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Comment by hammock

8 hours ago

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!

  • What if you're married? Does it still make sense, if you know you won't ever be sleeping with a new partner?

    • A question for your doctor and your partner (and of course, you can read the data in the link I posted above and use that to influence your conversation and decision!)

      I'm not being avoidant here -- medical decisions are always subjective and multi-factor, and I can't begin to tell you what you should do. (But I also sincerely believe that propagandists try to reduce nuanced data to talking points, which is equally wrong.)

      Please note the caveat about gender that I just added. The data for biological men and women are very different. Also, I haven't discussed risks at all, which is the other side of the ledger -- these vaccines are pretty darned safe, but everything comes with risk, and only you can decide what level of risk is appropriate for your life.

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    • You get to make your own health choices here, but as someone who got the vaccine in my 30s, I am glad as I didn’t know about my future divorce when I got vaccinated.

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    • Ha, we had this conversation with our doctor and they said not to worry about the vaccine if you are married and monogamous. It would likely have zero benefit to us at that point in time.

      Now maybe that changes if you get divorced and get a new sexual partner.

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"