pinned down before, but he's too big and strong now and the doctor would was very clear he had to agree to having it done.

My five year old is needle phobic. Unfortunately he has a very serious illness which means he has to have needles every month. It's hell but he needs it to be healthy (and alive). I know it hard but you be the adult here. Bribery will work just fine the key, there will be something he wants

I think Gillick competence dates back to the 1980s

Explain why it is important to have it. Whilst I doubt he'll be known to your son, the comedian Mark Steel is currently recovering from cancer caused by HPV, he talked about it on his podcast.

Just tell him to suck it up it will be fine, when did these become children's decision.

Is he demand avoidant?

The nurse used the buzzy bee device at my son’s college, he’s ASD plus anxiety about anything like that. He didn’t feel any pain with it. There’s also numbing gels, ice packs, distraction techniques etc… which can be used too. My son hates the thought of anything like that, but he also has anxiety over being ill, a bit of a hypochondriac, so I just have to persuade him that the disease is worse than the immunisation. But anyway for him this Buzzy device worked brilliantly. It was the thought of being painful that he didn’t like rather than being immunised.

I don't remember anything before I was almost three. It's a bit different to 13.

@Funkytuna would he try the numbing cream? You could put it on him as a test run and he could poke the numb bit himself to see if it is working.

DS has had to have a fair few blood tests and developed a fear of the pain- but with the cream he said just felt like a tickle and he says he is totally relaxed about needing anymore now.

I'm afraid you can't force him

I watched my cousin's deal with their dad going through a HPV related cancer and yet the youngest as far as I know is still refusing to have her HPV vaccine. She's seen the repercussions and her dad going through tough chemo so if anyone would have had the vaccine you think she would have....

@S0livagant Healthcare professionals involved in treating head and neck cancers (those treating anal/rectal cancers as well) campaigned for years for boys to also receive the HPV vaccine. There were increasing numbers of HPV driven oral cancers being detected which is why so many of these healthcare professionals were paying to have their sons vaccinated as well prior to it being offered by the NHS.

In saying that there isn’t anything you can do to force him to have the vaccine and no doctor/nurse is going to hold him down to have the vaccine. Even if he isn’t Gillick competent no one is going to assess the risk of possible cancer in the future would outweigh the trauma and lasting fear of medical treatment by holding him down.

I think try and get him to articulate (or write down) what he is worried about but remember fears are not logical. I’d try and explore getting some help (not sure from where on the NHS) as he is likely to need medical tests/treatment at some point that will be more pressing so trying to get him happier now would be worth the time. Good luck I hope you find a solution.

There is no fixed age, but in practice it's the stage of a typical 13 year so he is unlikely to be at that point.
Children 12 and under - there is no lower age limit for Gillick competence or Fraser guidelines to be applied. It would rarely be appropriate or safe for a child to consent to advice/intervention/treatment without parental consent.

I wouldn’t say my 7 year old asd+adhd son was gillick competent, but when he screamed and ran away every time the nurse tried to do the flu nasal spray she said she wasn’t prepared to do it. I said can you if I hold him still? (Which I usually wouldn’t do but he is clinically vulnerable and has a genetic disorder so I really really wanted him to have it)- she said no.

I'm thinking numbing gel but maybe also some hypnobirthing style techniques and affirmation work? Would that be something you think he could engage with?

You can get numbing gel. I found it helped my son psychologically to believe it wouldn't hurt.

Ask him what he remembers about having his baby vaccines.

I feel for him, it's really hard. I had a bad needle phobia growing up (not being able to sleep for weeks, endless crying and vomiting on the day, etc etc). I only pushed myself to get the vaccines as my mother would pile on the guilt and fear of something worse happening - which definitely did not help my health anxiety. She would usually trick me / not tell me it was going to happen, and once she got the doctor to come to our house unannounced - very much do not recommend!!

When I was around 20 something I decided to have therapy for the needle phobia and it is honestly the best thing I've ever done. It sorted the needle fear, and hugely helped with my health anxiety and confidence in general. It was a combination of CBT, and exposure therapy once a week for +/- 6 months. I imagine a practitioner with experience of ND patients would be best so they can tailor their approach.

I've also found these, but haven't tried them yet - https://www.buzzy4shots.co.uk/

Male cancers associated with HPV are rare. Most men will clear the virus without any health problems. I would leave it up to him.

I mean the practical question here is is he Gillick competent? If he is then he can refuse and no one can stop him. If he isn't then I think the doctors can agree it's in his best interests and give it to him anyway.

Being Gillick competent essentially means being adequately able to weigh up the risks and benefits so there is no set age and the age for even a single child will vary from procedure to procedure depending on the complexity.