Comment by stared
1 month ago
I would like to add:
- HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. Unless you plan to remain completely celibate, you are likely to contract a strain.
- Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive. While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/
- HPV16 is responsible for a large number of throat cancers (around 50% in smokers and 80% in non-smokers!). This affects both men and women. Vaccinating men is important for their own safety and to reduce transmission to their partners.
> Unless you plan to remain completely celibate
You can get HPV without sex too.
https://www.cdc.gov/sti/about/about-genital-hpv-infection.ht...
"HPV is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex"
This focuses on sex, but any virus that can be found on skin, also has a chance to be transmitted without sex just as well. Admittedly the chance here for HPV infection is much higher with regard to sex, but not non-zero otherwise. The HeLa cells also contain a HPV virus in the genome, though this was probably transmitted via sex:
"The cells are characterized to contain human papillomavirus 18 (HPV-18)"
HPV-18. I think HPV-18 may in general be more prevalent than HPV-16.
> also has a chance to be transmitted without sex just as well. Admittedly the chance here for HPV infection is much higher with regard to sex, but not non-zero otherwise
So, NOT in fact “just as well”.
Foot warts are HPV, like from the Gym locker room
Armpit skin tags also seem to be related to some HPV strains: https://en.wikipedia.org/wiki/Skin_tag
But they are not HPV16/18 and so not covered by this vaccine.
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>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives.
This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common.
But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gardasil-9, which I took as a male at age 35) protects against nine specific strains.
Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body).
People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case!
Does the vaccine guarantee immunity, by contrast?
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> This statistic seems to be used by some people to avoid the vaccine
The FDA itself restricted access to the vaccine on the basis of age. Given that virions aren't even involved in the production process, its safety should have been deemed good enough for the entire population early on.
The reason it's not recommended for all ages is money. Not safety concerns.
Same reason you can't get Shingrix under a certain age.
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They also did it by gender in the US when I was in college. Boys could not get it. At the same time that Europe was vaccinating everyone.
That’s not how drug approvals work. You don’t make assumptions about safety, you make decisions based on data.
The original trials were for a specific population - no prior HPV infection, young women. Hence the approval was for that population.
Additional trials have been run expanding the population, but the decision was based on data not “yeah, I’ll bet this is safe/works for this other group”
>>>>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. >> This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common.
As people cite these statistics, it would be useful to distinguish exposure to HPV causing foot warts, etc from the much more dangerous variants. I rarely see any statistics do this sort of segmentation.
> I rarely see any statistics do this sort of segmentation.
There are multiple publications. THe easiest way to find is Gemini 3 Pro or ChatGPT Thinking + find for publications (go to link, not just rely on summary).
They differ by population and methodology. For example, here is "Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia", 2023, https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/
I mostly hear this from healthcare-fatalists arguing against people in their 40s+ getting the vaccine later in life.
What about the people who know they have 16 or 18? Should they still get it?
Yes. It would still protect you from the other strains and reduce risks of reinfection by the strains you already have, which is the main issue preventing your immune system from clearing the infection up by itself
https://www.sciencedirect.com/science/article/pii/S0264410X2...
Yeah, I only read the abstract and looked at the plots, but this is what I hate about public health papers:
They say the prevalence of virus is down. They don't say that the cancer rate is down (granted too early to tell), nor do they talk about any adverse events or all cause mortality differences (again, probably too early to tell)
The only thing they can conclude is that the treatment given to stop the virus, stops the virus. But they don't mention any tradeoffs.
Not trying to be an anti-vaxxer conspiracy theorist, but good science needs to talk about the whole picture.
This is one research paper reporting on particular results.
It is DEFINITELY not too early to tell. Cervical cancer rates in Australia, which adopted the vaccine widely and early have decreased, and it has been widely reported ( https://www.canceraustralia.gov.au/cancer-types/cervical-can... )
Research papers are not literature reviews. This paper reports on the results of this study. And that study only investigated what it investigated.
In the case of public health, there are a bunch of organizations that keep on top of the research and maintain a more comprehensive view of their perception of the current consensus.
For day to day guidance, individuals should be referring to either those sources, or healthcare professionals.
If people are looking at individual studies like this to make decisions, something has gone very wrong.
You can’t talk about the whole picture unless you have all the parts. There’s no reason all of those parts have to come from the same study.
The first thing on your list of complaints is something that by your own admission cannot yet be determined. If you’re not trying to be an anti-vaxxer, you’re doing a bad job of it.
For those men wondering whether they should get vaccinated:
- HPV causes genital warts, HPV is permanent, doctors won't test you for HPV unless you demand it, and the tests aren't reliable, which is why they literally won't diagnose you unless you already have genital warts.
- Once you are confirmed HPV positive (again, you won't be confirmed without getting genital warts), you need to inform your partners, as it causes cancer in both men and women (but mostly women).
You are giving some honestly really bad and dangerous info.
The HPV strains that cause cancer and the ones that cause genital warts are different. The strains that cause cancer do not cause warts.
So you can very much have HPV without genital warts.
And conversely, while having genital warts tells you you are infected with the low risk strains, it does not guarantee you that it is the only strain you are carrying.
Thus you cannot rely on the presence of genital warts to know if you are or are not infected with the high risk strains, they are completely uncorellated.
The cancer-causing strains cause no symptoms and can only be detected by getting tested for them.
You're putting words and assumptions in my mouth that I never said in my comment. My comment includes different facts about different strains, in one comment, which some people might misinterpret. Your reply is re-stating the facts in more detail, so that's fine, I am happy for anyone to clarify information. However, the assigning of bad faith and action to me just because you don't like the way I presented the facts, is pretty rude. If you want to get really specific, we should probably clarify to the readers these statements you made:
> The cancer-causing strains cause no symptoms and can only be detected by getting tested for them
Cancer-causing strains can still cause the following symptoms: persistent sore throat, lumps, pain when swallowing, earaches (one-sided), swollen lymph nodes in the neck (painless lump), painful/difficult urination or bowel movements, unusual lumps or sores, or unexplained weight loss, in addition to others I have not listed here. However, early cancers often do not present symptoms.
> and can only be detected by getting tested for them
There is no test that covers all strains. You would need to get penile brushing, urethral brushing, semen samples, and anal pap smear. So "getting tested" is not the only solution, and getting regular scans for cancer is the best detection method. Therefore there is more involved than you have indicated, making your own comment as ;really bad and dangerous' as mine.
Perhaps we should trust people to do their own research and ask their doctor, rather than only listen to randos on the internet?
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You missed three very important caveats that complicate the story you’re trying to tell:
1) not every strain of HPV causes cancer (iirc, the bad ones are rare).
2) many people (in fact, most people) who are active in the world have been infected with at least one strain of HPV.
3) it’s common to have asymptomatic HPV infections. you probably have one now.
one more:
4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman).
Overall, it’s a situation where you’re asking that sexual partners “disclose” something that the partner probably already has, if they bothered to be tested for it to begin with. Moreover, nobody does these tests (in men, at least), because there’s no point to doing them, other than creating anxiety.
I will leave the nuances of bioethics to other people, but it’s not as clear a situation as you’re making it out to be.
One final thing: these infections aren’t “permanent”. They generally clear naturally in a few years.
> 4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman).
This guidance is changing. Vaccinating men protects women. Also just because you were infected with one strain, that doesn't mean you can't contract another, possibly oncogenic one. Get vaccinated, it protects against the most common cancer-causing strains. I did, why would I want to unknowingly give someone cancer?
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Does it not prevent cancer in the throat in men? Not sure why that would be women only.
The situation is pretty clear when you're a woman who got cancer from her boyfriend who knew he had HPV and didn't tell her, or didn't get vaccinated because he didn't feel like it. I think most people would want to avoid that situation. The genital warts thing is just embarrassing but another good-enough reason to get vaccinated early.
On Permanence: 10-20% of HPV infections either don't go away, or go dormant and recur throughout your lifetime. These strains are the ones likely to cause cancer. Low-risk ones cause genital warts that continue causing warts throughout your lifetime. High-risk ones may cause cancer.
The vaccine is available up until 45 years old. Worst case it does nothing, best case it prevents genital warts and cancer.
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#4, anything that reduces cancer risk is a plus in my book, regardless to time and gender
I, a male, got vaccinated with the Gardasil 9 vaccine shortly before turning 40. Convincing my doctor to prescribe it wasn't terribly difficult, I told them a few things about my sexual history and explained some of my sexual plans, and that was that.
I wish more people would get vaccinated.
That is terribly difficult. Why the hell do I have to make an appointment weeks in advance, then take time out of my day just to get permission from some asshole who asks about my sexual history? Why can't I just walk up to the counter, say "I'll take one HPV vaccine please" and pay the money? If you want me to get vaccinated make it easy.
You can make an appointment at eg Walgreens (and probably also CVS) and pay out of pocket for the Gardasil-9 HPV vaccination without any consultation with or referral from a GP (General Practitioner) or a Specialist.
Gardasil https://en.wikipedia.org/wiki/Gardasil
https://www.google.com/search?q=gardasil+shot+cost
https://www.goodrx.com/gardasil-9/how-much-is-gardasil-witho... :
> When you have your first shot is the main factor that determines whether you will need 2 doses or 3 doses
> Without insurance, the average price of 1 dose of Gardasil is $368.82. But you could pay as little as $169.50 with a GoodRx coupon at certain pharmacies
A prescription is only required for insurance reimbursement fwiu
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Because we over-rely on insurance for routine medical care, when really insurance should just be reserved for the catastrophic and everything else out of pocket (and/or directly subsidized).
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My GP just offered it during my physical along with the flu and COVID booster. I declined the COVID booster since I had just gotten a mild case a couple months back. Got two shots in the left arm, was sore for a day and that was that.
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This is why you have to go to the grey market for medical stuff in the USA anymore. Every rich celebrety, and women with body dysmorphia knows how easy it is to get GLP-1s right now. Good and thank goodness for it.
Deregulating medical systems regarding patient choice and access to drugs is good, but you'll eventually get some bootlicker claiming that "we can't do that because SOMEONE WITH A VIRUS MIGHT USE AN ANTIBIOTIC INCORRECTLY" while ignoring the mass consumption of antibiotics by farm animals as a vector for super bugs.
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I did the same at 34. There's a dermatology/STI clinic in Budapest where I live that gives the shot at cost (about 130 euros) because they think people should get it.
How much did it cost? I've considered it but it seems the only option for me is to pay for it out of pocket (~$1000 for the full course), which seems kind of not worth it at this point.
I feel very uncomfortable trying to talk my doctor into doing something they don't recommend. I know too many people who buy into fake medical stuff.
Why is this different? Why is pestering a doctor to give me a medicine they don't recommend a good idea?
Your own doctor is as likely to be a quack/have quack-like beliefs as you are. Unironically this is true! Better learn to start reading Pubmed!
Doctors/medical associations don't agree with each other on much, even at the very highest levels. For example, the USA and EU have totally different recommendations related to digital rectal exams for aging men. One believes that finding cancer in old men is important, the other claims it's bad because most of those cancers are benign and sticking a finger up an old mans butt often causes its own complications.
Doctors don't have the time or capacity to know their patients well enough to make personalized recommendations in most cases. If you show up with symptoms of X they can recommend Y and will probably ask you whether you have Z which can impact the treatment. But virtually no doctor is going to ring you up proactively and say "hey, I noticed you haven't had a HPV vaccine yet, and I think it might make sense for you because I know this and that about your risk profile".
Doctors are not all knowing, infallible oracles. They are human beings you can have a conversation with about your health. If you think something makes sense for you, you can run it past them. No one is suggesting randomly asking doctors to prescribe random shit.
Because doctors are human and fallible operating in suboptimal systems. Don't want to provide me with a low risk, potentially high reward, low cost intervention? I'll shop until I find a doctor who will, or source it myself. Suboptimal systems and practitioners of various quality require advocating for one's self. I had to twist Planned Parenthood's arm to get Gardasil before it was approved for older adults, even though I was paying cash out of pocket, but had no problem with a trusted PCP providing me Metformin, GLP-1 prescriptions, etc simply by arguing my case and meeting sufficient criteria it would not come back to bite them.
The doctor likely didn't recommend it because GP is 40 years old. Most people's sex lives is comparatively... boring at that age.
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You need to be your own advocate.
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Best of luck, the reason it took so long for males to be approved for Gardasil use and they slowly keep pushing it up by age is two fold:
1) if you've ever been exposed to HPV already, then the vaccine is useless
2) there is no test to determine if a male has been exposed, although there is one for females
so they just push the ages up by probability, over time. As the probability of a man being with an older and therefore unvaccinated woman decreases - since with women is the most probable - the age can rise
> 1) if you've ever been exposed to HPV already, then the vaccine is useless
This is patently incorrect. The vaccine protects against 9 variants. Having been exposed to all 9 before vaccination sounds like really bad luck.
> 2) there is no test to determine if a male has been exposed, although there is one for females
The female HPV tests, as I understand, only test for the presence of HPV in the cervix. It can be present in many other areas. No one is testing women for the presence of HPV on their hands or in their throats.
Most places now offer HPV vaccines to young boys as well. People over 40 more or less missed the boat, but they can still get vaccinated. How useful it is depends entirely on their personal circumstances and risk profiles.
> 2) there is no test to determine if a male has been exposed, although there is one for females
It is incorrect. I had it tested multiple times. It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology.
See:
- https://www.droracle.ai/articles/607248/what-methods-are-use...
- https://pmc.ncbi.nlm.nih.gov/articles/PMC12256477/
- https://www.tandfonline.com/doi/full/10.1080/22221751.2024.2...
> 1) if you've ever been exposed to HPV already, then the vaccine is useless
Also no. See other comments.
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this is what I don't understand, why is it useless? there're multiple variants, vaccination could create reaction to a different part of the virus, etc.
Europe approved it for males at the same time as for females.
I’m confused why it won’t clear an existing infection while still working on future infections.
Here is what I know (which may be limited, I’m not a biologist) and also what I’m assuming:
1) The body apparently doesn’t eliminate the virus on its own when it picks up the virus unvaccinated. I’m assuming that this is because it isn’t registered by the immune system as being harmful, for whatever reason.
2) The attenuated virus in the vaccine would not produce an immune response without the adjuvant, because even viruses that are registered as harmful are not reliably registered as harmful when attenuated. This is where the adjuvant packaged with the attenuated virus comes in - it is registered by the body as harmful, and in its confusion the immune system also adds the virus to the registry.
So, naively, if the immune system previously didn’t register the natural infection as harmful, and if it does register the virus in the vaccine as harmful, why doesn’t the registry entry for the vaccine also get applied to the natural infection, the same way as it does for a person who wasn’t previously infected?
Is there some kind of specificity hierarchy, along with a “not harmful” registry alongside the “harmful” registry, such that the natural infection continues to get its previous classification of “not harmful” because the “not harmful” registry entry is more specific than the “harmful” registry entry? That’s the only explanation I can (naively) think of.
And if that’s the case, could we first wipe out the registry by infecting the person with measles, and then give them the HPV vaccine? Just kidding about this part!
I am assuming they meant it won't clear one strain that you already have but may protect against another one you don't
Yes, I understand that. Would you mind reading my comment above? The thing I’m confused about is why it won’t protect you against one you already have.
Like for viruses that have a vaccine, normally you wouldn’t vaccinate someone who had the virus already because the vaccine would be redundant - they already have natural immunity.
But in the case of HPV, apparently they don’t have effective natural immunity, the immunity naturally acquired is worse than the vaccine one. So why can’t the vaccine one take effect after the absent (or at least ineffective one) natural one isn’t (or is slightly) in place? That’s what I don’t understand. It seems like the natural immunity prevents the vaccine induced immunity from developing, but the natural immunity in this case doesn’t seem to work, while the vaccine induced immunity does work. Why…?
> - Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive.
However, the vaccination is expensive (~1k) and it is difficult to find doctors who will do non-recommended vaccinations for self-payers.
YCMV
> However, the vaccination is expensive (~1k)
Depends entirely on where you are and what your healthcare situation is. Mine cost me ~100eur.
This is ultimately an American site so you can assume 80%+ of comments come from a US background (I'm not American, I've just been here longer than I should have).
(even for rest-of-the-world topics)
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Are there insurance plans that won't cover it? I know that a lot of plans love not paying for things but vaccines seem to be the one thing that they all at least seem fairly good at (at least in my experience).
I am currently getting the HPV series and I only had to pay my copay for the first appointment have nothing for the second one (I am assuming it will be the same for the third)
are you under the age of 27? this is the key difference in cost of HPV vaccination
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Yeah I just did it at 50. Only got 2 gardasil shots though. They're so expensive because only young people get them subsidized.
I heard 1 shots already conveys a lot of protection so I'm wondering whether to take the third. I'm a bit late with it too
How much did it cost you ?
200 euro per shot (so 400 in total but the recommended amount is 3 shots)
Here in Spain that's a lot of money.
> Unless you plan to remain completely celibate,
Or you (and your future partner) practice abstinence until you're ready to commit to a lifelong monogamous relationship.
Yeah, one downside to giving this vaccine to your kids is you're basically telling them you expect they won't do this, even if they plan to (and you planned to, and in fact did). But pediatricians talk about how you really have to do it young, before they're going to be sexually active, and how it's hard to get later (not entirely true, as demonstrated by the comments here).
Is there any issue for adult males vaccinating ? I seem to remember some mention of risk by my doctor when I asked about it, but I might be misremembering.
No vaccine is without risk, but the vaccine approach is based on that risk being so low (but not zero) in comparison to the risk of not vaccinating that it is vastly the better choice.
Ok that was a bad question, let me rephrase: isn't there something particularly bad about this one for males that are already adults that makes it not recommended by doctors by default?
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There is currently no vaccine that is zero risk
and in the same breathe, the risk is closer to zero than not.
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Life is generally not zero risk :)
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What's the risk of a vaccine? What could happen?
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> While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/
The study you've quoted here is not definitive evidence of the claim you're making, and that claim is...let's just say that it's controversial. Conventional wisdom is that you're unlikely to benefit from HPV vaccination unless you have not already seroconverted for at least one of the 9 strains (6, 11, 16, 18, 31, 33, 45, 52, 58) in the current vaccine.
There's not much hard evidence to suggest that vaccination for HPV has strong ability to protect you from a strain after you've already been infected with that strain [1], as the best available data shows a substantial decline in efficacy for women over age 26 and for women of any age who had prior documented infection [2]. This study is small, unrandomized, and the measured primary outcome (anti-HPV IgG) doesn't really tell you anything about relative effectiveness at clearing an infection. The only real evidence they advance for this claim is:
> Persistent HPV infection after vaccination was significantly less frequent in the nine-valent vaccinated group (23.5%) compared to the control group (88.9%; p < 0.001).
...but again, this is a small, unrandomized trial. We don't know how these 60 people differ from the typical HPV-positive case. You can't rely on this kind of observational data to claim causality.
Vaccination is great, but let's not exaggerate or spread inaccurate claims in a fit of pro-vaccine exuberance. The HPV vaccine has age range recommendations [3] for a reason.
[1] For the somewhat obvious reason that your immune system has already seen the virus.
[2] See tables 2 and 3 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
It's also worth calling out table 4, which shows the (IMO bad) efficacy data for biological men, which is why I only talk about women, above, and why anyone who recommends vaccination without mentioning this factor is not being entirely forthright. Few people are rushing to give older men the HPV vaccine because it's not really supported by data!
[3] I believe the current guideline is under age 45 in the USA.
I understand why it wouldn't be recommended in policy but individually, provided you are rich enough to waste a hundred bucks, worse case is it's useless, best case you are 1-5% likely to spread a bad strain dangerous to yourself or to your partners, right ?
It's your body, and you can do whatever you want (assuming someone will consent to give it to you), but the worst case is that you have a bad reaction. It's rare, but not impossible, and things like GBS do happen -- though it must be emphasized that these vaccines are extremely safe by any reliable form of measurement [1].
But that's the general response to any question of this form. Medical treatments carry risk, however small. There is no free lunch.
> best case you are 1-5% likely to spread a bad strain dangerous to yourself or to your partners, right ?
I don't know where you're getting this number. I don't think anyone knows the actual answer to this question.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC4964727/
The age 45 bit isn't actually a guideline. Rather, finding naive but at risk individuals over 45 is quite difficult. They did not test it on anyone over 45, thus the FDA approval cuts off at 45.
That’s definitely true, but if you look at the RCT data, there’s also a question of efficacy in older recipients.
For whatever reason the vaccine just doesn’t seem to work as well when administered to adults, even if they’re naive to the viruses.
What are the chances that you develop cancer if you get infected by the worst HPV strain?
I would like to add:
Weaknesses / Counters:
1) Surrogate endpoint only — HPV PCR positivity is not a clinical outcome; no CIN2/3, no cancer, no mortality measured
2) Correlation ≠ causation — HPV-cancer link is epidemiological association; Koch's postulates not fulfilled in traditional sense; detecting DNA doesn't prove pathogenic activity
3) PCR detection ≠ disease — Transient HPV infections are common and clear spontaneously; most HPV-positive women never develop lesions or cancer
4) Type replacement signal ignored — 66% higher incidence of non-vaccine HR types in vaccinated group is dismissed rather than investigated as potential clinical concern
5) No long-term clinical follow-up — Cervical cancer takes 15-30 years to develop; this 7-year study cannot assess actual cancer prevention
6) Confounding in vaxxed vs unvaxxed comparison — Unvaccinated group is small (n=859), likely differs in health behaviors, screening adherence, socioeconomic factors
7) Circular reasoning — Vaccine "works" because it reduces detection of the types it targets; says nothing about whether those types were actually causing disease in this population
8) Assumes HPV16/18 reduction = cancer reduction — Untested assumption; clinical benefit must be demonstrated, not inferred from PCR
9) High baseline HR-HPV in vaccinated group unexplained — 32% prevalence of other HR types suggests substantial ongoing oncogenic exposure despite vaccination
10) Genome validity unestablished — HPV reference genomes are in-silico constructs assembled computationally; never validated by sequencing purified, isolated viral particles; PCR/sequencing performed on mixed clinical samples where true origin of amplified fragments is indeterminate
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Venereal diseases have been a significant cause of human mortality for ages. The first outbreak of Syphilis in Europe killed ~7% of the population. The only thing that broke up that state of affairs was the advent of antibiotics.
And if it turns out you weren’t a perfect judge of character and your partner cheats on you, then fuck you, right? I guess you deserved to die from cancer because you couldn’t read your fiancé’s mind. Or maybe it’s your fault for not being a good enough spouse.
Than take a jab, since your risk assessment shows you'll benefit from it.
But then, don't blame me for your partner being a slut.
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You're replying on a post that shows a literal >16x reduction in prevalence, with "just don't be a slut, worked for thousands of years".
I'd invite you to look up the prevalence of STDs during the most puritanical eras and places, maybe you'd change that stupid take.
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"I know no-one who died from hunger, therefore hunger does not exist, famine is a scam."
A quick find: https://en.wikipedia.org/wiki/Category:Deaths_from_throat_ca...
Almost zero? So you have seen throat cancer cases? And you don’t think it would have been good for those people not to have had throat cancer? Did they seem to enjoy the experience or something?
Who is feeding you this? Vaccines are some of the most unambiguously positive things ever developed, they're an easy win.
> Unless you plan to remain completely celibate
Uh, monogamy of both partners is also an option, not just celibacy. Not common in these times, I know, but you don't have to completely abstain from sex to be safe.