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)

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.

I'm 44 and didn't catch any gruff from the staff. I'd complain to the head pharmacist.

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.

You can pretty much walk into any decent clinic and just ask for one.

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.

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.

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.

> 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.)

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.

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.

Conspiracy theory: they want old people to die.

> 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.

That's interesting and I would like to take, can you give me a link/ ref for citation?

so how would one in the US go about getting it? gardasil?

If you’re having casual sex at 45+ you probably already carry HPV.

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.

The issue is getting it covered by insurance. Otherwise it can cost over $1,000 for the full course of shots.

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.

> 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.

Doctor recommended it to me when I was almost 30. So yeah, I'd say still go for it.

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.

[1] https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...

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.

Why?

1) If your wife was having a high risk pregnancy and couldn't get vaccinated, she really shouldn't have been working on the front lines during Covid, anyway.

2) Take a look in the mirror and try blaming the people who have made "getting a vaccine" a culture war political statement rather than something routine and uncontroversial. If vaccines were uncontroversial, medical exemptions from them would also be rare and uncontroversial.

Restrict your partners to Danes and you are unlikely to contract it.

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Not as vile as having sex with someone who's already infected, whether protected/vaccinated or not.

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?

> hypertension is not contagious

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.