Comment by phkahler
6 hours ago
>> 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?
Parent is overstating the case. Neither infection nor vaccination provides sterilizing immunity [1], but the general reasons to prefer vaccination are (in order of descending quality of evidence & reasoning):
1) you probably haven't had all N strains yet.
2a) you likely haven't been infected with the ones that cause cancer, because they're relatively rare.
2b) ...that is especially true if you're young and not sexually active.
2) being infected with one strain does not provide sterilizing cross-immunity against the other strains.
3) even if you've been infected with a strain, some of the vaccines have been shown to prevent reinfection and reactivation better than natural infection alone.
4) in general, the vaccination-mediated immunity might last longer or be "stronger" than the natural version, since the vaccines are pretty immunogenic, and the viruses are not.
But for point 4, it's well-known that vaccine efficacy is lower for people who have already seroconverted (cf [1]), so there's clearly some amount of practical immunity provided by infection.
[1] The vaccines are roughly 90% effective for the major cancer-causing strains, but it's not a simple answer, and varies a lot by how you frame the question. See table 2 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
Also be sure to see table 4 if you're a man. The data for biological men and women are surprisingly different!
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It's never a guarantee in practice, the CDC says "More than 98% of recipients develop an antibody response to HPV types included in the respective vaccines 1 month after completing a full vaccination series"
> 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.
I think the main reason it isn't recommended for all ages is that it wears off. If you get it before 50, when your immune system starts declining, you might end up getting shingles when you're 60 or 70.
Insurance companies used to only pay for the vaccine at 60. They've reduced it to 50 now because people (like me) were getting it in their 50's. I got it in my left eye and because my immune system is kinda shit, I still have it, though it doesn't give me too much grief now. But it did trash my cornea in that eye, so it's messed my vision up pretty good. And since there's still an active infection (after 8 years), I can't get a cornea transplant.
https://www.health.harvard.edu/staying-healthy/two-dose-shin...
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Beg for forgiveness, don't ask permission. I got Shingrix when I was under the age of 40, and at no cost to myself even, simply by scheduling a Shingrix vaccine at CVS. It wasn't until I went back for the booster shot months later that the nurse was like "Wait, aren't you too young for this?", but they nevertheless gave me the second dose to complete the vaccine course. You can just so things.
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I would happily pay for Shingrix.
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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/
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?
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.