Comment by elric
6 hours ago
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
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).
I agree with that, and I don't have a problem with insurance companies demanding a doctor's approval before paying. What I have a problem with is that I can't even pay my own way without a doctor.
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.
Antibiotics are actually an exception to my general opinion that all medications should be available without prescription. Unlike most drugs, their use has major externalities which means there is a role for larger societal regulation of their use.
Also, are farms actually the major vector for antibiotic resistance in the human population? I was under the impression that the majority of antibiotic resistant infections occur in places like hospitals rather than among farm workers, which would seem to indicate farm animals are not the main problem (I 100% support banning the practice anyway).
Not to mention farm animals being the source of most if not all flu strains.
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.
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.
> 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.
No. The general reason that people don't do the test for men is that DNA testing is extremely sensitive, and produces a lot of false positives for a virus that is widespread.
It's also not actionable. You can't treat an asymptomatic infection, and a positive leads to the same outcome they would give anyway: use physical barriers and abstinence.
(Edit: hilariously, your first link says exactly what I just wrote, at the very top of the page. Did you read it?)
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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?
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.
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.
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.