If you're living in the US: please consider getting the vaccine, ragardless of your age. It was covered by my (rather shitty) health insurance. It consists of just 2 (EDIT: 3 for adults!) doses. It is recommended for both Males and Females.
It is actually not straightforward to do. Safeway Pharmacy refused to actually give me the vaccine when I showed up saying I'm not in a group that's eligible. One Medical told me that it would be a $400/shot 3-shot regimen. I'll probably just travel to India some time to visit family and get Cervavac there instead of Gardasil here. It's about $20/shot.
The Walgreens pharmacist scolded my 35 year old girlfriend for getting it, saying that it was useless at her age. She insisted and he reluctantly administered the first dose (and later got the rest at another location). He even questioned her motives for getting it once she was in the room. I was appalled by the whole interaction.
Maybe I could have understood if I had said she was my wife. But it is still stupid to assume that there will be no other sexual partners ever again in her life.
With the prevalence of HPV, it's likely that we have one or more strains already, but who knows. Maybe the strain of a future partner is what will trigger cancer.
If anyone here can enlighten me about the pharmacist's attitude, I would be grateful.
I got vaccinated way before I met her, and even as a male I didn't get any comments from the pharmacists that gave me the shots.
Gotta love the logic of telling adults not to get the vaccine because its probably too late and you're already infected, while also telling parents not to give it to their kids because it's only for "prostitutes and promiscuous gay men" (per RFK)
That's right; that particular HHS Secretary comment was about Hepatitis B.
> "“Hepatitis B vaccine was made for prostitutes and for promiscuous gay men,” Kennedy said in an interview on his Children’s Health Defense show in 2022."
The WaPo article doesn't bother to refute RFK's lies, but here's /r/medicine responding to them (in the context that's topical this week—RFK ordering the removal of the Hepatitis B vaccine from the children's schedule):
> "Let's be even more clear about this. If you contract Hep B in the first year of life, more than 90% develop the chronic form, and the need for liver transplant is much higher.... Worldwide, the second most common route for children under 5 to catch HBV is from other children, and that's not by doing IV drugs or having sex. (First most common is vertical, through mother.)"
Even if you're married, you might not be married forever, could be in an open relationship, or a partner may cheat. None of which is the pharmacist's business.
MY partner also had a hard time getting it, at the age of 26. I also had a hard time getting it, at age 26.
People read the recommendation guideline, and brainlessly follow it without care of why it's in place. If you haven't had a reason to be exposed by 30, 30 is as good of a time to get the shot as 9.
One of the few times I can say the majority of medical practitioners don't know what they are talking about when they spit dogma instead of life-saving sense.
HPV is approved up to age 45 with “shared clinical decision making”. Above age 26 it may be more difficult without a clinician due to unimportant bullshit. Try a Planned Parenthood.
My Dr doesn't give me stuff. But that's only because I'm one of the millions of Americans who has no healthcare beyond what can paid out of my pocket. Not his fault.
He could but then I'd still need to pay for the vaccine - which is the issue. Specifically, I would be adding the vaccine onto the long, long list of medical stuff (vaccines, tests, procedures) that I need to buy if the funds ever come available.
as far as I can tell, pharmacists cannot give vaccines off-label (this is an issue for the new covid guidelines and some states fell back to an Rx if no longer eligible for the covid booster).
Your PCP may give a vaccine off-label though, which is how I got my Shingrix, though I had to pay out of pocket.
There is many different strains of HPV, the likelihood of already have contracted them all is small. It will still protect you against strains you don't have. It also protects against genital warts. The vaccionation program targets young girls because thats the most efficient time to take it and has highest benefit/cost. You will still reap benefits of taking it later.
I dont see any reason not to take if you get it for free and you are planning to be sexually active with multiple different partners.
This. Protects against strains you don't have, reduces the spreading. We (male that have sex with females, and haven't been vaccinated) are a huge infection vector.
My doctors have generally refused vaccinating me for years (Male/43yo), but finally a new (female) doctor told me it's a good idea. I'm not in a risk group, so I have to pay for the vaccine: Gardasil 9, 3 doses, 3 months away of each other, ~€200 each, although studies say that 2 doses might be enough.
In reality, you can pay to a private doctor so they write you a prescription, but I feel more validated if my doctor says it's OK :)
just keep in mind that not all kinds of HPV vaccines protect against all the strains causing warts! Some do, but not all, check the specific brand you're getting! Obviously cancer is worse, but the extra protection is nice to have.
Even if there's a small chance that it would make a difference, wouldn't it be worth it if you have the money and you feel like it's your duty to protect others ? At worst, it's useless and you have contributed to make a vaccine more profitable (which, IIUC is a problem for vaccines ?)
From top of my layperson head: bruised insertion sites, tainted needles, tainted vaccine supply, customer capacity crowding for the pharmacy, squeezing supply capacity for actual target demographics, etc etc etc.
Things have tradeoffs, even if they are subtle. Relentless follow-through on marginal protocols should generally be treated with suspicion.
Stranger danger advocates brush off the criticism that most abductions occur among family with the "if there's a small chance it would make a difference" argument, but this ignores the real harms of teaching children to fear everyone by default.
This is mostly guesswork but I think you need to get the vaccine before you catch it and lots of people have it as they get older.
If you have a limited supply the greater bang per buck would be to start with the young people who almost certainly haven't caught it yet and then work your way up.
It's less that and more "we just haven't tested it in older populations yet".
Sure you are more likely to have it the older you are but even then you are unlikely to have all the strains. The vaccine covers like 9 or 10 different strains so it can protect you from the other strains even if you already have one of them.
It's generally only when you get into the 60s and up that the justification for not recommending the vaccine changes. Once you get into those later years the immune response changes a bit and you get new concerns.
An example being herpes zoster (chickenpox) where after a certain age you are recommended to get the shingles vaccine instead of the chickenpox vaccine since the way the disease presents and how the body reacts to it changes with age (technically shingles can happen at any age but generally herpes zoster presents as shingles instead of chickenpox the older you get).
> you are recommended to get the shingles vaccine instead of the chickenpox vaccine since the way the disease presents and how the body reacts to it changes with age (technically shingles can happen at any age but generally herpes zoster presents as shingles instead of chickenpox the older you get).
If the underlying virus is the same, what is different between the vaccines? How it presents shouldn't matter as much?
The shingles vaccine is a larger/more aggressive dose than the chickenpox vaccine.
And nowadays chickenpox vaccine uses live attenuated viruses (i.e. modified to be non-infectious but still look the same) whereas the shingles vaccine uses recombinant proteins. This allows the shingles vaccine to deliver the higher viral load that they want for inoculating against shingles without putting a bunch of live viruses into the body.
It's also worth noting that the recombinant vaccine is more effective for shingles compared to the equivalent viral load live vaccine by a significant margin. It's something like 90% reduction in incidence vs 50%.
----------
> How it presents shouldn't matter as much?
It's not an all or nothing thing but it's a matter of percentages.
And the big reason why they present differently is that chickenpox kind of attacks every part of the body since it's new. It of course does best at infecting the skin and nerves but it mildly affects every part of the body. But then it goes dormant in the nerves because that's where it's most "compatible" and the body is the worst at fighting it.
So then with shingles your body still has the immunity but the reactivated virus is able to out-compete your immunity in the nerves and it wakes up in whatever specific nerve and spreads along that nerve. This is why shingles generally presents in a band on the body. It's spreading along a specific nerve "line" rather than spreading throughout the whole body, blood, and all.
And so the because the infection can't spread broadly throughout your body it ends up concentrated in that location and presumably the higher viral load combined with focusing on the specific proteins rather than the whole virus increases the body's sensitivity to these flair ups, catching them before they can reach momentum. And then that focused immune training sits on top of the body's existing immunity for the initial "whole body" presentation of the virus.
> Why is there an age limit on an all encompassing vax
Vaccines are subject to stringent safety standards since they’re administered to healthy people. The age limit may suggest that at the time of the recommendation, in the relevant jurisdiction, the manufacturer had not studied its safety and efficacy in >40 year olds.
(I also don’t think it’s an age limit as much as the upper end of a recommendation.)
E.g., the Shingles vaccine simply hasn't been tested in <50 populations. But if you're under 50 and you've had the chicken pox, you should ask your PCP to prescribe the shingles vaccine off-label and go get it, because shingles sucks and the vaccine definitely works.
I don't follow your logic here. The GP comment is saying that the vaccine isn't available for populations it hasn't been tested for. Why are you recommending people ignore the fact that safety and efficacy testing isn't available for their population?
And how can you say the vaccine definitely works for populations it hasn't been tested on?
It's an age limit to the approval caused by a lack of studies. To study it in over 45s you need suitable over 45s--but there aren't a lot of over 45s with risk but not prior exposure.
The rationale is that most sexually active people have already been infected with HPV anyway, so the largest benefit of administering the vaccine is at a young age.
A lot of replies that are mostly true, or somewhat true, or simply missing the real reasons.
There are two factors here:
1) Vaccine-derived immunity is a function of the individual's immune response, which in general, weakens significantly with age. It is not unrealistic for a vaccine to simply fail to elicit any response in someone old enough.
2) It is very, very difficult to recruit folks without HPV that are over 40 for a clinical trial. Most people of that age, who were never immunized, most likely have had it. This significantly convolutes the signal.
3) This is all especially confounded once something becomes "standard of care". Every year there are fewer and fewer people age 40+ with HPV.
For these reasons, the vaccine is currently officially ??? in people over 40. Most doctors will prescribe it anyways if you ask. It may or may not infer immunity. It almost certainly will not harm you.
In the US, recommendations come from the United States Preventive Services Task Force. They explicitly do not consider cost in their decisions. They look at harm vs benefit, usually with a focus on mortality reduction. Most insurance companies will base their coverage on the USPSTF.
Decisions as to whether or not to pursue regulatory approval for, example, expanded coverage of the HPV vaccine to men, or older age groups, is very commonly informed by cost-benefit calculations. I've worked on those projects, seen presentations by my colleagues, etc. There was a good two years of my life where this was what I worked on (mostly strain replacement post-vaccination).
It's a level of evidence that's generated (usually) prior to ACIP, and it is presented to them, while there is not necessarily a bright line threshold.
if you suspect that the cdc has been captured by big pharma, "and we don't care about cost of these recommended drugs" should pretty much seal the deal for you :)
There used to be fears of "death panels" controlling access to medical care when Clinton tried to propose universal health care.
The CDC and FDA are about safety, not cost management. And they get significant complaints about how much they regulate pharma and are impediments to pharma for that!
Now the conspiracy theorists of the other side seem to be having their day in the public mind.
This isn't a conspiracy theory - I worked on projects around that during graduate school, and talked to my colleagues who worked on them. Cost-effectiveness thresholds are a consideration that goes into how widely a vaccine will be rolled out, etc.
That was, for example, why boys were originally not part of the recommendation for the HPV vaccine. It would double to cost, while doing very little to prevent cervical cancer via indirect protection. Once the evidence accumulated that it was associated with other cancers, that stopped being true.
Cost considerations would be more from the CDC's Advisory Committee on Immunization Practices, not the mentioned above United States Preventive Services Task Force. (Oh, and I see that another comment parallel to mine up there now mentions ACIP too...)
In any case, somebody thinking that evaluating safety and efficacy aside from cost considerations means that there's collusion with pharmaceutical companies would be a conspiracy theory.
have you ever wondered if it's a great idea to have former generals populate the defense department, procurement, and revolving door employment with defense contractors? what could go wrong? what could go expensive?
you are one of the generals in this scenario, thinking that evaluating safety and efficacy aside from cost considerations couldn't possibly lead to higher costs because you yourself and everybody in your industry are so darn smart, clever and by god ethical.
what did you do before this? work on creating the covid 19 virus, or just calling people who questioned it "conspiracy theorists"? what's that, you were in caves tracking down the zoonotic transfer, which you'll find any day now, scientific consensus and all, peter daszak assured you you'll find it and he's beyond reproach!
and I resent you saying that I'm a conspiracy theorist because I have not said any of this is happening, I am pointing out the vector where it could happen (go back, look, where did I say any of this was happening?)
it's simply, methinks the lady doth protest too much
>have you ever wondered if it's a great idea to have former generals populate the defense department, procurement, and revolving door employment with defense contractors? what could go wrong? what could go expensive?
The real question is why are people who are capable of identifying the problem when it's generals sitting on the board of Lockheed or a telecom industry insider heading the FCC suddenly unable to do so when it's someone who's made their career engineering stormwater solutions taking a position at the EPA or the pharma industry funding research that the CDC will base its policy on.
The CDC, the DOD, etc, etc, these are all symptoms of the problem and a distracting sideshow.
As usual, the real evil is in the minds of the people who peddle double standards and the fact that we have architected society such that this behavior is mainstream and those who engage in it are not marginalized.
the cdc decides to make recommendations no matter how expensive, and big pharma collects the expensive, and the expert community works for the cdc and big pharma? do you even understand what regulatory capture is? do you understand how framing something as saving lives no matter the cost draws attention away from funneling money to big pharma no matter the deficit?
Since you already replied to my other comment, hopefully you understand now that ACIP takes into account cost as part of its recommendations, but the independent group we were talking about in this thread does not.
Even with CDC its recommendations, it's not the final word.
The reasoning you're highlighting here is highly conspiratorial
Yeah, screw those old people with their houses! We should deliberately kill them off so that we can have cheaper houses! But please, don't let the next generation do that to us when housing turns out to be expensive for them too!
I have yet to see my government subsidise dangerous recreations based on a cost benefit analysis.
I think government costs for a retiree are about NZD27000 a year.
A government should be subsidising a good deadly recreation for say NZD10000 a year. Assume expected life remaining is 10 years, assume recreation has a 10% chance of clean death, assume low chance of expensive ongoing chronic outcomes.
Maybe a better way would be to allow people to gamble with their lives to win a few tens of thousands (need to balance costs against expected savings). Pay out to winners, but saves the government their expected lifetime of expenses for the losers. Let the old and unhappy roll-the-dice and the winners get to live it up a little . . .
It's not approved for those over 45. (AFIAK, simply because so few people in that age group would have risk without having had prior exposure. Basically only those who had divorced or lost their long time partner.)
This is not true any more. The vaccine has been shown to lower cancer risk for those who already carry the virus, so it is recommended even for people who are HPV positive
This is a totally predictable result, there are dozens of HPV strains and the vaccine will immunize against 9 of them that are high risk.
So, unless you are a sex worker or similar, it's unlikely you "have" all of them to the point where the vaccine is completely useless. You might later get infected with a strain that you didn't yet have, and it's precisely the one that kills you.
That feels like a wild assumption to me - we really think people 45+ aren't having casual sex? less casual sex maybe, but I would imagine still a decent amount, statistically.
There are over 30 strains of HPV with just 2 causing the majority of cancers. So sure, most people may have had some strain of it, but that's not really relevant unless immunity is broad across strains.
Or, you could have been suddenly cheated on and exposed, or divorced and recently entered the dating market, or thinking about opening up your relationship after decades of monogamy.
But the number of such people is low, it would not be easy to find candidates for the trial. Just because there are some doesn't mean there are enough to make it worthwhile for the drug company to do the testing to be able to market it to such groups.
The original criteria was for people who had not already been exposed.
And over 45s that engage in casual sex have almost certainly been exposed. Those who don't have prior exposure probably have few or one partner in a marriage or marriage-like situation and thus are not likely to be exposed. Yes, they could be cheated on or the like but exposure is not expected so effectiveness can not be measured.
I met with a new PCP a few weeks ago and it was recommended to me (at age 43). I got the first shot with the 2nd and 3rd scheduled for the coming months.
Thanks for the recommendation! It seems like a good option, but afaict you still need to get your doctor to write you a prescription, and they may have to administer the shots as well:
I'm sorry, but you sound like the people who try to get me take ivermectine for Covid. "just get it off label" or "tell the doctor you just got back from pauea new guinea and saw worms in your stool."
I know you are very well intentioned, but American's actually have very good doctors.
Ivermectin is also used to treat COVID in countries that have endemic parasite outbreaks. COVID responds well to steroids, but so do parasites. Giving steroids to someone with parasites causes the parasites to become much stronger, and trigger reactions from the immune system: fever, etc.
I ideally you could test for parasites, but time and resources don't allow for that in many countries. So if it's generally safe to just give ivermectin along with steroids when treating COVID - in countries where parasites are common.
Maybe I'm wrong about this. Maybe I'm making it up. Don't listen to what I say. Listen to your doctor.
It's a standard vaccine for preteen/teen boys now too. If your doctor has been telling you not to get it for the past 15 years, they've been doing you a disservice.
I got 3 doses of gardasil at 37 in Norway. I do not want to expose women to a potentially deadly virus (plus I’d also like to avoid having penile cancer and mouth/throat cancer myself). If your doctor is seriously advising you against taking the vaccine, you should consult another doctor for a second opinion.
“The route of HPV transmission is primarily through skin-to-skin or skin-to-mucosa contact. Sexual transmission is the most documented, but there have been studies suggesting non-sexual courses.
The horizontal transfer of HPV includes fomites, fingers, and mouth, skin contact (other than sexual). Self-inoculation is described in studies as a potential HPV transmission route, as it was certified in female virgins, and in children with genital warts (low-risk HPV) without a personal history of sexual abuse. Vertical transmission from mother to child is another HPV transfer course” [1].
Right, but do the vaccines help against the strains of HPV that are transmitted via non-sexual contact? The vaccine being 9-valent implies (to me, a layman) that strains need to be targeted fairly specifically in order for vaccination to be effective.
Yes. While direct genital contact is the highest probability way to spread it, any skin-skin, skin-mucosa, skin-object-skin contact can potentially spread it. Consider how much you trust others to wash their hands after using the restroom. Low probability, but possible.
You’ve got a low probability of getting polio, but there’s no reason not to be vaccinated if you can.
Even if you already have a strain, there are multiple types. In fact, people who got a vaccine early on, should consider an updated shot for more complete protection.
The protection from the vaccines lasts (probably) a lifetime, and HPV is quite widespread because it is: very easily communicable, and infections linger for potentially long periods of time without any obvious symptoms
Something like 80% of people are sexually active at all will be infected with HPV at some point. You may not have been sexually active, but your future partners may have been. I personally have a friend who went through stage 4 cancer contracted from her (now ex) husband.
So, of course not literally everyone needs to take it, assess your own risks, but it's quite an easy, highly effective vaccine: don't overthink it.
Rape, you might become sexually active in the future, and although sexual transmission is the most common way, there are some other ways to get infected.
Unless you're never sexually active (meaning, you eventually do have sex), it's worthwhile getting since there is a risk to yourself if you get infected.
HPV tests are of low value (as an adult, if ever sexually active, you likely have it but can do nothing about it); a new biomarker test that can detect the cancers is being developed [1]. Ongoing cancer surveillance is all you can do once exposed without having been vaccinated (and if cancer occurs, immunotherapy).
As pm90 wrote, I strongly recommend getting vaccinated [2] unless a doctor tells you otherwise, even if you already have HPV or have had previous potential exposure.
Isn't that basically everyone who's had sex with someone who had sex before the vaccine was common? I was denied when I asked my last doctor, on that logic. I'll ask my current doctor.
Right. And a few years ago my doctor's office had orders for both the the quadvalent vaccine and the nonavalent vaccine in the system and almost ordered only the quad for me.
Definitely ensure you're requesting the 9 strain version.
Information from the CDC [1], indicates Adverse Reactions are similar to administration of a placebo, which is not zero. Any vaccine administration has potential for negative adverse reactions, it's reasonable not to get a vaccine if you judge the upside is not worth the downside, even if the downside is small.
The CDC says:
> Like all medical interventions, vaccines can have some side effects.
> A temperature of 100°F during the 15 days after vaccination was reported in 10% to 13% of HPV vaccine recipients. A similar proportion of placebo recipients reported an elevated temperature.
If you take some research subjects, do nothing to them, and then ask how they did 15 days after, I would be surprised if 10-13% reported a 100F fever during that time. But, that's a reasonable result from a saline or hpv injection.
I'm male and read about this exposure vector back in 2012 when it was only rolled out to 12 year old girls, with a further guideline that nobody over 26 should take it.
this was pre- antivaxxer anxiety, and just run of the mill 'is the government condoning sex' anxiety, and it was controversial for that reason alone
the issue was that if you've been exposed already then the vaccine doesn't work. they had a test for women that can prove they've been exposed or not, and most adults have. they don't have a test for men that can prove they've been exposed or not, and most adults have. At the time, they had also only considered males to be carriers, with no cancers themselves.
so for the US government to recommend a limited stock and get insurers on board, it was all based on probabilities of exposure and utility.
I was younger at the time, naturally, I paid $600 out of pocket to get it across 3 doses because I figured it was worse than that, or I could get some 'male ally' brownie points from women. I wasn't wealthy then but figured this experience couldn't be taken from me even if I went bankrupt.
Since then, they've further linked it to throat cancers in males, because of our mouth's contact with genitals, and insurers are told to cover it across all genders and up to mid 40s. that's not really much of a difference now though, since the checkpoint is basically the same group of people, 13 years later.
They're still assuming older people are not worth bothering with, due to likely exposure.
There is an amusing side of this if you are male and not vaccinated yet, since nobody can tell if you've been exposed still: keep your sexual relationships with younger women. lol. in case you needed an excuse - higher probability they're vaccinated.
"this was pre- antivaxxer anxiety" - It was really, really not.
Another thing to keep in mind was that the initial trials were only using cervical cancer endpoints - the association between HOV infection and cervical cancer is really strong. At that time, vaccinating boys provided only indirect protection (you couldn't infect a female partner), rather than direct protection (you won't be infected) in the context of cervical cancer.
Women prior to sexual debut were the biggest "bang for the buck" and the obvious first recommendation target.
Researchers both at universities and in private industry then started working on other populations based on alternative endpoints.
> Women prior to sexual debut were the biggest "bang for the buck" and the obvious first recommendation target.
It was a stupid decision to leave out the boys. I mean hindsight is 20/20, but if heterosexual women were getting cervical cancer from HPV, and HPV is spread by sexual activity, then vaccinating the boys along with the girls would have been the logical thing to do in order to stop the spread.
I assume this wasn't done because they didn't do any studies on boys at first, because they were looking for cervical abnormalities to gauge vaccine effectiveness, and maybe it would have been hard to recruit a bunch of boys for a vaccine study that would probably not benefit them.
With that same hindsight we now know that HPV vaccination also prevents some oral cancers, and that leaving out the boys was a very stupid decision indeed.
These days most places do seem to also vaccinate boys. I got an HPV vaccine at some point in my 30s, and I pretty much had to wrestle my doctor into submission in order to get a prescription.
The current recommended cutoff is 45 (well, pre the current US administration). So I think it was a question of we tested this at the time in these high risk age groups and we were still waiting on the results for other cohorts that were less important.
I went to my local megacorp pharmacy out here in California, and asked about the COVID vaccine that’s no longer recommended by our anti-vaxxer overlords.
Apparently, it’s about as easy to get as an old-school medical marijuana card.
Results vary by state though. No need to travel to Canada or Mexico (yet).
That is a truly naïve way of thinking about a pharmaceutical product.
Would you say the same about any other drug? What about blood pressure medicines, should everyone "consider getting it"?
Completely ignorant, you have to consider multiple factors for the individual before taking any pharmaceutical drug and then you have to consider the risk from the drug, yes, low and behold, even vaccines can give side effects! The level of ignorance of the comments is staggering!
Apples and oranges. Blood pressure medicine is for people who have hypertension, and not everyone does. And hypertension is not contagious.
Conversely, almost every adult over 45 is carrying some form of HPV and a few of those forms cause cancer. If any of those adults has unprotected sex with someone without HPV who is unvaccinated, they almost certainly will transmit the virus. Even if condoms are used, HPV can still be transmitted. This is a much more contagious virus than HIV.
The HPV vaccine is both extremely safe and extremely effective. Suggesting that every human consider getting the vaccine -- with appropriate consultation with their healthcare provider -- is sound advice.
Common causes of hypertension are "contagious". Summary:
spousal concordance: one partner’s chronic disease raises the odds the other has it too. If one spouse has hypertension, multiple studies suggest the other spouse’s risk is about 1.3 to 1.5 times higher than their cohort.
Genetic causes can easily double risk over baseline cohort for children.
However there is a strong environmental/lifestyle effect in children. Studies in Scandinavia show that children adopted into hypertensive households carry an elevated risk compared to the general population. A hypertensive parent with an adopted child nudges the child’s later-life risk by about 20–30% higher than baseline.
If we had as trivial of vaccinations for smallpox, anthrax, and rabies as we have for HPV, I'd collect them all. One fewer risk in my life, and a finite reduction in the risk of everyone around me's life, with no downside at all.
1 pin prick * 340,000,000 people > 340,000,000 people * 6.1 cases of cervical cancer * 0.9 efficacy / 100,000 people
Your world view assigns equally negative utility to at most 18,214 shots as 1 case of cervical cancer.
Put another way: If you were told you had to either take a shot every day, or you are guaranteed to get cancer, would you really choose the cancer?
There is no human alive who has smallpox that you could catch it from, so getting vaccinated for it is pointless unless you think it's likely that some samples in a lab somewhere might escape.
Good stuff. Australia has a target for eliminating cervical cancer by 2035 and ofcourse HPV is responsible for a large proportion of penile, mouth, throat and anal cancers as well. All my kids got free vaccinations at school.
It is shocking that there are still places in the world where this is controversial. You can tell a lot about the qualities of a society by the way they care for their own.
You should think about how you would react to “you can tell a lot about the qualities of a society by the way they [detain people on Nauru | reject asyl seekers | don’t care for indigenous populations]”.
I feel your comment is a generalisation and could be construed as provocation/trolling. Probably not your intention, but just so you are aware how this is coming over.
Better maybe: “societies that have good health care thrive” or something like this. Sounds less judgmental and it doesn’t put all US Americans in one basket.
I fully agree on the content though, only criticising the form here.
Australian indigenous women do in fact have a higher risk of HPV and cervical cancer than the general population. We do need to do better but we also face some challenges in delivering quality services to rural and remote communities. Achieving a consensus amongst millions of people on how to run a country isn't simple and stupid shit often happens.
Anyway, well done Denmark. We are trying to do the same thing here in Australia with some success. Not sure how it became about the US but good luck to you all as well.
It might be a cultural misunderstanding. It isn't a big deal. It's tricky because while we are using the same language we don't all share the same culture and influences.
Perhaps it is less common to say positive things about other countries in the US unless you are making some point about domestic politics. Sometimes I am deeply critical of the USA but this wasn't one of those times.
So just to be really clear eradication of HPV and by extension elimination of some forms of cancer is a really noble thing for humanity to be doing and is being pursued by many countries, including ones that aren't as privileged and wealthy as Australia and Denmark. It's a group that historically included the USA which clearly means there are people there who deeply care about this stuff as well.
The people who oppose public health programs like this are just evil in my opinion wherever they are.
RFK Jr may be a bit biased, his opposition has been profitable
> Kennedy for years has earned referral fees from Wisner Baum, a Los Angeles personal injury law firm that is currently suing Merck, alleging the pharmaceutical giant failed to properly warn the public about risks from its vaccine against human papillomavirus (HPV), Gardasil, according to financial disclosure documents filed by Kennedy with the Office of Government Ethics.
Remember to look for critical takes. I encourage you to look at stuff like this with an open mind, and if you disagree with anything, look into the details:
There is recent research showing that it can (slightly) help even during HPV infection, see "Effect of HPV Vaccination on Virus Disappearance in Cervical Samples of a Cohort of HPV-Positive Polish Patients", J Clin Med (2023) https://pubmed.ncbi.nlm.nih.gov/38137661/.
Also, the eligibility criterion of not vaccinating people above certain age is NOT valid. I mean, sooner better. But if you are adult and there is any chance that you ever get a new sexual parter, get a vaccine.
90% people with get at least one HPV strain in their life.
10-30% people have at least one HPV strain right now.
(I recommend doing PCR test with strains genotyping. I do it periodically.)
Sure, our organism usually gets rid of such on 1-3 years, with no consequences. Yet, vaccine boosts your immunity.
Also, over 50% of cases of throat cancer are HPV-lead. So if you have male body, also vaccinate - both to protect others and yourself.
Ideally for 9 strains, but HPV 16 and HPV 18 are by far the most important.
> Also, the eligibility criterion of not vaccinating people above certain age is NOT valid. I mean, sooner better. But if you are adult and there is any chance that you ever get a new sexual parter, get a vaccine.
The eligibility criterion has primary been about controlling cost to focus about the groups where the societal effect is greatest.
I expect it may gradually get broadened, but most places you can also get it privately even if you fall outside those ages.
E.g. in the UK, most private providers will vaccinate you up to 45, and at least some private providers will give you the vaccine with no upper age limit (and a lower age limit of 9) at a relatively reasonable cost (~180 pounds per dose - 2 to 3 doses)
At the same time, guidelines go differently, e.g. "Vaccination is not recommended for everyone older than age 26 years." from https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm.... These things propagate among doctors and most of them do not recommend vaccination (contrary to modern research data!)
The goal wasn't to eliminate the HPV strains, it was to decrease cervical cancer. Has Denmark encountered a drop in cervical cancer? If so, that's a great outcome!
The lead time from infection to cancer is very long, we would not expect to see too much of a drop *yet*. But testing for those strains seems to be as useful for screening as a pap smear.
> No cases of invasive cancer were recorded in women immunized at 12 or 13 years of age irrespective of the number of doses.
> Women vaccinated at 14 to 22 years of age and given 3 doses of the bivalent vaccine showed a significant reduction in incidence compared with all unvaccinated women
For the second group, cases dropped from 8.4 to 3.2 per 100k.
The Danish center for disease control's webpage for the vaccine links to a recent (5 year old) Swedish study: https://www.nejm.org/doi/10.1056/NEJMoa1917338 , but I couldn't find any Danish studies.
Wasn’t this also the same conclusion for Australia? Cervical cancer plummeted to record rates. Men should still get it so they don’t effect their partners and HPV causes all sort of cancer too.
Yes, Michael Douglas had a throat cancer he said was from "oral sex" meaning HPV infection, and I remember social media berating him for saying that as if it were impossible, but it really is.
Random anecdote: with whole genome sequencing, which is fairly common among the rich with cancer, you can sometimes find the exact cancer driving genes that the HPV has amplified. I remember looking at one case where the HER2 gene was amplified with many copies, and you could see it attached to chunks of HPV genome. Fortunately there's now many drugs that specifically target amplified HER2, originally developed only for breast cancer, where there are diagnostic test to find the subset of breast cancers with the amplification.
Australia rolled out the HPV vaccine for girls in 2007. Boys were included in the program in 2013. Modelling says that "elimination" depends on both the vaccine and a screening program [3].
- it was therefore initially introduced to women as a cervical cancer thing
- HPV however hits men at around half the cancer rate of women but through throat cancer
Or something like that. So actually the benefit to men is of a similar order of magnitude as that to women but it was just given to women to save money. Every child should be given it.
Edit:
Total Rate (of HPV caused cancers) in Women: Approximately 15.9 cases per 100,000 females per year.
Total Rate in Men: Approximately 9.3 cases per 100,000 males per year.
Edit 2:
Severity-Adjusted HPV Cancer Burden:
When adjusted for the severity and impact on life, the relative burden of HPV-related cancers shifts. Cancers with higher mortality rates and more debilitating treatments, like oropharyngeal cancer, carry a heavier weight.
Total Burden in Men: Approximately 135 DALYs per 100,000 males per year.
Total Burden in Women: Approximately 125 DALYs per 100,000 females per year.
The HPV vaccine became part of the government vaccination program for boys/men 6 years ago (almost to the date) precisely for the reasons you mention. Personally really happy to see this as there was some initial fear mongering related to the HPV vaccine some years ago.
It has only been targeted against the strains known to cause cancer. I haven't looked but I would guess getting all strains would have been a greater challenge, and would not have greatly increased uptake of the vaccine. The false perception that it's a vaccine that will encourages unprotected sex has already greatly hindered adoption in the US.
That's really interesting, and from that I would assume that the risk of cervical (or other cancers) from HPV is associated with how often someone is reinfected? ie, someone who got HPV once in college doesn't have HPV their whole life? And potentially has a lower cancer risk than someone who is repeatedly re-infected?
It's incredibly prevalent, but most people clear it within a couple years, and won't even know that they had it. The time to clear it is just variable and depends on your body's immune response, the longer you go without clearing it the higher the cancer risk.
In a sense no, hence the choice to vaccinate younger children who will mostly not be sexually active yet.
But because the modern versions of these vaccines cover many strains (initial vaccines were two, Denmark chose a 4 way vaccine, now a nine way) it's very possible that you get a meaningful benefit by being protected from say six strains your body has never seen, even though the three it has already seen wouldn't be prevented.
I've heard of it being administered post exposure as a way to help the body fight the existing infection. Seemed a little odd when I first heard it as HPV should clear on it's own.
Many doctors in Germany stick very closely to the recommendations of the Stiko (standing committee on vaccinations) and take a lot of convincing to vaccinate more, or they outright refuse. It's really annoying.
Depends on your health insurance. My previous insurance company paid back the full cost when I was 30 years old. I can recommend checking https://www.entschiedengegenkrebs.de/vorbeugen/kostenerstatt... (and then also confirming that with the insurance company over text, just to be safe)
In Denmark you can. I was in my mid thirties when I went to my doctor to ask them to prescribe it. Before each shot I would go to the pharmacy and buy one dose and go to the doctor to have them administer it for me (if I wanted to). At that time I think it was free for teenage girls, now it's free for teenage boys as well.
The evolution of who gets HPV vaccines is really interesting. At first it was young women, as vaccinating young men had a very marginal decrease in cervical cancer rates via indirect protection (which itself is a function of how many young women are vaccinated). Then as HPV infection was linked to more cancers, vaccinating young men crossed the cost-effectiveness thresholds many governments use.
Vaccinating older populations is similarly just a less clear-cut case, but it's a cost-effectiveness argument, not one purely driven by if the vaccine offers protection.
Seriously. My memories of this vaccine are so foggy because I distinctly remember being told "its not effective for men" and that it would be an expensive out of pocket cost. Yet, the whole point would always have been to prevent the spread.
it's not just the cost of the vaccine roll-out though, you need test on your target demo and since these are healthy people the bar is very high. If the demographic (like males over 45) shows very little involvement in the infection vectors then testing might fail the cost-effectiveness, not the delivery of the vaccine.
Generally yes. I asked my primary care physician and would have been able to get the vaccine dose from the pharmacy (paying for it myself) and she would have administered it.
> "Details of the Gardasil litigation show how Kennedy took action beyond sowing doubt about the safety and efficacy of vaccines in the court of public opinion and helped build a case against the pharmaceutical industry before judges and juries."
> "Kennedy, a longtime plaintiffs' lawyer, became involved in the Gardasil litigation in 2018 in collaboration with Robert Krakow, an attorney specializing in vaccine injury cases, Krakow said"
I remember this being a big controversy in Texas in the 2000s. Our Republican governor, forcing girls to get the vaccine! What does he think Texan girls are, lusty?
Not like disease prevention is a universally good thing and some people tend to have sex.
At the end of the day, religious radicals like STDs because it enforces their worldview that having multiple sexual partners in a lifetime is a sin.
If i have no memory/record of getting this vaccine (but there was a possibility that i could have already gotten the vaccine years ago), is it okay to take it again?
That's great to hear! Here where I am, Ontario, Canada, I just barely missed out on getting the HPV vaccine for free in high school. At the time, they were only vaccinating girls, but added boys a year or two after me.
This site is full of people perfectly capable of reading most studies. I would much rather see these links go to studies than endless clickbait articles about studies.
The conclusion of the study show that about 30% of the women in the study from 2017-2014 tested positive for one of several types of HPV infection. This does appear to be a reduction from an earlier 2013 study but the earlier study was by different authors with different methodology so gauging the scale of the reduction is not straightforward. My opinion is that a safe conclusion of the study is that HPV prevalence has not increased.
> Infection with HPV types covered by the vaccine (HPV16/18) has been almost eliminated. Before vaccination, the prevalence of HPV16/18 was between 15–17%, which has decreased in vaccinated women to < 1% by 2021. However, about one-third of women still had HPV infection with non-vaccine high-risk HPV types, and new infections with these types were more frequent in vaccinated than in unvaccinated women.
The conclusion seems to be that the vaccine is extremely effective at preventing infection by the strains included in the vaccine. One might reach a stretch conclusion and infer that the 9-valent vaccine would be even better as it would (probably) dramatically reduce the risk of several of the remaining “high-risk” variants.
The study is linked early in the article and is fairly dense, the article summarized it well and is a lot more readable.
16/18 are the most carcinogenic strains, they have been close to eradicated in Denmark. "Denmark close to wiping out leading cancer-causing HPV strains after vaccine roll-out" is the full headline and 100% accurate.
Those were the only two high risk strains covered by the vaccine used in the time frame studied. The study covers the first cohort of girls given the 2008 version of the vaccine when they recently reached age to start screening. It is expected to not see other strains affected in this study, even though current vaccines are broader. The total number of high risk HPV cases in the study went down post-vaccination.
The notion of numbered strains of HPV is about diverging lineages going back hundreds of thousands of years in a highly conserved, slowly mutating virus. They are not comparable to things like seasonal COVID or flu strains.
> about 30% of the women in the study from 2017-2014 tested positive for one of several types of HPV infection.
That number was referring to different strains not covered by the vaccine. The study says the rate of infection dropped to less than 1% among those strains the vaccine protects against.
It could still protect you from one or more strains that you haven’t been exposed to through sexual partners and avoid contracting or passing it along to a future partner. There’s no practical way for a man to be tested for HPV (I asked and the doc said “it’ll be very painful and the result will be the same: get the vax”)
I experienced zero side effects when I got HPV vaxxed at 38yo.
It turns out a human body has a lot of surfaces facing the "outside" in some sense and we forget about the parts we can't see. Most of this surface is not covered in what we'd conventionally consider skin. It's bit like if you were looking at surfaces in a house and forgot the walls and ceiling.
It’s insane to think that someday humanity will finally find a cure for cancer, and then after all this money and research and struggle people will just… choose not to use it.
A cure is a treatment, a vaccine is a prophylactic. The most dangerous, by far, cancer that this would help mitigate is cervical cancer which makes up about 0.7% of cancer deaths in the US, exclusively amongst women. The overwhelming majority of cervical cancers occur in Africa due to the fact that HIV/AIDS dramatically increases your susceptibility to developing it.
> The overwhelming majority of cervical cancers occur in Africa due to the fact that HIV/AIDS dramatically increases your susceptibility to developing it.
Considering we're talking about a sexually transmitted disease, the much higher prevalence in Africa of having multiple simultaneous sexual partners is surely relevant.
> having multiple simultaneous sexual partners is surely relevant.
medically, not really. the vaccine acts the same. epidemiology wise, it makes it more effective, assuming the correct coverage.
I would just suggest that stating that an entire continent of different races/culture/religions "having multiple simultaneous partners" smells just a little bit of "savages over there", which given that we are talking about _evidence_ based outcomes, jars somewhat.
> medically, not really. the vaccine acts the same.
That's not a response. The multiple simultaneous sexual partners are relevant to the fact that prevalence of the disease in Africa is very high. This is not a vaccine-related question, so the action of the vaccine can't speak to it.
> I would just suggest that stating that an entire continent of different races/culture/religions "having multiple simultaneous partners" smells just a little bit of "savages over there"
Funny, if you look at my comment, you should see that it refers to "the much higher prevalence" of this behavior in Africa.
HPV infections can usually be cleared up by a healthy immune system, so there's a causal relationship with the immune system. There's a lot more information on it available here. [1] Risk factors for it managing to progress onto cancer include obviously the type of HPV infection and "immune status, the presence of other sexually transmitted infections, number of births, young age at first pregnancy, hormonal contraceptive use, and smoking."
I also wonder if 'number of births' is not largely a proxy instead for the shift in the immune system of a woman while pregnant; in effect they tend to become slightly immunocompromised, probably as a means of preventing an immune response from harming the baby.
I think this is untrue. All work by uncontrolled replication of cells. This is why nanotechnology had the promise of being able to eliminate cancer - imagine a nano scale robot regularly cycling through your body on occasion, looking for and eliminating cancerous growths.
Drugs, though, probably have very limited potential.
And even before the antivax nutters here went from fringe to a significant social force, HPV vaccines were already being decried for "promoting casual sex." Our culture is so broken in so many ways.
Also, forget "She might die of cancer" just exactly how bad is it if your daughter is a whore ? What else are we ruling out, independent business owner, politician ?
What happened to "I just want my children to be happy" ?
Of course, I for sure held off on having casual unprotected sex with multiple partners as a teenager because I was worried about contracting HPV, but thanks to Gardasil my slut era was legendary and enduring.
Maybe we’re seeing selection pressure against those prone to addictive cycles of social-media influenced misinformation?
Like, anti-vaxers died at higher rates in Covid [1]. This will continue across disease outbreaks, particularly ones for which we have near-comprehensive vaccines like measles. And given antivax sensibility is heritable (through parenting, not genes), one would expect this to stabilize the population over several generations to one that doesn’t have this defect.
The article you are referencing is based on CDC data which is not matched by a more complete data maintained by UKHSA. I think Norman Fenton commented on that at some point. I'd be careful when taking its conclusions at a face value. I actually went through that paper and looked at the UKHSA data back in 2023.
And the government was spreading a lot of BS, too.
I'll let the "CDC can do no wrong" crowd pile up.
very few people are against vaccines per se, they are just against *unsafe* vaccines. "anti-vax" is a term used to dismiss dissident without having to deal with their arguments i.e an ad hominem. As an analogy, if I object to high levels of mercury in fish, am I anti-fish? or anti-poisonous-fish ?
The people that are against "unsafe" vaccines do not do the proper research to determine whether a vaccine is actually safe. These people claim that safe vaccines, like the COVID shots, are actually unsafe because they googled up some claims that were not rigorously researched or reviewed.
I had seen attempts to engage with these arguments in good faith. It was wasted effort.
I think you missed the point. Granted the disease is dangerous, but what if the cure is worse ? If we don't know this is true, we ought to assume the risk outweighs the benefits until PROVEN otherwise- that is the precautionary principle. As an analogy take Vioxx, a headache remedy that caused thousands of heart attacks. Merck the manufacturer started an advertising campaign for the drug AFTER the learned it was killing people - they were ultimately fined 4.5 billion.
The docket shows us that pharmaceutical companies are serial felons who have paid some of the largest fines in history for lying about their products. It is prudent to be skeptical until proven otherwise.
I agree.
Pfizer settled more than a few cases.
When talking about a low probability but catastrophic event, the burden lies on the side of the vaccine manufacturer and a mandating agency (and not on the side of the consumer) to prove beyond any doubt that the treatment is safe. I doubt Pfizer has met that bar.
Edit: To all the pro-Pfizer downvoters, feel free to take some Zantac. You have learned nothing.
All the brand new vaccines with no sufficient testing can be considered unsafe. I like vaccines in general (I am European, we have lots of free and mandatory vaccines as kids), but I don't like to be a test subject for brand new ones. Yes, someone needs to test new vaccines to gather data about safety, but some people are more risk adverse. I am a "take it later" guy.
I specified "widely used", which effectively excludes brand-new vaccines.
I don't have any issue with what you're describing. The J&J COVID vaccine would be an example of caution being advisable, since you never know what unusual interactions (e.g. with blood clotting) might occur in a larger population than the safety studies looked at.
But that's not the usual definition of an anti-vaxxer.
Anti-vaxxers carry on about things like thimerasol which (1) were removed from most vaccines 25 years ago and (2) give you an exposure to mercury equivalent to eating something like a single can of tuna.
This is now a global problem. The guy who started it, Andrew Wakefield, is British, and we have long had antivaxxers in Europe too.
Prior to Covid, the antivaxx scene was vaguely left-and-green oriented, biomoms, vegans and other "very natural" people; you would expect them to vote for Greens or even more alternative parties. This changed abruptly and now the antivaxx scene is mostly rightwing, but the common base is still the same distrust.
I wonder if this is the price we pay for radical informational transparency. Nowadays, democratic countries with reasonable freedom of press cannot really prevent their own fuckups from surfacing in the worst possible way. Some people react by complete rejection of anything that comes from "official" channels and become ripe for manipulation from other actors.
i dont think its nearly so transparent. its easy to be recommended and read some viewpoints, but very technical and hard to be recommended others.
with radical information transparency, id expect both views to be equally easy to parse and to be recommended both, in which case the choice would be obvious to everyone, or at least they could very well describe their risk tolerance to different risks, or laziness, for why they made a certain choice.
i expect im not up to date on all the vaccines i should be, but its on laziness rather than gwtting bad information. ...also a lack of information on which ones i should have.
> I wonder if this is the price we pay for radical informational transparency. Nowadays, democratic countries with reasonable freedom of press cannot really prevent their own fuckups from surfacing in the worst possible way. Some people react by complete rejection of anything that comes from "official" channels and become ripe for manipulation from other actors.
Such people have always existed, unfortunately. I don't think it's a result of anything particularly new.
The people existed, but a portable always-running conveyor belt of bad news that is addictive enough to make them glued to the screen did not.
In the 1990s, you had maybe 15 minutes a day on average to consume news, either from a paper newspaper, or from an evening TV relation. Now, quite a lot of people spend 20 times as much time doomscrolling. Of course the impact will be much more massive.
I think it’s a myth that people consumed less information just a few decades ago. Remember that newspapers used to have at least two daily editions (morning and afternoon). And of course radio has had continuous news flashes for a century.
This is similar to the myth that people communicated less before the messaging apps: they were glued to their phone for hours, sent telegrams and even sent very short letters (delivered same day!) to just say "thanks for the lunch that was very nice" (I found some in my grand-parents’s papers)
Our (social) communication appetite has always been quite insatiable.
Sure, but this implies the only source of "manipulation from other actors" is the news, media, or government. Churches, cults, and just other ignorant people existed to cause distrust in authority.
I'm not denying that there's a difference - obviously technology has enabled the scale of things to grow quite a bit, both good and bad - but it's beside my point, which is that, given that it's not a new phenomenon, blaming it on technology seems doomed to failure. Without solving for the underlying issues, people will continue to mistrust authority, whether they're being told to by news or their neighbor.
Mistrusting authority might be good. What I see happening is in fact trusting too much into "authority" without penalizing it for inconsistencies - I would call it more like blind faith. I feel this happens because it makes it easier than questioning everything you hear and deciding for yourself, and accepting you might be wrong, or that the information is unknown. People want a savior and a simple solution!
> blaming it on technology seems doomed to failure
Recognizing that technology is now so convenient, psychology manipulative, and operates in a furiously fast feedback evolutionary regime, and that it has radically increased the spread of cultural irrationality isn't about "blame" in a judgy moral way.
It is about characterizing major factors behind the problem.
The enormous amount of near instant coordinated (by intention or dynamic), interactive misinformation, made so conveniently available that large percentages of the population routinely and enthusiastically expose themselves to it, participate in reinforcing it, throughout their typical day, is very new.
> "Not everything that is faced can be changed, but nothing can be changed until it is faced." -- James Baldwin
That's a little like saying nuclear bombs aren't a technology, but a human problem. And you bet, they sure are, but it's a lot harder to wipe out everyone, if the nutjobs in your community just have a pointed stick.
And 'nutjobs' may be pejorative, but I'll hold on to it as apt. At the same time I assign no blame, for it is an issue of cognition. The best way I can describe it is, intelligence is not a single factor. And it's not even a few factors. It's a massive bar graph, with 1000s upon 1000s of bars, each delineating a different aspect of intelligence.
A lucky few may score high on all those bars, yet even the most intelligent of us tend to score high on only some of those bars. And my point is, I've seen people immensely intelligent on some of those bars, yet astonishingly deficient on others.
We love to make fun of politicians, so I'll use one as an example here. Politicians tend to be incredibly personable, and very difficult to dislike in person. They exude congeniality, they read you like a book, and can often orate your wallet completely out of your pocket, and you'll thank them for it too. It's how they managed to go so far politically, yet some of these same politicians have severe and massive deficiencies in cognition.
Back to the pointed sticks, and the nutjobs who would wield them pre-tech, these people are simply as they are. Yet in the past, you'd see one nutjob in a community, and they'd be surrounded by normalcy, it would temper them, mitigate their effect, sand off their edges so to speak.
Yet as our communities grew in size and scope, these individuals could finally meet more of their ilk. A large city might have dozens of them, larger still cities hundreds, and they'd meet up. And as technology grew, and access to the printing press become possible for all, and for less and less cost, these same people could then send their madness in newsletter form to even those small communities where maybe only one nutjob existed.
But those people needed to still connect in some way. Maybe through an ad in the back of a magazine, or something akin yet far less gated by 'normals'.
Yet today? Now? Algorithms match you up with all those nutjobs. Where before you might live in isolation, and the friends you had might scoff at that weird idea you have, now you've found a community of hundreds, or thousands just like you! And they all affirm your madness, they pat you on the back, they congratulate you for seeing the light! They whisper all those sweet nothings into your ear, all those secret things you knew were true, and they listen to all you say on the subject.
For the first time in your life you have a home, a community, and before TikTok, or some weird forum, it would have never all been possible. You'd have been isolated, even in the age of magazines, and print, for you'd have never found one another.
And worse, now profit enters the system. Those who would steal, or thieve, or build bridges with sub-standard concrete for profit, or anything for money regardless of cost to us all, appear on this scene. They see those nutjobs, and they seek to profit from them. They own youtube, or tiktok channels, and often do not believe in anything but profit. They'll tell you anything you want to hear, espouse any crazy idea, and like that bridge built with substandard concrete, they'll take the money and run as society collapses around them.
This profit motive was always there, see cults. Yet the reach and scope was just not what it is today, there is so much more range given to a single person now.
People have had a mistrust in authority as far back as when nomadic tribes were the norm but somebody had to decide where to hunt or gather that day or to move on. Good luck changing human nature.
Chatty Kathy could only share her moonbat ideas with a couple people at a time. Now she has a TikTok and the ability to go viral. Even folks sharing her video to mock it are spreading her message.
That was the most ignorant comment I have seen on this matter. Nothing about vaccines, just attacks on the people questioning vaccine safety. If you truly believe all vaccines are completely safe I have a bridge to sell to you.
I don't believe that any medication is completely safe, but I am fed up with all the "Gates puts 5G chips in vacciness in order to sterilize humanity" kooks who are the flag-bearers of the entire movement, and I am also fed up with the somewhat less crazy people marching behind them, who nevertheless cling to the long discredited Wakefield paper and scream 'autism, autism!'
The fraudulent Wakefield paper may be one of the most destructive pieces of information released upon mankind.
Although you are (as I understand) right, the question itself is valid, lots of diseases spread to species other than the one that is in the name… Chickenpox, monkeypox, swine flu, or even the Spanish flu.
Lots of diseases are potentially zoonotic. When diseases have animals in the name, it often just refers to zoonosis itself (except of course chickenpox). But when diseases or parasites have human in there name, it's almost always because it's a disease that only effects humans.
The human flea is not extinct and is actually one of the counter examples as it does infect other species such as pigs.
Humans cannot host infestations of dog fleas. You can be bitten by a dog flea, but you cannot complete it's life cycle. If you find yourself constantly dealing with fleas, you are in the presence of an active infestation from another animal.
Denmark is in a chronic baby shortage [1] and people in Western democracies are having less sex generally [2]. So, yay, less HPV. Go get vaccinated [3]. Unfortunately, there are some pretty significant (and sad, yes, sad) confounders.
Do you mean there is a causality between less sex and HPV vaccination, when you write “confounder”? I can’t find any study supporting this, hence double checking.
I think maybe they mean that the fact that people are having less sex is confounding the cause-effect relationship between vaccination and fewer cases of HPV. I don't know about people having less sex, though. That seems hard to believe.
If you're living in the US: please consider getting the vaccine, ragardless of your age. It was covered by my (rather shitty) health insurance. It consists of just 2 (EDIT: 3 for adults!) doses. It is recommended for both Males and Females.
It is actually not straightforward to do. Safeway Pharmacy refused to actually give me the vaccine when I showed up saying I'm not in a group that's eligible. One Medical told me that it would be a $400/shot 3-shot regimen. I'll probably just travel to India some time to visit family and get Cervavac there instead of Gardasil here. It's about $20/shot.
The Walgreens pharmacist scolded my 35 year old girlfriend for getting it, saying that it was useless at her age. She insisted and he reluctantly administered the first dose (and later got the rest at another location). He even questioned her motives for getting it once she was in the room. I was appalled by the whole interaction.
Maybe I could have understood if I had said she was my wife. But it is still stupid to assume that there will be no other sexual partners ever again in her life.
With the prevalence of HPV, it's likely that we have one or more strains already, but who knows. Maybe the strain of a future partner is what will trigger cancer.
If anyone here can enlighten me about the pharmacist's attitude, I would be grateful.
I got vaccinated way before I met her, and even as a male I didn't get any comments from the pharmacists that gave me the shots.
Gotta love the logic of telling adults not to get the vaccine because its probably too late and you're already infected, while also telling parents not to give it to their kids because it's only for "prostitutes and promiscuous gay men" (per RFK)
As someone with a relative dying of HPV cancer, who had at most two partners in their life, I hope RFK endures the most painful death possible.
I'm so sorry you and your family are going through that. My condolences, from an internet stranger with family members with cancer as well.
I don't condone violence or wish ill upon anyone... But there are certainly some people that I'm just like, fuck that guy. And yeah, fuck RFK.
My heart goes out to you and your family :-(
> it's only for "prostitutes and promiscuous gay men" (per RFK)
It’s almost as though he has had a brain injury.
I believe you are referring to comments made about the hepatitis B vaccine, not HPV.
That's right; that particular HHS Secretary comment was about Hepatitis B.
> "“Hepatitis B vaccine was made for prostitutes and for promiscuous gay men,” Kennedy said in an interview on his Children’s Health Defense show in 2022."
https://www.washingtonpost.com/health/2025/06/25/rfk-jr-vacc...
The WaPo article doesn't bother to refute RFK's lies, but here's /r/medicine responding to them (in the context that's topical this week—RFK ordering the removal of the Hepatitis B vaccine from the children's schedule):
> "Let's be even more clear about this. If you contract Hep B in the first year of life, more than 90% develop the chronic form, and the need for liver transplant is much higher.... Worldwide, the second most common route for children under 5 to catch HBV is from other children, and that's not by doing IV drugs or having sex. (First most common is vertical, through mother.)"
https://old.reddit.com/r/medicine/comments/1niml9d/kennedys_...
Even if you're married, you might not be married forever, could be in an open relationship, or a partner may cheat. None of which is the pharmacist's business.
MY partner also had a hard time getting it, at the age of 26. I also had a hard time getting it, at age 26.
People read the recommendation guideline, and brainlessly follow it without care of why it's in place. If you haven't had a reason to be exposed by 30, 30 is as good of a time to get the shot as 9.
One of the few times I can say the majority of medical practitioners don't know what they are talking about when they spit dogma instead of life-saving sense.
I think it’s more that people judge and then look at the guidelines and get even more judgey and feel justified in doing so.
I'm 44 and didn't catch any gruff from the staff. I'd complain to the head pharmacist.
HPV is approved up to age 45 with “shared clinical decision making”. Above age 26 it may be more difficult without a clinician due to unimportant bullshit. Try a Planned Parenthood.
PP is where we managed to do it. Anyone who hasn't had the Gardesil-9 — which actively targets cancerous strains — please don't hesitate. It's byad.
Depending on the state you’re in, you likely have to get a prescription from a doctor, not a pharmacist, due to the wording of the law.
Simplest route would be to call your primary doctor and ask if they can give it to you at your next annual checkup.
My Dr doesn't give me stuff. But that's only because I'm one of the millions of Americans who has no healthcare beyond what can paid out of my pocket. Not his fault.
Maybe try Planned Parenthood, they do stuff like this.
Surely he can give you a prescription.
He could but then I'd still need to pay for the vaccine - which is the issue. Specifically, I would be adding the vaccine onto the long, long list of medical stuff (vaccines, tests, procedures) that I need to buy if the funds ever come available.
as far as I can tell, pharmacists cannot give vaccines off-label (this is an issue for the new covid guidelines and some states fell back to an Rx if no longer eligible for the covid booster).
Your PCP may give a vaccine off-label though, which is how I got my Shingrix, though I had to pay out of pocket.
What’s the procedure of getting Cervavac in india?
You can pretty much walk into any decent clinic and just ask for one.
In Denmark its not recommended for women over a certain age.
So please don’t get it regardless of age. Its not really considered effective for women who have been sexually active for some time.
Which is why its only recommended for girls, not women.
https://www.ssi.dk/vaccinationer/boernevaccination/vaccinati....
Tldr; Dont rush to get a vaccine that is probably not effective for you. Make an appointment with your doctor and discuss it with her first.
There is many different strains of HPV, the likelihood of already have contracted them all is small. It will still protect you against strains you don't have. It also protects against genital warts. The vaccionation program targets young girls because thats the most efficient time to take it and has highest benefit/cost. You will still reap benefits of taking it later.
I dont see any reason not to take if you get it for free and you are planning to be sexually active with multiple different partners.
This. Protects against strains you don't have, reduces the spreading. We (male that have sex with females, and haven't been vaccinated) are a huge infection vector.
My doctors have generally refused vaccinating me for years (Male/43yo), but finally a new (female) doctor told me it's a good idea. I'm not in a risk group, so I have to pay for the vaccine: Gardasil 9, 3 doses, 3 months away of each other, ~€200 each, although studies say that 2 doses might be enough.
In reality, you can pay to a private doctor so they write you a prescription, but I feel more validated if my doctor says it's OK :)
just keep in mind that not all kinds of HPV vaccines protect against all the strains causing warts! Some do, but not all, check the specific brand you're getting! Obviously cancer is worse, but the extra protection is nice to have.
Even if there's a small chance that it would make a difference, wouldn't it be worth it if you have the money and you feel like it's your duty to protect others ? At worst, it's useless and you have contributed to make a vaccine more profitable (which, IIUC is a problem for vaccines ?)
At worst, it's harmful!
From top of my layperson head: bruised insertion sites, tainted needles, tainted vaccine supply, customer capacity crowding for the pharmacy, squeezing supply capacity for actual target demographics, etc etc etc.
Things have tradeoffs, even if they are subtle. Relentless follow-through on marginal protocols should generally be treated with suspicion.
Stranger danger advocates brush off the criticism that most abductions occur among family with the "if there's a small chance it would make a difference" argument, but this ignores the real harms of teaching children to fear everyone by default.
Thank you for a sane comment in this discussion.
And note i believe they just increased the recommended age of administration up to ~40yo? Throat cancer sucks. Get the vax.
Why is there an age limit on an all encompassing vax, wasn't the famous posterchild for this disease Michael Douglas?
This is mostly guesswork but I think you need to get the vaccine before you catch it and lots of people have it as they get older.
If you have a limited supply the greater bang per buck would be to start with the young people who almost certainly haven't caught it yet and then work your way up.
It's less that and more "we just haven't tested it in older populations yet".
Sure you are more likely to have it the older you are but even then you are unlikely to have all the strains. The vaccine covers like 9 or 10 different strains so it can protect you from the other strains even if you already have one of them.
It's generally only when you get into the 60s and up that the justification for not recommending the vaccine changes. Once you get into those later years the immune response changes a bit and you get new concerns.
An example being herpes zoster (chickenpox) where after a certain age you are recommended to get the shingles vaccine instead of the chickenpox vaccine since the way the disease presents and how the body reacts to it changes with age (technically shingles can happen at any age but generally herpes zoster presents as shingles instead of chickenpox the older you get).
> you are recommended to get the shingles vaccine instead of the chickenpox vaccine since the way the disease presents and how the body reacts to it changes with age (technically shingles can happen at any age but generally herpes zoster presents as shingles instead of chickenpox the older you get).
If the underlying virus is the same, what is different between the vaccines? How it presents shouldn't matter as much?
> what is different between the vaccines?
The shingles vaccine is a larger/more aggressive dose than the chickenpox vaccine.
And nowadays chickenpox vaccine uses live attenuated viruses (i.e. modified to be non-infectious but still look the same) whereas the shingles vaccine uses recombinant proteins. This allows the shingles vaccine to deliver the higher viral load that they want for inoculating against shingles without putting a bunch of live viruses into the body.
It's also worth noting that the recombinant vaccine is more effective for shingles compared to the equivalent viral load live vaccine by a significant margin. It's something like 90% reduction in incidence vs 50%.
----------
> How it presents shouldn't matter as much?
It's not an all or nothing thing but it's a matter of percentages.
And the big reason why they present differently is that chickenpox kind of attacks every part of the body since it's new. It of course does best at infecting the skin and nerves but it mildly affects every part of the body. But then it goes dormant in the nerves because that's where it's most "compatible" and the body is the worst at fighting it.
So then with shingles your body still has the immunity but the reactivated virus is able to out-compete your immunity in the nerves and it wakes up in whatever specific nerve and spreads along that nerve. This is why shingles generally presents in a band on the body. It's spreading along a specific nerve "line" rather than spreading throughout the whole body, blood, and all.
And so the because the infection can't spread broadly throughout your body it ends up concentrated in that location and presumably the higher viral load combined with focusing on the specific proteins rather than the whole virus increases the body's sensitivity to these flair ups, catching them before they can reach momentum. And then that focused immune training sits on top of the body's existing immunity for the initial "whole body" presentation of the virus.
> Why is there an age limit on an all encompassing vax
Vaccines are subject to stringent safety standards since they’re administered to healthy people. The age limit may suggest that at the time of the recommendation, in the relevant jurisdiction, the manufacturer had not studied its safety and efficacy in >40 year olds.
(I also don’t think it’s an age limit as much as the upper end of a recommendation.)
E.g., the Shingles vaccine simply hasn't been tested in <50 populations. But if you're under 50 and you've had the chicken pox, you should ask your PCP to prescribe the shingles vaccine off-label and go get it, because shingles sucks and the vaccine definitely works.
I don't follow your logic here. The GP comment is saying that the vaccine isn't available for populations it hasn't been tested for. Why are you recommending people ignore the fact that safety and efficacy testing isn't available for their population?
And how can you say the vaccine definitely works for populations it hasn't been tested on?
It's an age limit to the approval caused by a lack of studies. To study it in over 45s you need suitable over 45s--but there aren't a lot of over 45s with risk but not prior exposure.
The rationale is that most sexually active people have already been infected with HPV anyway, so the largest benefit of administering the vaccine is at a young age.
A lot of replies that are mostly true, or somewhat true, or simply missing the real reasons.
There are two factors here:
1) Vaccine-derived immunity is a function of the individual's immune response, which in general, weakens significantly with age. It is not unrealistic for a vaccine to simply fail to elicit any response in someone old enough.
2) It is very, very difficult to recruit folks without HPV that are over 40 for a clinical trial. Most people of that age, who were never immunized, most likely have had it. This significantly convolutes the signal.
3) This is all especially confounded once something becomes "standard of care". Every year there are fewer and fewer people age 40+ with HPV.
For these reasons, the vaccine is currently officially ??? in people over 40. Most doctors will prescribe it anyways if you ask. It may or may not infer immunity. It almost certainly will not harm you.
To be blunt: Cost-effectiveness.
In the US, recommendations come from the United States Preventive Services Task Force. They explicitly do not consider cost in their decisions. They look at harm vs benefit, usually with a focus on mortality reduction. Most insurance companies will base their coverage on the USPSTF.
https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
Decisions as to whether or not to pursue regulatory approval for, example, expanded coverage of the HPV vaccine to men, or older age groups, is very commonly informed by cost-benefit calculations. I've worked on those projects, seen presentations by my colleagues, etc. There was a good two years of my life where this was what I worked on (mostly strain replacement post-vaccination).
It's a level of evidence that's generated (usually) prior to ACIP, and it is presented to them, while there is not necessarily a bright line threshold.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7652907/
if you suspect that the cdc has been captured by big pharma, "and we don't care about cost of these recommended drugs" should pretty much seal the deal for you :)
Oh wow how the conspiracy theories change.
There used to be fears of "death panels" controlling access to medical care when Clinton tried to propose universal health care.
The CDC and FDA are about safety, not cost management. And they get significant complaints about how much they regulate pharma and are impediments to pharma for that!
Now the conspiracy theorists of the other side seem to be having their day in the public mind.
This isn't a conspiracy theory - I worked on projects around that during graduate school, and talked to my colleagues who worked on them. Cost-effectiveness thresholds are a consideration that goes into how widely a vaccine will be rolled out, etc.
That was, for example, why boys were originally not part of the recommendation for the HPV vaccine. It would double to cost, while doing very little to prevent cervical cancer via indirect protection. Once the evidence accumulated that it was associated with other cancers, that stopped being true.
Similar logic applied to older women and men.
Cost considerations would be more from the CDC's Advisory Committee on Immunization Practices, not the mentioned above United States Preventive Services Task Force. (Oh, and I see that another comment parallel to mine up there now mentions ACIP too...)
In any case, somebody thinking that evaluating safety and efficacy aside from cost considerations means that there's collusion with pharmaceutical companies would be a conspiracy theory.
have you ever wondered if it's a great idea to have former generals populate the defense department, procurement, and revolving door employment with defense contractors? what could go wrong? what could go expensive?
you are one of the generals in this scenario, thinking that evaluating safety and efficacy aside from cost considerations couldn't possibly lead to higher costs because you yourself and everybody in your industry are so darn smart, clever and by god ethical.
what did you do before this? work on creating the covid 19 virus, or just calling people who questioned it "conspiracy theorists"? what's that, you were in caves tracking down the zoonotic transfer, which you'll find any day now, scientific consensus and all, peter daszak assured you you'll find it and he's beyond reproach!
and I resent you saying that I'm a conspiracy theorist because I have not said any of this is happening, I am pointing out the vector where it could happen (go back, look, where did I say any of this was happening?)
it's simply, methinks the lady doth protest too much
>have you ever wondered if it's a great idea to have former generals populate the defense department, procurement, and revolving door employment with defense contractors? what could go wrong? what could go expensive?
The real question is why are people who are capable of identifying the problem when it's generals sitting on the board of Lockheed or a telecom industry insider heading the FCC suddenly unable to do so when it's someone who's made their career engineering stormwater solutions taking a position at the EPA or the pharma industry funding research that the CDC will base its policy on.
The CDC, the DOD, etc, etc, these are all symptoms of the problem and a distracting sideshow.
As usual, the real evil is in the minds of the people who peddle double standards and the fact that we have architected society such that this behavior is mainstream and those who engage in it are not marginalized.
clear financial incentives are never conspiracy theories: always follow the money.
thinking that they are conspiracy theories? that's a conspiracy theorist.
There's no clear financial incentive on the decisions here. If there were, it would be collusion, and not in the open, and therefore not clear.
the cdc decides to make recommendations no matter how expensive, and big pharma collects the expensive, and the expert community works for the cdc and big pharma? do you even understand what regulatory capture is? do you understand how framing something as saving lives no matter the cost draws attention away from funneling money to big pharma no matter the deficit?
let me guess, you work in this area too.
Since you already replied to my other comment, hopefully you understand now that ACIP takes into account cost as part of its recommendations, but the independent group we were talking about in this thread does not.
Even with CDC its recommendations, it's not the final word.
The reasoning you're highlighting here is highly conspiratorial
It's likely that they haven't tested it as thoroughly in older folks and that most older folks have already been exposed to HPV.
Already exposed without having any issues from it.
That last part doesn't matter. You can develop cancer later.
Conspiracy theory: they want old people to die.
Finally, affordable housing!
Yeah, screw those old people with their houses! We should deliberately kill them off so that we can have cheaper houses! But please, don't let the next generation do that to us when housing turns out to be expensive for them too!
Brilliant.
I have yet to see my government subsidise dangerous recreations based on a cost benefit analysis.
I think government costs for a retiree are about NZD27000 a year.
A government should be subsidising a good deadly recreation for say NZD10000 a year. Assume expected life remaining is 10 years, assume recreation has a 10% chance of clean death, assume low chance of expensive ongoing chronic outcomes.
Suggestions: Car racing, climbing, fentanyl habit, boat racing, ocean sports, Russian roulette, foreign legion soldiering, free climbing, wingsuiting.
Maybe a better way would be to allow people to gamble with their lives to win a few tens of thousands (need to balance costs against expected savings). Pay out to winners, but saves the government their expected lifetime of expenses for the losers. Let the old and unhappy roll-the-dice and the winners get to live it up a little . . .
Fun fact, that’s what happened in my country of birth, which is USSR. To some extent.
In the UK, the recommendation is up to 45, but there are providers that offer it without an upper limit.
It's not approved for those over 45. (AFIAK, simply because so few people in that age group would have risk without having had prior exposure. Basically only those who had divorced or lost their long time partner.)
This is not true any more. The vaccine has been shown to lower cancer risk for those who already carry the virus, so it is recommended even for people who are HPV positive
That's interesting and I would like to take, can you give me a link/ ref for citation?
This is a totally predictable result, there are dozens of HPV strains and the vaccine will immunize against 9 of them that are high risk.
So, unless you are a sex worker or similar, it's unlikely you "have" all of them to the point where the vaccine is completely useless. You might later get infected with a strain that you didn't yet have, and it's precisely the one that kills you.
so how would one in the US go about getting it? gardasil?
That feels like a wild assumption to me - we really think people 45+ aren't having casual sex? less casual sex maybe, but I would imagine still a decent amount, statistically.
If you’re having casual sex at 45+ you probably already carry HPV.
There are over 30 strains of HPV with just 2 causing the majority of cancers. So sure, most people may have had some strain of it, but that's not really relevant unless immunity is broad across strains.
Or, you could have been suddenly cheated on and exposed, or divorced and recently entered the dating market, or thinking about opening up your relationship after decades of monogamy.
But the number of such people is low, it would not be easy to find candidates for the trial. Just because there are some doesn't mean there are enough to make it worthwhile for the drug company to do the testing to be able to market it to such groups.
Sure, but you probably don't already have all the strains which can cause cancer.
Yeah that makes much more sense as an explanation than OP.
Maybe, but all 9 cancer causing strains covered by the vaccine? HPV also clears on its own usually after some time afaik.
The original criteria was for people who had not already been exposed.
And over 45s that engage in casual sex have almost certainly been exposed. Those who don't have prior exposure probably have few or one partner in a marriage or marriage-like situation and thus are not likely to be exposed. Yes, they could be cheated on or the like but exposure is not expected so effectiveness can not be measured.
It's not "recommended" but your PCP can prescribe it off-label if you ask -- just ask.
I met with a new PCP a few weeks ago and it was recommended to me (at age 43). I got the first shot with the 2nd and 3rd scheduled for the coming months.
The issue is getting it covered by insurance. Otherwise it can cost over $1,000 for the full course of shots.
You can get costs down somewhat (half that) even uninsured with GoodRx.
Thanks for the recommendation! It seems like a good option, but afaict you still need to get your doctor to write you a prescription, and they may have to administer the shots as well:
https://support.goodrx.com/hc/en-us/articles/360000707483-Ho...
I'm sorry, but you sound like the people who try to get me take ivermectine for Covid. "just get it off label" or "tell the doctor you just got back from pauea new guinea and saw worms in your stool."
I know you are very well intentioned, but American's actually have very good doctors.
This is very different from recommending horse dewormer; if you can't tell the difference, I'm sorry.
When I'm in my doctor's office, and the doctor is saying "don't do that" it is quite hard to tell the difference.
Did you actually ask your doctor and receive that guidance, or is this purely a hypothetical?
Multiple times. I’ve specifically asked about this vaccine again and again.
I’ve had a few GPs in the past 20 years. They’re consistent.
I admit it’s weird. And ideologically I feel like a bit of a laggard.
But I’ve had both the conversation with my doctor, and the conversation with online “smart people who know better than my doctor” many times.
Ok, great. I'm just asking people to have that conversation.
Ivermectin is also used by dermatologists to fight face parasites that cause bad acne.
Ivermectin is also used to treat COVID in countries that have endemic parasite outbreaks. COVID responds well to steroids, but so do parasites. Giving steroids to someone with parasites causes the parasites to become much stronger, and trigger reactions from the immune system: fever, etc.
I ideally you could test for parasites, but time and resources don't allow for that in many countries. So if it's generally safe to just give ivermectin along with steroids when treating COVID - in countries where parasites are common.
Maybe I'm wrong about this. Maybe I'm making it up. Don't listen to what I say. Listen to your doctor.
It more like “I’d rather not have a current or future partner go through a painful LEEP procedure or cervical cancer because I exposed her to HPV”
> American's actually have very good doctors
Doctors aren't setting the rules on who gets what vaccine and when. RFK Jr is. Health insurance companies are.
RFK Jr wasn't doing anything worth talking about during the multiple times in the past 15 years my doctors have told me it wasn't recommended.
Please do not turn mainstream medical advice into a fringe position.
It's a standard vaccine for preteen/teen boys now too. If your doctor has been telling you not to get it for the past 15 years, they've been doing you a disservice.
I haven’t been a preteen boy for the past 15 years.
I got 3 doses of gardasil at 37 in Norway. I do not want to expose women to a potentially deadly virus (plus I’d also like to avoid having penile cancer and mouth/throat cancer myself). If your doctor is seriously advising you against taking the vaccine, you should consult another doctor for a second opinion.
I trust my doctor ... he's not some quack. I've looked online (multiple times over the years) and he's simply applying federal guidelines.
Family members have died from cervical cancer so I get it. I also made sure my younger children received this vaccine.
There a ton of vaccines I could seek out. Why HPV specifically?
If you’re not sexually active, is it still worth doing?
Yes.
“The route of HPV transmission is primarily through skin-to-skin or skin-to-mucosa contact. Sexual transmission is the most documented, but there have been studies suggesting non-sexual courses.
The horizontal transfer of HPV includes fomites, fingers, and mouth, skin contact (other than sexual). Self-inoculation is described in studies as a potential HPV transmission route, as it was certified in female virgins, and in children with genital warts (low-risk HPV) without a personal history of sexual abuse. Vertical transmission from mother to child is another HPV transfer course” [1].
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC7579832/
Right, but do the vaccines help against the strains of HPV that are transmitted via non-sexual contact? The vaccine being 9-valent implies (to me, a layman) that strains need to be targeted fairly specifically in order for vaccination to be effective.
Unclear. There are reports that warts (a form of hpv - but not one the vacine is directly for) are also reduced - but I'm not aware of formal studies
Yes. While direct genital contact is the highest probability way to spread it, any skin-skin, skin-mucosa, skin-object-skin contact can potentially spread it. Consider how much you trust others to wash their hands after using the restroom. Low probability, but possible.
You’ve got a low probability of getting polio, but there’s no reason not to be vaccinated if you can.
Even if you already have a strain, there are multiple types. In fact, people who got a vaccine early on, should consider an updated shot for more complete protection.
The protection from the vaccines lasts (probably) a lifetime, and HPV is quite widespread because it is: very easily communicable, and infections linger for potentially long periods of time without any obvious symptoms
Something like 80% of people are sexually active at all will be infected with HPV at some point. You may not have been sexually active, but your future partners may have been. I personally have a friend who went through stage 4 cancer contracted from her (now ex) husband.
So, of course not literally everyone needs to take it, assess your own risks, but it's quite an easy, highly effective vaccine: don't overthink it.
Life is long and unpredictable, while the cost is very low.
If you ever intend to be, yes.
Yes.
Why?
Rape, you might become sexually active in the future, and although sexual transmission is the most common way, there are some other ways to get infected.
Probably in reverse order
Unless you're never sexually active (meaning, you eventually do have sex), it's worthwhile getting since there is a risk to yourself if you get infected.
rape
Huh.
Any way to test for previous exposure? I'd be pretty surprised if I didn't already have antibodies. I suppose it doesn't matter though.
HPV tests are of low value (as an adult, if ever sexually active, you likely have it but can do nothing about it); a new biomarker test that can detect the cancers is being developed [1]. Ongoing cancer surveillance is all you can do once exposed without having been vaccinated (and if cancer occurs, immunotherapy).
As pm90 wrote, I strongly recommend getting vaccinated [2] unless a doctor tells you otherwise, even if you already have HPV or have had previous potential exposure.
[1] Circulating tumor human papillomavirus DNA whole genome sequencing enables human papillomavirus-associated oropharynx cancer early detection - https://academic.oup.com/jnci/advance-article-abstract/doi/1... | https://doi.org/10.1093/jnci/djaf249
[2] https://en.wikipedia.org/wiki/HPV_vaccine
(had three doses in my 30s via Planned Parenthood)
> previous potential exposure.
Isn't that basically everyone who's had sex with someone who had sex before the vaccine was common? I was denied when I asked my last doctor, on that logic. I'll ask my current doctor.
Yes.
Doctor recommended it to me when I was almost 30. So yeah, I'd say still go for it.
Note that the modern vaccine covers 9 different strains.
Right. And a few years ago my doctor's office had orders for both the the quadvalent vaccine and the nonavalent vaccine in the system and almost ordered only the quad for me.
Definitely ensure you're requesting the 9 strain version.
Not sure but theres zero downside to getting it
Information from the CDC [1], indicates Adverse Reactions are similar to administration of a placebo, which is not zero. Any vaccine administration has potential for negative adverse reactions, it's reasonable not to get a vaccine if you judge the upside is not worth the downside, even if the downside is small.
The CDC says:
> Like all medical interventions, vaccines can have some side effects.
[1] https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
If it's similar to placebo, doesn't that imply that it's pretty much non-existent?
No, the CDC says (at my previous link):
> A temperature of 100°F during the 15 days after vaccination was reported in 10% to 13% of HPV vaccine recipients. A similar proportion of placebo recipients reported an elevated temperature.
If you take some research subjects, do nothing to them, and then ask how they did 15 days after, I would be surprised if 10-13% reported a 100F fever during that time. But, that's a reasonable result from a saline or hpv injection.
... did you finish the series? I think for adults it should be 3 doses. https://www.cdc.gov/vaccines/vpd/hpv/hcp/administration.html
> It consists of just 2 doses.
Wasn't it 3 doses before?
you're right its 3, updated message
I'm male and read about this exposure vector back in 2012 when it was only rolled out to 12 year old girls, with a further guideline that nobody over 26 should take it.
this was pre- antivaxxer anxiety, and just run of the mill 'is the government condoning sex' anxiety, and it was controversial for that reason alone
the issue was that if you've been exposed already then the vaccine doesn't work. they had a test for women that can prove they've been exposed or not, and most adults have. they don't have a test for men that can prove they've been exposed or not, and most adults have. At the time, they had also only considered males to be carriers, with no cancers themselves.
so for the US government to recommend a limited stock and get insurers on board, it was all based on probabilities of exposure and utility.
I was younger at the time, naturally, I paid $600 out of pocket to get it across 3 doses because I figured it was worse than that, or I could get some 'male ally' brownie points from women. I wasn't wealthy then but figured this experience couldn't be taken from me even if I went bankrupt.
Since then, they've further linked it to throat cancers in males, because of our mouth's contact with genitals, and insurers are told to cover it across all genders and up to mid 40s. that's not really much of a difference now though, since the checkpoint is basically the same group of people, 13 years later.
They're still assuming older people are not worth bothering with, due to likely exposure.
There is an amusing side of this if you are male and not vaccinated yet, since nobody can tell if you've been exposed still: keep your sexual relationships with younger women. lol. in case you needed an excuse - higher probability they're vaccinated.
"this was pre- antivaxxer anxiety" - It was really, really not.
Another thing to keep in mind was that the initial trials were only using cervical cancer endpoints - the association between HOV infection and cervical cancer is really strong. At that time, vaccinating boys provided only indirect protection (you couldn't infect a female partner), rather than direct protection (you won't be infected) in the context of cervical cancer.
Women prior to sexual debut were the biggest "bang for the buck" and the obvious first recommendation target.
Researchers both at universities and in private industry then started working on other populations based on alternative endpoints.
> Women prior to sexual debut were the biggest "bang for the buck" and the obvious first recommendation target.
It was a stupid decision to leave out the boys. I mean hindsight is 20/20, but if heterosexual women were getting cervical cancer from HPV, and HPV is spread by sexual activity, then vaccinating the boys along with the girls would have been the logical thing to do in order to stop the spread.
I assume this wasn't done because they didn't do any studies on boys at first, because they were looking for cervical abnormalities to gauge vaccine effectiveness, and maybe it would have been hard to recruit a bunch of boys for a vaccine study that would probably not benefit them.
With that same hindsight we now know that HPV vaccination also prevents some oral cancers, and that leaving out the boys was a very stupid decision indeed.
These days most places do seem to also vaccinate boys. I got an HPV vaccine at some point in my 30s, and I pretty much had to wrestle my doctor into submission in order to get a prescription.
They had and still have no test for males.
So this is more about the inflexibility of our recommendation process and how insurers are tied to the regulatory agencies.
The logic makes sense but its about who is paying for administering to the carriers. Or what was initially seen as just carriers.
The current recommended cutoff is 45 (well, pre the current US administration). So I think it was a question of we tested this at the time in these high risk age groups and we were still waiting on the results for other cohorts that were less important.
I went to my local megacorp pharmacy out here in California, and asked about the COVID vaccine that’s no longer recommended by our anti-vaxxer overlords.
Apparently, it’s about as easy to get as an old-school medical marijuana card.
Results vary by state though. No need to travel to Canada or Mexico (yet).
Kaiser is continuing to cover it for everyone.
You might not have the same experience in OK or FL
If you live outside of the US, you should get vaccine too. Even one dose is effective.
https://publichealth.jhu.edu/ivac/the-power-of-a-single-dose...
That is a truly naïve way of thinking about a pharmaceutical product. Would you say the same about any other drug? What about blood pressure medicines, should everyone "consider getting it"? Completely ignorant, you have to consider multiple factors for the individual before taking any pharmaceutical drug and then you have to consider the risk from the drug, yes, low and behold, even vaccines can give side effects! The level of ignorance of the comments is staggering!
Apples and oranges. Blood pressure medicine is for people who have hypertension, and not everyone does. And hypertension is not contagious.
Conversely, almost every adult over 45 is carrying some form of HPV and a few of those forms cause cancer. If any of those adults has unprotected sex with someone without HPV who is unvaccinated, they almost certainly will transmit the virus. Even if condoms are used, HPV can still be transmitted. This is a much more contagious virus than HIV.
The HPV vaccine is both extremely safe and extremely effective. Suggesting that every human consider getting the vaccine -- with appropriate consultation with their healthcare provider -- is sound advice.
> hypertension is not contagious
Common causes of hypertension are "contagious". Summary:
Sweden is also on the verge of eradicating this disease. How many deaths you ask? Zero of course.
You're very confused about the statistics here.
I've been through this with medical providers, and they say it's not recommended for me.
I don't take medical advice from internet strangers, especially when it contradicts my doctors'.
I'm not particularly interested in discussing the how's and why's. My doctor said he doesn't recommend I get it, so I don't.
In most countries it's recommended for everyone. It just isn't in the US because they don't want to pay for it.
From what I have heard, that is true for many, many vaccines.
I think it's weird and creepy people are selectively opting into vaccines that are not recommended for them.
It feels a bit like those ads that say "bring up Expedia with your doctor!"
This isn't a good PSA.
Should I be vaccinated against smallpox too? How about anthrax?
If we had as trivial of vaccinations for smallpox, anthrax, and rabies as we have for HPV, I'd collect them all. One fewer risk in my life, and a finite reduction in the risk of everyone around me's life, with no downside at all.
1 pin prick * 340,000,000 people > 340,000,000 people * 6.1 cases of cervical cancer * 0.9 efficacy / 100,000 people
Your world view assigns equally negative utility to at most 18,214 shots as 1 case of cervical cancer.
Put another way: If you were told you had to either take a shot every day, or you are guaranteed to get cancer, would you really choose the cancer?
If I was told by my doctor I shouldn’t get the vaccine I wouldn’t get it.
There is no human alive who has smallpox that you could catch it from, so getting vaccinated for it is pointless unless you think it's likely that some samples in a lab somewhere might escape.
Good stuff. Australia has a target for eliminating cervical cancer by 2035 and ofcourse HPV is responsible for a large proportion of penile, mouth, throat and anal cancers as well. All my kids got free vaccinations at school.
It is shocking that there are still places in the world where this is controversial. You can tell a lot about the qualities of a society by the way they care for their own.
You should think about how you would react to “you can tell a lot about the qualities of a society by the way they [detain people on Nauru | reject asyl seekers | don’t care for indigenous populations]”.
I feel your comment is a generalisation and could be construed as provocation/trolling. Probably not your intention, but just so you are aware how this is coming over.
Better maybe: “societies that have good health care thrive” or something like this. Sounds less judgmental and it doesn’t put all US Americans in one basket.
I fully agree on the content though, only criticising the form here.
Australian indigenous women do in fact have a higher risk of HPV and cervical cancer than the general population. We do need to do better but we also face some challenges in delivering quality services to rural and remote communities. Achieving a consensus amongst millions of people on how to run a country isn't simple and stupid shit often happens.
Anyway, well done Denmark. We are trying to do the same thing here in Australia with some success. Not sure how it became about the US but good luck to you all as well.
No one mentioned the US before you did.
It might be a cultural misunderstanding. It isn't a big deal. It's tricky because while we are using the same language we don't all share the same culture and influences.
Perhaps it is less common to say positive things about other countries in the US unless you are making some point about domestic politics. Sometimes I am deeply critical of the USA but this wasn't one of those times.
So just to be really clear eradication of HPV and by extension elimination of some forms of cancer is a really noble thing for humanity to be doing and is being pursued by many countries, including ones that aren't as privileged and wealthy as Australia and Denmark. It's a group that historically included the USA which clearly means there are people there who deeply care about this stuff as well.
The people who oppose public health programs like this are just evil in my opinion wherever they are.
I don’t understand your point. Why would my critic (of the form, to be clear again) not apply anymore if the parent comment meant the french?
This discovery, and generally the ground breaking connection between a virus and cancer, was awarded the Nobel Prize in 2008.
https://www.nobelprize.org/prizes/medicine/2008/press-releas...
Good to hear what's happening in the more advanced countries.
RFK Jr may be a bit biased, his opposition has been profitable
> Kennedy for years has earned referral fees from Wisner Baum, a Los Angeles personal injury law firm that is currently suing Merck, alleging the pharmaceutical giant failed to properly warn the public about risks from its vaccine against human papillomavirus (HPV), Gardasil, according to financial disclosure documents filed by Kennedy with the Office of Government Ethics.
https://www.cbsnews.com/news/rfk-jr-confirmation-robert-f-ke...
Remember to look for critical takes. I encourage you to look at stuff like this with an open mind, and if you disagree with anything, look into the details:
https://www.youtube.com/watch?v=HqI_z1OcenQ
There is recent research showing that it can (slightly) help even during HPV infection, see "Effect of HPV Vaccination on Virus Disappearance in Cervical Samples of a Cohort of HPV-Positive Polish Patients", J Clin Med (2023) https://pubmed.ncbi.nlm.nih.gov/38137661/.
Also, the eligibility criterion of not vaccinating people above certain age is NOT valid. I mean, sooner better. But if you are adult and there is any chance that you ever get a new sexual parter, get a vaccine.
90% people with get at least one HPV strain in their life. 10-30% people have at least one HPV strain right now.
(I recommend doing PCR test with strains genotyping. I do it periodically.)
Sure, our organism usually gets rid of such on 1-3 years, with no consequences. Yet, vaccine boosts your immunity.
Also, over 50% of cases of throat cancer are HPV-lead. So if you have male body, also vaccinate - both to protect others and yourself. Ideally for 9 strains, but HPV 16 and HPV 18 are by far the most important.
A few more links: https://pinboard.in/u:pmigdal/t:hpv
> any chance that you ever get a new sexual parter, get a vaccine.
Not only that - I learned recently that you can contract certain strains from a shower floor [1]
[1] https://dermnetnz.org/topics/non-sexually-acquired-human-pap...
> Also, the eligibility criterion of not vaccinating people above certain age is NOT valid. I mean, sooner better. But if you are adult and there is any chance that you ever get a new sexual parter, get a vaccine.
The eligibility criterion has primary been about controlling cost to focus about the groups where the societal effect is greatest.
I expect it may gradually get broadened, but most places you can also get it privately even if you fall outside those ages.
E.g. in the UK, most private providers will vaccinate you up to 45, and at least some private providers will give you the vaccine with no upper age limit (and a lower age limit of 9) at a relatively reasonable cost (~180 pounds per dose - 2 to 3 doses)
Prioritization makes a lot of sense.
At the same time, guidelines go differently, e.g. "Vaccination is not recommended for everyone older than age 26 years." from https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm.... These things propagate among doctors and most of them do not recommend vaccination (contrary to modern research data!)
The goal wasn't to eliminate the HPV strains, it was to decrease cervical cancer. Has Denmark encountered a drop in cervical cancer? If so, that's a great outcome!
> it was to decrease cervical cancer
HPV can cause cancers in the cervix, vulva, vagina, penis, anus and back of the throat [1].
[1] https://www.cdc.gov/hpv/about/cancers-caused-by-hpv.html
The lead time from infection to cancer is very long, we would not expect to see too much of a drop *yet*. But testing for those strains seems to be as useful for screening as a pap smear.
There are some results from Scotland already, all very positive https://academic.oup.com/jnci/article/116/6/857/7577291?logi...
> No cases of invasive cancer were recorded in women immunized at 12 or 13 years of age irrespective of the number of doses. > Women vaccinated at 14 to 22 years of age and given 3 doses of the bivalent vaccine showed a significant reduction in incidence compared with all unvaccinated women
For the second group, cases dropped from 8.4 to 3.2 per 100k.
The Danish center for disease control's webpage for the vaccine links to a recent (5 year old) Swedish study: https://www.nejm.org/doi/10.1056/NEJMoa1917338 , but I couldn't find any Danish studies.
This seems to have some data that suggests they have seen a decline: https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.35081
There's a chart about 2/3 down the page that shows a drop in several age groups, and a particularly striking drop in the 20-29 age group: https://onlinelibrary.wiley.com/cms/asset/fd3e820c-4610-4c4e...
Cervical cancer really doesn't need to be a thing anymore, the vast majority of cases are oncoviral, and we know how to prevent HPV.
Wasn’t this also the same conclusion for Australia? Cervical cancer plummeted to record rates. Men should still get it so they don’t effect their partners and HPV causes all sort of cancer too.
Yes, Michael Douglas had a throat cancer he said was from "oral sex" meaning HPV infection, and I remember social media berating him for saying that as if it were impossible, but it really is.
Random anecdote: with whole genome sequencing, which is fairly common among the rich with cancer, you can sometimes find the exact cancer driving genes that the HPV has amplified. I remember looking at one case where the HER2 gene was amplified with many copies, and you could see it attached to chunks of HPV genome. Fortunately there's now many drugs that specifically target amplified HER2, originally developed only for breast cancer, where there are diagnostic test to find the subset of breast cancers with the amplification.
Australia rolled out the HPV vaccine for girls in 2007. Boys were included in the program in 2013. Modelling says that "elimination" depends on both the vaccine and a screening program [3].
[1] https://www.cancercouncil.com.au/news/australian-success-sto...
[2] https://www.ncirs.org.au/sites/default/files/2022-07/HPV%20F...
[3] https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...
I think the history of this is something like:
- it was an expensive vaccine
- it was therefore initially introduced to women as a cervical cancer thing
- HPV however hits men at around half the cancer rate of women but through throat cancer
Or something like that. So actually the benefit to men is of a similar order of magnitude as that to women but it was just given to women to save money. Every child should be given it.
Edit: Total Rate (of HPV caused cancers) in Women: Approximately 15.9 cases per 100,000 females per year.
Total Rate in Men: Approximately 9.3 cases per 100,000 males per year.
Edit 2: Severity-Adjusted HPV Cancer Burden:
When adjusted for the severity and impact on life, the relative burden of HPV-related cancers shifts. Cancers with higher mortality rates and more debilitating treatments, like oropharyngeal cancer, carry a heavier weight.
Total Burden in Men: Approximately 135 DALYs per 100,000 males per year.
Total Burden in Women: Approximately 125 DALYs per 100,000 females per year.
The HPV vaccine became part of the government vaccination program for boys/men 6 years ago (almost to the date) precisely for the reasons you mention. Personally really happy to see this as there was some initial fear mongering related to the HPV vaccine some years ago.
Does the vaccine benefit you if you've already been infected?
There are multiple strains of HPV and most people haven't been infected with all of the strains.
from https://www.health.harvard.edu/diseases-and-conditions/by_th...
Does the vaccine work against all strains ?
It has only been targeted against the strains known to cause cancer. I haven't looked but I would guess getting all strains would have been a greater challenge, and would not have greatly increased uptake of the vaccine. The false perception that it's a vaccine that will encourages unprotected sex has already greatly hindered adoption in the US.
No, it's targeted against those most associated with cancer.
Potentially, yes. HPV infections are cleared over time, and there are many strains of HPV.
That's really interesting, and from that I would assume that the risk of cervical (or other cancers) from HPV is associated with how often someone is reinfected? ie, someone who got HPV once in college doesn't have HPV their whole life? And potentially has a lower cancer risk than someone who is repeatedly re-infected?
Am I understanding that correctly?
https://www.hpvworld.com/articles/the-frequency-of-hpv-infec...
It's incredibly prevalent, but most people clear it within a couple years, and won't even know that they had it. The time to clear it is just variable and depends on your body's immune response, the longer you go without clearing it the higher the cancer risk.
> someone who got HPV once in college doesn't have HPV their whole life?
Doesn't necessarily have HPV their whole life - time-to-clearance is somewhat variable.
And yes, both slower clearance and just more infections are both associated with increased risk.
In a sense no, hence the choice to vaccinate younger children who will mostly not be sexually active yet.
But because the modern versions of these vaccines cover many strains (initial vaccines were two, Denmark chose a 4 way vaccine, now a nine way) it's very possible that you get a meaningful benefit by being protected from say six strains your body has never seen, even though the three it has already seen wouldn't be prevented.
It should be noted that the decision to vaccinate younger children is a combination of disease prevention and cost, not just vaccine effectiveness.
And access! If you vaccinate in earlier grades of school, the kids haven’t had a chance to drop out yet.
I've heard of it being administered post exposure as a way to help the body fight the existing infection. Seemed a little odd when I first heard it as HPV should clear on it's own.
The key is you want it to clear as quickly as possible.
And I can't get the shot in Germany because I'm "too old" and just assumed to be infected with it already, anyway.
What a great system.
Many doctors in Germany stick very closely to the recommendations of the Stiko (standing committee on vaccinations) and take a lot of convincing to vaccinate more, or they outright refuse. It's really annoying.
My health insure only covers HPV vaccines for 26 year olds and younger: https://www.sbk.org/beratung-leistungen/vorsorge-und-praeven...
Depends on your health insurance. My previous insurance company paid back the full cost when I was 30 years old. I can recommend checking https://www.entschiedengegenkrebs.de/vorbeugen/kostenerstatt... (and then also confirming that with the insurance company over text, just to be safe)
Sort of similar in most EU countries. I could get it in Austria but it's prohibitively expensive.
Can you pay for it?
In Denmark you can. I was in my mid thirties when I went to my doctor to ask them to prescribe it. Before each shot I would go to the pharmacy and buy one dose and go to the doctor to have them administer it for me (if I wanted to). At that time I think it was free for teenage girls, now it's free for teenage boys as well.
The evolution of who gets HPV vaccines is really interesting. At first it was young women, as vaccinating young men had a very marginal decrease in cervical cancer rates via indirect protection (which itself is a function of how many young women are vaccinated). Then as HPV infection was linked to more cancers, vaccinating young men crossed the cost-effectiveness thresholds many governments use.
Vaccinating older populations is similarly just a less clear-cut case, but it's a cost-effectiveness argument, not one purely driven by if the vaccine offers protection.
Seriously. My memories of this vaccine are so foggy because I distinctly remember being told "its not effective for men" and that it would be an expensive out of pocket cost. Yet, the whole point would always have been to prevent the spread.
But from a personal POV it is very cost-effective! Even if it is not so at the population at as large group.
Do you mean from the POV of a particular high risk (or high income) person or from the POV of every individual?
it's not just the cost of the vaccine roll-out though, you need test on your target demo and since these are healthy people the bar is very high. If the demographic (like males over 45) shows very little involvement in the infection vectors then testing might fail the cost-effectiveness, not the delivery of the vaccine.
Indeed. Generally for HPV, there were modeling studies showing this was probably a good idea before trials started.
Generally yes. I asked my primary care physician and would have been able to get the vaccine dose from the pharmacy (paying for it myself) and she would have administered it.
India started one of the biggest programs for HPV vaccines - https://www.news18.com/india/india-bets-on-jan-aushadhi-kend...
By way of contrast, America's current top "doctor" organized a class-action lawsuit against the HPV vaccine.
https://www.reuters.com/business/healthcare-pharmaceuticals/... ("Kennedy played key role in Gardasil vaccine case against Merck")
> "Details of the Gardasil litigation show how Kennedy took action beyond sowing doubt about the safety and efficacy of vaccines in the court of public opinion and helped build a case against the pharmaceutical industry before judges and juries."
> "Kennedy, a longtime plaintiffs' lawyer, became involved in the Gardasil litigation in 2018 in collaboration with Robert Krakow, an attorney specializing in vaccine injury cases, Krakow said"
It's okay, he'll have us treat cervical cancer with a juice cleanse and vibes.
Don't forget prayer--the ultimate solution to everything!
Also the juice is whale juice.
I remember this being a big controversy in Texas in the 2000s. Our Republican governor, forcing girls to get the vaccine! What does he think Texan girls are, lusty?
Not like disease prevention is a universally good thing and some people tend to have sex.
At the end of the day, religious radicals like STDs because it enforces their worldview that having multiple sexual partners in a lifetime is a sin.
Rick Perry?
We have the first leaders.
If i have no memory/record of getting this vaccine (but there was a possibility that i could have already gotten the vaccine years ago), is it okay to take it again?
That's great to hear! Here where I am, Ontario, Canada, I just barely missed out on getting the HPV vaccine for free in high school. At the time, they were only vaccinating girls, but added boys a year or two after me.
Check your (or your parent's) drug coverage insurance. You may be covered (mine is under the drug name gardasil).
No worries. Some developed countries[1] will make sure to preserve these strains.
[1] The list has just a single entry for now.
HPV vaccine is certainly not fully rolled out across developed countries.
How do men and men that are older get it?
https://en.wikipedia.org/wiki/Human_papillomavirus_infection...
This article headline is a gross abuse of the conclusions of the actual study which is here: https://www.eurosurveillance.org/content/10.2807/1560-7917.E...
This site is full of people perfectly capable of reading most studies. I would much rather see these links go to studies than endless clickbait articles about studies.
The conclusion of the study show that about 30% of the women in the study from 2017-2014 tested positive for one of several types of HPV infection. This does appear to be a reduction from an earlier 2013 study but the earlier study was by different authors with different methodology so gauging the scale of the reduction is not straightforward. My opinion is that a safe conclusion of the study is that HPV prevalence has not increased.
That link says:
> What have we learnt from this study?
> Infection with HPV types covered by the vaccine (HPV16/18) has been almost eliminated. Before vaccination, the prevalence of HPV16/18 was between 15–17%, which has decreased in vaccinated women to < 1% by 2021. However, about one-third of women still had HPV infection with non-vaccine high-risk HPV types, and new infections with these types were more frequent in vaccinated than in unvaccinated women.
The conclusion seems to be that the vaccine is extremely effective at preventing infection by the strains included in the vaccine. One might reach a stretch conclusion and infer that the 9-valent vaccine would be even better as it would (probably) dramatically reduce the risk of several of the remaining “high-risk” variants.
The study is linked early in the article and is fairly dense, the article summarized it well and is a lot more readable.
16/18 are the most carcinogenic strains, they have been close to eradicated in Denmark. "Denmark close to wiping out leading cancer-causing HPV strains after vaccine roll-out" is the full headline and 100% accurate.
Those were the only two high risk strains covered by the vaccine used in the time frame studied. The study covers the first cohort of girls given the 2008 version of the vaccine when they recently reached age to start screening. It is expected to not see other strains affected in this study, even though current vaccines are broader. The total number of high risk HPV cases in the study went down post-vaccination.
The notion of numbered strains of HPV is about diverging lineages going back hundreds of thousands of years in a highly conserved, slowly mutating virus. They are not comparable to things like seasonal COVID or flu strains.
> about 30% of the women in the study from 2017-2014 tested positive for one of several types of HPV infection.
That number was referring to different strains not covered by the vaccine. The study says the rate of infection dropped to less than 1% among those strains the vaccine protects against.
Is there a test to see if you have the virus already? So I know whether I should take the vaccine.
Can I still take that vaccine regardless of sexual activity as a 41 years old male? Will it prevent centers that can cause by HPV?
It could still protect you from one or more strains that you haven’t been exposed to through sexual partners and avoid contracting or passing it along to a future partner. There’s no practical way for a man to be tested for HPV (I asked and the doc said “it’ll be very painful and the result will be the same: get the vax”)
I experienced zero side effects when I got HPV vaxxed at 38yo.
There some circumstantial evidence it could help with plantar warts, too.
In the US, there is no male test for HPV
Cervical cancer (uterus), not skin cancer from a bad papillomas as I thought after looking up what HPV meant
Also throat, mouth, tongue, anal and penile cancers.
Add in anal cancer too
It turns out a human body has a lot of surfaces facing the "outside" in some sense and we forget about the parts we can't see. Most of this surface is not covered in what we'd conventionally consider skin. It's bit like if you were looking at surfaces in a house and forgot the walls and ceiling.
Humans (and most animals) are just tubes with extra bits.
"Denmark completely autistic." -Unnamed US federal government secretary
It’s insane to think that someday humanity will finally find a cure for cancer, and then after all this money and research and struggle people will just… choose not to use it.
A cure is a treatment, a vaccine is a prophylactic. The most dangerous, by far, cancer that this would help mitigate is cervical cancer which makes up about 0.7% of cancer deaths in the US, exclusively amongst women. The overwhelming majority of cervical cancers occur in Africa due to the fact that HIV/AIDS dramatically increases your susceptibility to developing it.
> The overwhelming majority of cervical cancers occur in Africa due to the fact that HIV/AIDS dramatically increases your susceptibility to developing it.
Considering we're talking about a sexually transmitted disease, the much higher prevalence in Africa of having multiple simultaneous sexual partners is surely relevant.
> having multiple simultaneous sexual partners is surely relevant.
medically, not really. the vaccine acts the same. epidemiology wise, it makes it more effective, assuming the correct coverage.
I would just suggest that stating that an entire continent of different races/culture/religions "having multiple simultaneous partners" smells just a little bit of "savages over there", which given that we are talking about _evidence_ based outcomes, jars somewhat.
> medically, not really. the vaccine acts the same.
That's not a response. The multiple simultaneous sexual partners are relevant to the fact that prevalence of the disease in Africa is very high. This is not a vaccine-related question, so the action of the vaccine can't speak to it.
> I would just suggest that stating that an entire continent of different races/culture/religions "having multiple simultaneous partners" smells just a little bit of "savages over there"
Funny, if you look at my comment, you should see that it refers to "the much higher prevalence" of this behavior in Africa.
HPV infections can usually be cleared up by a healthy immune system, so there's a causal relationship with the immune system. There's a lot more information on it available here. [1] Risk factors for it managing to progress onto cancer include obviously the type of HPV infection and "immune status, the presence of other sexually transmitted infections, number of births, young age at first pregnancy, hormonal contraceptive use, and smoking."
I also wonder if 'number of births' is not largely a proxy instead for the shift in the immune system of a woman while pregnant; in effect they tend to become slightly immunocompromised, probably as a means of preventing an immune response from harming the baby.
[1] - https://www.who.int/news-room/fact-sheets/detail/cervical-ca...
There will never be a single cure to all cancers. Different cancers have different underlying mechanisms and affect different tissues.
I think this is untrue. All work by uncontrolled replication of cells. This is why nanotechnology had the promise of being able to eliminate cancer - imagine a nano scale robot regularly cycling through your body on occasion, looking for and eliminating cancerous growths.
Drugs, though, probably have very limited potential.
Maybe. The fact that some animals are especially immune to cancers suggest there are ways to prevent the outcome (cell replication/mutation).
Are they immune to cancer, or do they simply not live long enough to develop them? AFAIK, only plants are immune to cancer.
These might not technically be cancers but the similarity is there.
https://en.wikipedia.org/wiki/Gall https://en.wikipedia.org/wiki/Burl
Elephants and naked mole rats.
https://www.sciencealert.com/these-animals-can-t-get-cancer-...
Good news.
Bad news is that many countries came close to wiping out measles et al. too, but it takes sustained effort to keep things like that.
Amazing how badly the United States is regressing. Literally measles is making a comeback due to idiots like RFK.
And even before the antivax nutters here went from fringe to a significant social force, HPV vaccines were already being decried for "promoting casual sex." Our culture is so broken in so many ways.
"Why haven't you cured cancer yet?"
"We have a vaccine to prevent some very serious cancers."
"But it might turn my daughter into a hussy."
Also, forget "She might die of cancer" just exactly how bad is it if your daughter is a whore ? What else are we ruling out, independent business owner, politician ?
What happened to "I just want my children to be happy" ?
I always thought "Cervical cancer is a just punishment for my daughter's mistakes" (leaving aside if it is a mistake) was horrific.
Of course, I for sure held off on having casual unprotected sex with multiple partners as a teenager because I was worried about contracting HPV, but thanks to Gardasil my slut era was legendary and enduring.
Teenagers are notorious for making decisions based on consequences that are decades away from manifesting.
I can't tell if you think what I said was serious, I tried to hard to convey the /s.
Don't worry; it was very obvious.
"you never want grandchildren?"
Maybe we’re seeing selection pressure against those prone to addictive cycles of social-media influenced misinformation?
Like, anti-vaxers died at higher rates in Covid [1]. This will continue across disease outbreaks, particularly ones for which we have near-comprehensive vaccines like measles. And given antivax sensibility is heritable (through parenting, not genes), one would expect this to stabilize the population over several generations to one that doesn’t have this defect.
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC10123459/
The article you are referencing is based on CDC data which is not matched by a more complete data maintained by UKHSA. I think Norman Fenton commented on that at some point. I'd be careful when taking its conclusions at a face value. I actually went through that paper and looked at the UKHSA data back in 2023. And the government was spreading a lot of BS, too. I'll let the "CDC can do no wrong" crowd pile up.
very few people are against vaccines per se, they are just against *unsafe* vaccines. "anti-vax" is a term used to dismiss dissident without having to deal with their arguments i.e an ad hominem. As an analogy, if I object to high levels of mercury in fish, am I anti-fish? or anti-poisonous-fish ?
The people that are against "unsafe" vaccines do not do the proper research to determine whether a vaccine is actually safe. These people claim that safe vaccines, like the COVID shots, are actually unsafe because they googled up some claims that were not rigorously researched or reviewed.
I had seen attempts to engage with these arguments in good faith. It was wasted effort.
For just being "against *unsafe* vaccines" they sure tend to have some very weird ideas of what a safe vaccine is.
"unsafe" is a loaded term
in your fish analogy, you eat mecury directly, but wont eat fish that might have mercury.
the communicable disease is itself quite dangerous
I think you missed the point. Granted the disease is dangerous, but what if the cure is worse ? If we don't know this is true, we ought to assume the risk outweighs the benefits until PROVEN otherwise- that is the precautionary principle. As an analogy take Vioxx, a headache remedy that caused thousands of heart attacks. Merck the manufacturer started an advertising campaign for the drug AFTER the learned it was killing people - they were ultimately fined 4.5 billion.
https://www.nejm.org/doi/full/10.1056/NEJMp048286
The docket shows us that pharmaceutical companies are serial felons who have paid some of the largest fines in history for lying about their products. It is prudent to be skeptical until proven otherwise.
I agree. Pfizer settled more than a few cases. When talking about a low probability but catastrophic event, the burden lies on the side of the vaccine manufacturer and a mandating agency (and not on the side of the consumer) to prove beyond any doubt that the treatment is safe. I doubt Pfizer has met that bar.
Edit: To all the pro-Pfizer downvoters, feel free to take some Zantac. You have learned nothing.
> "anti-vax" is a term used to dismiss dissident without having to deal with their arguments i.e an ad hominem.
A slur.
Which vaccines that are widely used today do you believe are unsafe? And why do you believe they’re unsafe?
> “anti-vax" is a term used to dismiss [dissent]
No, it’s a term used to dismiss people who keep bringing up the same arguments that have been refuted over and over.
All the brand new vaccines with no sufficient testing can be considered unsafe. I like vaccines in general (I am European, we have lots of free and mandatory vaccines as kids), but I don't like to be a test subject for brand new ones. Yes, someone needs to test new vaccines to gather data about safety, but some people are more risk adverse. I am a "take it later" guy.
I specified "widely used", which effectively excludes brand-new vaccines.
I don't have any issue with what you're describing. The J&J COVID vaccine would be an example of caution being advisable, since you never know what unusual interactions (e.g. with blood clotting) might occur in a larger population than the safety studies looked at.
But that's not the usual definition of an anti-vaxxer.
Anti-vaxxers carry on about things like thimerasol which (1) were removed from most vaccines 25 years ago and (2) give you an exposure to mercury equivalent to eating something like a single can of tuna.
We've been dealing with anti-vaxxers for years. I've yet to see an argument from one that holds any water.
This is now a global problem. The guy who started it, Andrew Wakefield, is British, and we have long had antivaxxers in Europe too.
Prior to Covid, the antivaxx scene was vaguely left-and-green oriented, biomoms, vegans and other "very natural" people; you would expect them to vote for Greens or even more alternative parties. This changed abruptly and now the antivaxx scene is mostly rightwing, but the common base is still the same distrust.
I wonder if this is the price we pay for radical informational transparency. Nowadays, democratic countries with reasonable freedom of press cannot really prevent their own fuckups from surfacing in the worst possible way. Some people react by complete rejection of anything that comes from "official" channels and become ripe for manipulation from other actors.
i dont think its nearly so transparent. its easy to be recommended and read some viewpoints, but very technical and hard to be recommended others.
with radical information transparency, id expect both views to be equally easy to parse and to be recommended both, in which case the choice would be obvious to everyone, or at least they could very well describe their risk tolerance to different risks, or laziness, for why they made a certain choice.
i expect im not up to date on all the vaccines i should be, but its on laziness rather than gwtting bad information. ...also a lack of information on which ones i should have.
> I wonder if this is the price we pay for radical informational transparency. Nowadays, democratic countries with reasonable freedom of press cannot really prevent their own fuckups from surfacing in the worst possible way. Some people react by complete rejection of anything that comes from "official" channels and become ripe for manipulation from other actors.
Such people have always existed, unfortunately. I don't think it's a result of anything particularly new.
The people existed, but a portable always-running conveyor belt of bad news that is addictive enough to make them glued to the screen did not.
In the 1990s, you had maybe 15 minutes a day on average to consume news, either from a paper newspaper, or from an evening TV relation. Now, quite a lot of people spend 20 times as much time doomscrolling. Of course the impact will be much more massive.
I think it’s a myth that people consumed less information just a few decades ago. Remember that newspapers used to have at least two daily editions (morning and afternoon). And of course radio has had continuous news flashes for a century.
This is similar to the myth that people communicated less before the messaging apps: they were glued to their phone for hours, sent telegrams and even sent very short letters (delivered same day!) to just say "thanks for the lunch that was very nice" (I found some in my grand-parents’s papers)
Our (social) communication appetite has always been quite insatiable.
Back then we had the National Enquirer and Weekly World News and similar for all the obscure conspiracy news you wanted.
I think that the social media is much more capable of turning various fence sitters and borderline cases into full blown conspiracy believers.
Unlike the paper products, which just lie around when not actively seeked for, the algorithms determining your feed have a lot more agency.
Sure, but this implies the only source of "manipulation from other actors" is the news, media, or government. Churches, cults, and just other ignorant people existed to cause distrust in authority.
Those organizations didn't have instantaneous global reach. Now everyone does.
I'm not denying that there's a difference - obviously technology has enabled the scale of things to grow quite a bit, both good and bad - but it's beside my point, which is that, given that it's not a new phenomenon, blaming it on technology seems doomed to failure. Without solving for the underlying issues, people will continue to mistrust authority, whether they're being told to by news or their neighbor.
Mistrusting authority might be good. What I see happening is in fact trusting too much into "authority" without penalizing it for inconsistencies - I would call it more like blind faith. I feel this happens because it makes it easier than questioning everything you hear and deciding for yourself, and accepting you might be wrong, or that the information is unknown. People want a savior and a simple solution!
> blaming it on technology seems doomed to failure
Recognizing that technology is now so convenient, psychology manipulative, and operates in a furiously fast feedback evolutionary regime, and that it has radically increased the spread of cultural irrationality isn't about "blame" in a judgy moral way.
It is about characterizing major factors behind the problem.
The enormous amount of near instant coordinated (by intention or dynamic), interactive misinformation, made so conveniently available that large percentages of the population routinely and enthusiastically expose themselves to it, participate in reinforcing it, throughout their typical day, is very new.
> "Not everything that is faced can be changed, but nothing can be changed until it is faced." -- James Baldwin
That's a little like saying nuclear bombs aren't a technology, but a human problem. And you bet, they sure are, but it's a lot harder to wipe out everyone, if the nutjobs in your community just have a pointed stick.
And 'nutjobs' may be pejorative, but I'll hold on to it as apt. At the same time I assign no blame, for it is an issue of cognition. The best way I can describe it is, intelligence is not a single factor. And it's not even a few factors. It's a massive bar graph, with 1000s upon 1000s of bars, each delineating a different aspect of intelligence.
A lucky few may score high on all those bars, yet even the most intelligent of us tend to score high on only some of those bars. And my point is, I've seen people immensely intelligent on some of those bars, yet astonishingly deficient on others.
We love to make fun of politicians, so I'll use one as an example here. Politicians tend to be incredibly personable, and very difficult to dislike in person. They exude congeniality, they read you like a book, and can often orate your wallet completely out of your pocket, and you'll thank them for it too. It's how they managed to go so far politically, yet some of these same politicians have severe and massive deficiencies in cognition.
Back to the pointed sticks, and the nutjobs who would wield them pre-tech, these people are simply as they are. Yet in the past, you'd see one nutjob in a community, and they'd be surrounded by normalcy, it would temper them, mitigate their effect, sand off their edges so to speak.
Yet as our communities grew in size and scope, these individuals could finally meet more of their ilk. A large city might have dozens of them, larger still cities hundreds, and they'd meet up. And as technology grew, and access to the printing press become possible for all, and for less and less cost, these same people could then send their madness in newsletter form to even those small communities where maybe only one nutjob existed.
But those people needed to still connect in some way. Maybe through an ad in the back of a magazine, or something akin yet far less gated by 'normals'.
Yet today? Now? Algorithms match you up with all those nutjobs. Where before you might live in isolation, and the friends you had might scoff at that weird idea you have, now you've found a community of hundreds, or thousands just like you! And they all affirm your madness, they pat you on the back, they congratulate you for seeing the light! They whisper all those sweet nothings into your ear, all those secret things you knew were true, and they listen to all you say on the subject.
For the first time in your life you have a home, a community, and before TikTok, or some weird forum, it would have never all been possible. You'd have been isolated, even in the age of magazines, and print, for you'd have never found one another.
And worse, now profit enters the system. Those who would steal, or thieve, or build bridges with sub-standard concrete for profit, or anything for money regardless of cost to us all, appear on this scene. They see those nutjobs, and they seek to profit from them. They own youtube, or tiktok channels, and often do not believe in anything but profit. They'll tell you anything you want to hear, espouse any crazy idea, and like that bridge built with substandard concrete, they'll take the money and run as society collapses around them.
This profit motive was always there, see cults. Yet the reach and scope was just not what it is today, there is so much more range given to a single person now.
People have had a mistrust in authority as far back as when nomadic tribes were the norm but somebody had to decide where to hunt or gather that day or to move on. Good luck changing human nature.
Chatty Kathy could only share her moonbat ideas with a couple people at a time. Now she has a TikTok and the ability to go viral. Even folks sharing her video to mock it are spreading her message.
And now there is code that says "This video is doing really well, I'm going to put it in front of every single human being I can"
Your local crazy used to get patronizing nods. Now they get 100 million views.
That was the most ignorant comment I have seen on this matter. Nothing about vaccines, just attacks on the people questioning vaccine safety. If you truly believe all vaccines are completely safe I have a bridge to sell to you.
If you trully believe all vaccines are completely unsafe I have a different bridge to sell you.
Measles and polio are terrible diseases which were almost eradicated with vaccines. We are not talking about covid.
I don't believe that any medication is completely safe, but I am fed up with all the "Gates puts 5G chips in vacciness in order to sterilize humanity" kooks who are the flag-bearers of the entire movement, and I am also fed up with the somewhat less crazy people marching behind them, who nevertheless cling to the long discredited Wakefield paper and scream 'autism, autism!'
The fraudulent Wakefield paper may be one of the most destructive pieces of information released upon mankind.
Unlike the measles, HPV is not a good eradication candidate due to the existence of non-human reservoirs.
I think you said that backwards. HPV does not have non-human reservoirs, per Wikipedia. (Do you have evidence that it's wrong?)
Ah, looks like I might have read the paper wrong. It's theorized that some HPV strains could also be carried by non-human primates.
Hence the "H"
Although you are (as I understand) right, the question itself is valid, lots of diseases spread to species other than the one that is in the name… Chickenpox, monkeypox, swine flu, or even the Spanish flu.
Lots of diseases are potentially zoonotic. When diseases have animals in the name, it often just refers to zoonosis itself (except of course chickenpox). But when diseases or parasites have human in there name, it's almost always because it's a disease that only effects humans.
Note that there was a human flea, but it's extinct. The fleas you might actually find on a human are dog fleas.
The human flea is not extinct and is actually one of the counter examples as it does infect other species such as pigs.
Humans cannot host infestations of dog fleas. You can be bitten by a dog flea, but you cannot complete it's life cycle. If you find yourself constantly dealing with fleas, you are in the presence of an active infestation from another animal.
and why do we trust gavi?
I remember arguing in favor of Gardasil as a teenager in highschool. And now RFK Jr calling it dangerous. Someday my head might just explode.
the
Denmark is in a chronic baby shortage [1] and people in Western democracies are having less sex generally [2]. So, yay, less HPV. Go get vaccinated [3]. Unfortunately, there are some pretty significant (and sad, yes, sad) confounders.
[1] https://www.sdu.dk/en/nyheder/faldende-fertilitet
[2] https://www.google.com/search?q=western+democracies+decreasi...
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC10399474/
Do you mean there is a causality between less sex and HPV vaccination, when you write “confounder”? I can’t find any study supporting this, hence double checking.
I think maybe they mean that the fact that people are having less sex is confounding the cause-effect relationship between vaccination and fewer cases of HPV. I don't know about people having less sex, though. That seems hard to believe.
A generation of ‘virgins’ is leading America’s next sexual revolution
https://www.theguardian.com/us-news/ng-interactive/2025/jun/...
Ah, got it. That is a valid point.