Comment by stared
5 hours 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.
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).
>> 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.
> 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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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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>>>>> 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/
What about the people who know they have 16 or 18? Should they still get it?
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.
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.
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).
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.
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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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.
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.
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?
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.
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.
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
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.
Life is generally not zero risk :)
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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.
> - 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)
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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"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.
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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.
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.
> I'd invite you to look up the prevalence of STDs during the most puritanical eras and places,
Even during the worst of times with the highest prevalence, not being a slut would reduce risk from STDs to a level that a vaccine would bring only a marginal benefit. A very high percentage of those infected indulged in promiscuous behavior, despite living in a puritan era and place.
> maybe you'd change that stupid take.
Only a stupid man without any arguments would resort to calling someone else's argument "a stupid take".
> 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.