| ▲ | stared 9 hours ago |
| I would like to add: - HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. Unless you plan to remain completely celibate, you are likely to contract a strain. - Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive. While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/ - HPV16 is responsible for a large number of throat cancers (around 50% in smokers and 80% in non-smokers!). This affects both men and women. Vaccinating men is important for their own safety and to reduce transmission to their partners. |
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| ▲ | shevy-java 9 hours ago | parent | next [-] |
| > Unless you plan to remain completely celibate You can get HPV without sex too. https://www.cdc.gov/sti/about/about-genital-hpv-infection.ht... "HPV is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex" This focuses on sex, but any virus that can be found on skin, also has a chance to be transmitted without sex just as well. Admittedly the chance here for HPV infection is much higher with regard to sex, but not non-zero otherwise. The HeLa cells also contain a HPV virus in the genome, though this was probably transmitted via sex: "The cells are characterized to contain human papillomavirus 18 (HPV-18)" HPV-18. I think HPV-18 may in general be more prevalent than HPV-16. |
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| ▲ | downrightmike 4 hours ago | parent [-] | | Foot warts are HPV, like from the Gym locker room | | |
| ▲ | odie5533 3 hours ago | parent [-] | | But they are not HPV16/18 and so not covered by this vaccine. | | |
| ▲ | tiahura 2 hours ago | parent [-] | | There is some clinical evidence of other strain effect. See pediatric dermatology article from a year or two ago. |
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| ▲ | phkahler 8 hours ago | parent | prev | next [-] |
| >> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common. |
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| ▲ | stared 8 hours ago | parent | next [-] | | But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gardasil-9, which I took as a male at age 35) protects against nine specific strains. Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body). People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case! | | |
| ▲ | hammock 8 hours ago | parent [-] | | Does the vaccine guarantee immunity, by contrast? | | |
| ▲ | timr 7 hours ago | parent | next [-] | | Parent is overstating the case. Neither infection nor vaccination provides sterilizing immunity [1], but the general reasons to prefer vaccination are (in order of descending quality of evidence & reasoning): 1) you probably haven't had all N strains yet. 2a) you likely haven't been infected with the ones that cause cancer, because they're relatively rare. 2b) ...that is especially true if you're young and not sexually active. 2) being infected with one strain does not provide sterilizing cross-immunity against the other strains. 3) even if you've been infected with a strain, some of the vaccines have been shown to prevent reinfection and reactivation better than natural infection alone. 4) in general, the vaccination-mediated immunity might last longer or be "stronger" than the natural version, since the vaccines are pretty immunogenic, and the viruses are not. But for point 4, it's well-known that vaccine efficacy is lower for people who have already seroconverted (cf [1]), so there's clearly some amount of practical immunity provided by infection. [1] The vaccines are roughly 90% effective for the major cancer-causing strains, but it's not a simple answer, and varies a lot by how you frame the question. See table 2 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/ Also be sure to see table 4 if you're a man. The data for biological men and women are surprisingly different! | | |
| ▲ | peab 7 hours ago | parent [-] | | What if you're married? Does it still make sense, if you know you won't ever be sleeping with a new partner? | | |
| ▲ | timr 7 hours ago | parent | next [-] | | A question for your doctor and your partner (and of course, you can read the data in the link I posted above and use that to influence your conversation and decision!) I'm not being avoidant here -- medical decisions are always subjective and multi-factor, and I can't begin to tell you what you should do. (But I also sincerely believe that propagandists try to reduce nuanced data to talking points, which is equally wrong.) Please note the caveat about gender that I just added. The data for biological men and women are very different. Also, I haven't discussed risks at all, which is the other side of the ledger -- these vaccines are pretty darned safe, but everything comes with risk, and only you can decide what level of risk is appropriate for your life. | | |
| ▲ | rawgabbit 6 hours ago | parent [-] | | I usually am pro vaccine. But the HPV vaccine discussion seems politicized to me. As someone who is monogamous and over fifty, I had trouble following the risk vs reward discussion. The CDC says it is only recommended for young adults so I interpret that for my case the answer is negative. | | |
| ▲ | tialaramex 4 hours ago | parent | next [-] | | All vaccination is now heavily politicized in the US. HPV vaccination was an obvious focal point initially because of why we'd do it when we do. The initial data says you should vaccinate somewhere around 12-14 year old girls because most of them will be HPV naive but if you wait longer they won't be any more. But too many US parents cannot imagine their little girl ever having sex and if they never have sex they almost certainly won't contract HPV so, why are we vaccinating them? Are you trying to make my daughter a slut? If you've been a teenage American this should strike you as very silly, and doubly so if you understand biology. Teenage girls are not, in fact, celibate by default, so some of them will get horny. And if you understand biology the viral infections aren't caused by the same mechanism as pregnancy "sexual activity" is a shorthand, you can easily get infected while steering clear of anything that would get somebody knocked up. A peck on grandma's cheek is unlikely to work, but if you're sucking face for most of a Stranger Things episode that's definitely enough that you might contract HPV. | |
| ▲ | electriclove 5 hours ago | parent | prev | next [-] | | Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents. | | |
| ▲ | daveungerer 2 hours ago | parent [-] | | > Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents. Did I read this correctly? You are going to decide for your children based on their plans to be monogamous? And you’re also going to decide for your parents? I can only assume you’re in the unfortunate situation where your parents are no longer capable of making decisions? |
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| ▲ | wolvoleo 4 hours ago | parent | prev [-] | | Of course if you're monogamous sure. But I'm also 50 and very polyamorous so for me it was a no brainer getting it. |
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| ▲ | Moto7451 6 hours ago | parent | prev | next [-] | | You get to make your own health choices here, but as someone who got the vaccine in my 30s, I am glad as I didn’t know about my future divorce when I got vaccinated. | | |
| ▲ | electriclove 5 hours ago | parent [-] | | Couldn’t you have gotten the vaccine after your divorce if you wanted? | | |
| ▲ | scarecrowbob 4 hours ago | parent | next [-] | | Consider that it's possible that the person's partner may have exposed them to their then-unknown extra partners, creating one of the conditions for the divorce. | |
| ▲ | fn-mote 3 hours ago | parent | prev | next [-] | | Think about your future health while your mind is clear. After the trauma of divorce is not the time. Also, I think these questions are in bad faith. It is actually hard to get people to change any behavior. The public health benefits should be a primary concern. Avoid vaccination if there is a downside to you personally, but that isn’t what I’m hearing from your comments. | |
| ▲ | Ensorceled 4 hours ago | parent | prev [-] | | You are presuming that people are monogamous up until their divorce when infidelity is one of the top reasons for divorce. |
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| ▲ | chollida1 5 hours ago | parent | prev [-] | | Ha, we had this conversation with our doctor and they said not to worry about the vaccine if you are married and monogamous. It would likely have zero benefit to us at that point in time. Now maybe that changes if you get divorced and get a new sexual partner. |
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| ▲ | tialaramex 7 hours ago | parent | prev [-] | | It's never a guarantee in practice, the CDC says "More than 98% of recipients develop an antibody response to HPV types included in the respective vaccines 1 month after completing a full vaccination series" |
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| ▲ | kevin_thibedeau 6 hours ago | parent | prev | next [-] | | > This statistic seems to be used by some people to avoid the vaccine The FDA itself restricted access to the vaccine on the basis of age. Given that virions aren't even involved in the production process, its safety should have been deemed good enough for the entire population early on. | | |
| ▲ | bboygravity 6 hours ago | parent | next [-] | | The reason it's not recommended for all ages is money. Not safety concerns. Same reason you can't get Shingrix under a certain age. | | |
| ▲ | prirun 5 hours ago | parent | next [-] | | I think the main reason it isn't recommended for all ages is that it wears off. If you get it before 50, when your immune system starts declining, you might end up getting shingles when you're 60 or 70. Insurance companies used to only pay for the vaccine at 60. They've reduced it to 50 now because people (like me) were getting it in their 50's. I got it in my left eye and because my immune system is kinda shit, I still have it, though it doesn't give me too much grief now. But it did trash my cornea in that eye, so it's messed my vision up pretty good. And since there's still an active infection (after 8 years), I can't get a cornea transplant. https://www.health.harvard.edu/staying-healthy/two-dose-shin... | | |
| ▲ | jghn 4 hours ago | parent [-] | | My PCP actually recommended holding off until later in the 50s for this reason. There's not currently a booster so his suggestion was to play the odds & delay a bit in order to get longer protection in my elderly years. |
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| ▲ | CydeWeys 4 hours ago | parent | prev | next [-] | | Beg for forgiveness, don't ask permission. I got Shingrix when I was under the age of 40, and at no cost to myself even, simply by scheduling a Shingrix vaccine at CVS. It wasn't until I went back for the booster shot months later that the nurse was like "Wait, aren't you too young for this?", but they nevertheless gave me the second dose to complete the vaccine course. You can just so things. | | |
| ▲ | loeg 3 hours ago | parent [-] | | I was unable to get a first dose just by asking the pharmacy -- they were happy to enforce the arbitrary 50 year age rule. But my PCP was happy to just prescribe it off-label. Do it; shingles is terrible and there's no reason to suffer it under 50. |
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| ▲ | lotsofpulp 5 hours ago | parent | prev [-] | | I would happily pay for Shingrix. | | |
| ▲ | anjel 5 hours ago | parent [-] | | Prepare your happy for a very profit-laden high three-figure bill. | | |
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| ▲ | anderber an hour ago | parent | prev [-] | | They also did it by gender in the US when I was in college. Boys could not get it. At the same time that Europe was vaccinating everyone. |
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| ▲ | TuringNYC 8 hours ago | parent | prev | next [-] | | >>>>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives.
>> This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common. As people cite these statistics, it would be useful to distinguish exposure to HPV causing foot warts, etc from the much more dangerous variants. I rarely see any statistics do this sort of segmentation. | | |
| ▲ | stared 7 hours ago | parent [-] | | > I rarely see any statistics do this sort of segmentation. There are multiple publications. THe easiest way to find is Gemini 3 Pro or ChatGPT Thinking + find for publications (go to link, not just rely on summary). They differ by population and methodology. For example, here is "Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia", 2023,
https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/ |
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| ▲ | loeg 3 hours ago | parent | prev | next [-] | | I mostly hear this from healthcare-fatalists arguing against people in their 40s+ getting the vaccine later in life. | |
| ▲ | hammock 8 hours ago | parent | prev | next [-] | | What about the people who know they have 16 or 18? Should they still get it? | |
| ▲ | michaelrpeskin 8 hours ago | parent | prev [-] | | Yeah, I only read the abstract and looked at the plots, but this is what I hate about public health papers: They say the prevalence of virus is down. They don't say that the cancer rate is down (granted too early to tell), nor do they talk about any adverse events or all cause mortality differences (again, probably too early to tell) The only thing they can conclude is that the treatment given to stop the virus, stops the virus. But they don't mention any tradeoffs. Not trying to be an anti-vaxxer conspiracy theorist, but good science needs to talk about the whole picture. | | |
| ▲ | okaram 5 hours ago | parent | next [-] | | This is one research paper reporting on particular results. It is DEFINITELY not too early to tell. Cervical cancer rates in Australia, which adopted the vaccine widely and early have decreased, and it has been widely reported ( https://www.canceraustralia.gov.au/cancer-types/cervical-can... ) | |
| ▲ | gizmo686 7 hours ago | parent | prev | next [-] | | Research papers are not literature reviews. This paper reports on the results of this study. And that study only investigated what it investigated. In the case of public health, there are a bunch of organizations that keep on top of the research and maintain a more comprehensive view of their perception of the current consensus. For day to day guidance, individuals should be referring to either those sources, or healthcare professionals. If people are looking at individual studies like this to make decisions, something has gone very wrong. | |
| ▲ | 5 hours ago | parent | prev | next [-] | | [deleted] | |
| ▲ | wat10000 5 hours ago | parent | prev [-] | | You can’t talk about the whole picture unless you have all the parts. There’s no reason all of those parts have to come from the same study. The first thing on your list of complaints is something that by your own admission cannot yet be determined. If you’re not trying to be an anti-vaxxer, you’re doing a bad job of it. |
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| ▲ | 0xbadcafebee 5 hours ago | parent | prev | next [-] |
| For those men wondering whether they should get vaccinated: - HPV causes genital warts, HPV is permanent, doctors won't test you for HPV unless you demand it, and the tests aren't reliable, which is why they literally won't diagnose you unless you already have genital warts. - Once you are confirmed HPV positive (again, you won't be confirmed without getting genital warts), you need to inform your partners, as it causes cancer in both men and women (but mostly women). |
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| ▲ | timr 4 hours ago | parent [-] | | You missed three very important caveats that complicate the story you’re trying to tell: 1) not every strain of HPV causes cancer (iirc, the bad ones are rare). 2) many people (in fact, most people) who are active in the world have been infected with at least one strain of HPV. 3) it’s common to have asymptomatic HPV infections. you probably have one now. one more: 4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman). Overall, it’s a situation where you’re asking that sexual partners “disclose”
something that the partner probably already has, if they bothered to be tested for it to begin with. Moreover, nobody does these tests (in men, at least), because there’s no point to doing them, other than creating anxiety. I will leave the nuances of bioethics to other people, but it’s not as clear a situation as you’re making it out to be. One final thing: these infections aren’t “permanent”. They generally clear naturally in a few years. | | |
| ▲ | sroussey 2 hours ago | parent | next [-] | | Does it not prevent cancer in the throat in men? Not sure why that would be women only. | |
| ▲ | tehjoker 3 hours ago | parent | prev | next [-] | | > 4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman). This guidance is changing. Vaccinating men protects women. Also just because you were infected with one strain, that doesn't mean you can't contract another, possibly oncogenic one. Get vaccinated, it protects against the most common cancer-causing strains. I did, why would I want to unknowingly give someone cancer? | | |
| ▲ | jgerrish 2 hours ago | parent [-] | | >> 4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman). > This guidance is changing. Vaccinating men protects women. Yeah, it was fucking like pulling teeth getting my HPV vaccine as an adult male. "It's for teenage girls" comments from multiple health care professionals. I only took the first fucking dose in the regime, and none of my health care providers now offer low cost or covered options. I had to spend Covid money when I had it. I still need the rest of the regime. Thank you thread for the reminder. |
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| ▲ | downrightmike 3 hours ago | parent | prev [-] | | #4, anything that reduces cancer risk is a plus in my book, regardless to time and gender |
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| ▲ | pfannkuchen an hour ago | parent | prev | next [-] |
| I’m confused why it won’t clear an existing infection while still working on future infections. Here is what I know (which may be limited, I’m not a biologist) and also what I’m assuming: 1) The body apparently doesn’t eliminate the virus on its own when it picks up the virus unvaccinated. I’m assuming that this is because it isn’t registered by the immune system as being harmful, for whatever reason. 2) The attenuated virus in the vaccine would not produce an immune response without the adjuvant, because even viruses that are registered as harmful are not reliably registered as harmful when attenuated. This is where the adjuvant packaged with the attenuated virus comes in - it is registered by the body as harmful, and in its confusion the immune system also adds the virus to the registry. So, naively, if the immune system previously didn’t register the natural infection as harmful, and if it does register the virus in the vaccine as harmful, why doesn’t the registry entry for the vaccine also get applied to the natural infection, the same way as it does for a person who wasn’t previously infected? Is there some kind of specificity hierarchy, along with a “not harmful” registry alongside the “harmful” registry, such that the natural infection continues to get its previous classification of “not harmful” because the “not harmful” registry entry is more specific than the “harmful” registry entry? That’s the only explanation I can (naively) think of. And if that’s the case, could we first wipe out the registry by infecting the person with measles, and then give them the HPV vaccine? Just kidding about this part! |
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| ▲ | elric 8 hours ago | parent | prev | next [-] |
| I, a male, got vaccinated with the Gardasil 9 vaccine shortly before turning 40. Convincing my doctor to prescribe it wasn't terribly difficult, I told them a few things about my sexual history and explained some of my sexual plans, and that was that. I wish more people would get vaccinated. |
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| ▲ | terminalshort 5 hours ago | parent | next [-] | | That is terribly difficult. Why the hell do I have to make an appointment weeks in advance, then take time out of my day just to get permission from some asshole who asks about my sexual history? Why can't I just walk up to the counter, say "I'll take one HPV vaccine please" and pay the money? If you want me to get vaccinated make it easy. | | |
| ▲ | gardasilotc 4 hours ago | parent | next [-] | | You can make an appointment at eg Walgreens (and probably also CVS) and pay out of pocket for the Gardasil-9 HPV vaccination without any consultation with or referral from a GP (General Practitioner) or a Specialist. Gardasil https://en.wikipedia.org/wiki/Gardasil https://www.google.com/search?q=gardasil+shot+cost https://www.goodrx.com/gardasil-9/how-much-is-gardasil-witho... : > When you have your first shot is the main factor that determines whether you will need 2 doses or 3 doses > Without insurance, the average price of 1 dose of Gardasil is $368.82. But you could pay as little as $169.50 with a GoodRx coupon at certain pharmacies A prescription is only required for insurance reimbursement fwiu | | |
| ▲ | vaxthrowawayy an hour ago | parent [-] | | You’re not kidding! I read your comment and literally just went and got the vaccine. Thank you! I had no idea. |
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| ▲ | 0_____0 5 hours ago | parent | prev | next [-] | | My GP just offered it during my physical along with the flu and COVID booster. I declined the COVID booster since I had just gotten a mild case a couple months back. Got two shots in the left arm, was sore for a day and that was that. | |
| ▲ | whimsicalism 5 hours ago | parent | prev | next [-] | | Because we over-rely on insurance for routine medical care, when really insurance should just be reserved for the catastrophic and everything else out of pocket (and/or directly subsidized). | | |
| ▲ | terminalshort 4 hours ago | parent [-] | | I agree with that, and I don't have a problem with insurance companies demanding a doctor's approval before paying. What I have a problem with is that I can't even pay my own way without a doctor. | | |
| ▲ | vaxthrowawayy an hour ago | parent [-] | | You can, see sibling comment by another poster. I also didn’t know, but literally just went and got vaccinated all in under an hour. |
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| ▲ | Der_Einzige 5 hours ago | parent | prev [-] | | This is why you have to go to the grey market for medical stuff in the USA anymore. Every rich celebrety, and women with body dysmorphia knows how easy it is to get GLP-1s right now. Good and thank goodness for it. Deregulating medical systems regarding patient choice and access to drugs is good, but you'll eventually get some bootlicker claiming that "we can't do that because SOMEONE WITH A VIRUS MIGHT USE AN ANTIBIOTIC INCORRECTLY" while ignoring the mass consumption of antibiotics by farm animals as a vector for super bugs. | | |
| ▲ | terminalshort 4 hours ago | parent | next [-] | | Antibiotics are actually an exception to my general opinion that all medications should be available without prescription. Unlike most drugs, their use has major externalities which means there is a role for larger societal regulation of their use. Also, are farms actually the major vector for antibiotic resistance in the human population? I was under the impression that the majority of antibiotic resistant infections occur in places like hospitals rather than among farm workers, which would seem to indicate farm animals are not the main problem (I 100% support banning the practice anyway). | | |
| ▲ | samus an hour ago | parent [-] | | I'd ask the opposite: are hospitals the places where the immunities develop or are they merely the places where the presence of antibiotic resistant bacteria is most deadly and therefore investigated? The dangerous thing about antibiotic immunity is that it can transfer also between bacteria species. |
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| ▲ | analog31 5 hours ago | parent | prev [-] | | Not to mention farm animals being the source of most if not all flu strains. |
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| ▲ | mostin 3 hours ago | parent | prev | next [-] | | I did the same at 34. There's a dermatology/STI clinic in Budapest where I live that gives the shot at cost (about 130 euros) because they think people should get it. | |
| ▲ | EE84M3i 8 hours ago | parent | prev | next [-] | | How much did it cost? I've considered it but it seems the only option for me is to pay for it out of pocket (~$1000 for the full course), which seems kind of not worth it at this point. | |
| ▲ | pyuser583 7 hours ago | parent | prev | next [-] | | I feel very uncomfortable trying to talk my doctor into doing something they don't recommend. I know too many people who buy into fake medical stuff. Why is this different? Why is pestering a doctor to give me a medicine they don't recommend a good idea? | | |
| ▲ | toomuchtodo 5 hours ago | parent | next [-] | | Because doctors are human and fallible operating in suboptimal systems. Don't want to provide me with a low risk, potentially high reward, low cost intervention? I'll shop until I find a doctor who will, or source it myself. Suboptimal systems and practitioners of various quality require advocating for one's self. I had to twist Planned Parenthood's arm to get Gardasil before it was approved for older adults, even though I was paying cash out of pocket, but had no problem with a trusted PCP providing me Metformin, GLP-1 prescriptions, etc simply by arguing my case and meeting sufficient criteria it would not come back to bite them. | |
| ▲ | elric 6 hours ago | parent | prev | next [-] | | Doctors don't have the time or capacity to know their patients well enough to make personalized recommendations in most cases. If you show up with symptoms of X they can recommend Y and will probably ask you whether you have Z which can impact the treatment. But virtually no doctor is going to ring you up proactively and say "hey, I noticed you haven't had a HPV vaccine yet, and I think it might make sense for you because I know this and that about your risk profile". Doctors are not all knowing, infallible oracles. They are human beings you can have a conversation with about your health. If you think something makes sense for you, you can run it past them. No one is suggesting randomly asking doctors to prescribe random shit. | |
| ▲ | sroussey 2 hours ago | parent | prev | next [-] | | You need to be your own advocate. | |
| ▲ | samus 5 hours ago | parent | prev | next [-] | | The doctor likely didn't recommend it because GP is 40 years old. Most people's sex lives is comparatively... boring at that age. | |
| ▲ | Der_Einzige 5 hours ago | parent | prev [-] | | Your own doctor is as likely to be a quack/have quack-like beliefs as you are. Unironically this is true! Better learn to start reading Pubmed! Doctors/medical associations don't agree with each other on much, even at the very highest levels. For example, the USA and EU have totally different recommendations related to digital rectal exams for aging men. One believes that finding cancer in old men is important, the other claims it's bad because most of those cancers are benign and sticking a finger up an old mans butt often causes its own complications. |
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| ▲ | yieldcrv 8 hours ago | parent | prev [-] | | Best of luck, the reason it took so long for males to be approved for Gardasil use and they slowly keep pushing it up by age is two fold: 1) if you've ever been exposed to HPV already, then the vaccine is useless 2) there is no test to determine if a male has been exposed, although there is one for females so they just push the ages up by probability, over time. As the probability of a man being with an older and therefore unvaccinated woman decreases - since with women is the most probable - the age can rise | | |
| ▲ | elric 8 hours ago | parent | next [-] | | > 1) if you've ever been exposed to HPV already, then the vaccine is useless This is patently incorrect. The vaccine protects against 9 variants. Having been exposed to all 9 before vaccination sounds like really bad luck. > 2) there is no test to determine if a male has been exposed, although there is one for females The female HPV tests, as I understand, only test for the presence of HPV in the cervix. It can be present in many other areas. No one is testing women for the presence of HPV on their hands or in their throats. Most places now offer HPV vaccines to young boys as well. People over 40 more or less missed the boat, but they can still get vaccinated. How useful it is depends entirely on their personal circumstances and risk profiles. | |
| ▲ | stared 7 hours ago | parent | prev | next [-] | | > 2) there is no test to determine if a male has been exposed, although there is one for females It is incorrect. I had it tested multiple times. It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology. See: - https://www.droracle.ai/articles/607248/what-methods-are-use... - https://pmc.ncbi.nlm.nih.gov/articles/PMC12256477/ - https://www.tandfonline.com/doi/full/10.1080/22221751.2024.2... > 1) if you've ever been exposed to HPV already, then the vaccine is useless Also no. See other comments. | | |
| ▲ | timr 6 hours ago | parent [-] | | > It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology. No. The general reason that people don't do the test for men is that DNA testing is extremely sensitive, and produces a lot of false positives for a virus that is widespread. It's also not actionable. You can't treat an asymptomatic infection, and a positive leads to the same outcome they would give anyway: use physical barriers and abstinence. (Edit: hilariously, your first link says exactly what I just wrote, at the very top of the page. Did you read it?) | | |
| ▲ | stared 6 hours ago | parent | next [-] | | The claim I refuted is that there are no test for men (there are). Not sure why you want to get needlessly argumentative here, repeating things I already linked (sic!). Sure, test from penis has lower specificity and sensitivity that for cervix, but it is not binary "works or not" (as side note, just measuring from urethra is rarely enough [1]). Life is probability, and it is a huge fallacy to believe that things work 100% or 0%, nothing in between (rarely the case in medicine). Results are actionable on many ways. Most important, screening for female partners, informed risk for partners or your on safety for ones partners (condoms BTW reduce infection rates, but do not fully protect, as HPV can be on other parts of skin). [1] > The overall prevalence of HPV was 65.4%. HPV detection was highest at the penile shaft (49.9% for the full cohort and 47.9% for the subcohort of men with complete sampling), followed by the glans penis/coronal sulcus (35.8% and 32.8%) and scrotum (34.2% and 32.8%). Detection was lowest in urethra (10.1% and 10.2%) and semen (5.3% and 4.8%) samples. Exclusion of urethra, semen, and either perianal, scrotal, or anal samples resulted in a <5% reduction in prevalence. https://pmc.ncbi.nlm.nih.gov/articles/PMC3904649/ | | |
| ▲ | timr 4 hours ago | parent | next [-] | | I quoted you, and responded specifically to the quote. The reason doctors don’t offer the test is not because of some straw man arguments (“a horrible mindset…”) involving their diminished judgment of importance of the virus in men, as you assert. You keep saying things in these sub threads that are factually incorrect in some important way that hides nuance, or otherwise seems calculated to provoke outrage. This was another example, which I why I replied here. | |
| ▲ | yieldcrv 6 hours ago | parent | prev [-] | | no reliable test for men, then and even if it is reliable, its utility is limited all leads to focusing solely on probability of exposure(s) |
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| ▲ | yieldcrv 6 hours ago | parent | prev [-] | | so far the comments are adding more vectors to understanding the situation, but nothing that fundamentally changes the user experience I think the most insightful thing is that there are 9 HPV variants some of which someone wouldn't have exposure to so its worthwhile to get the vaccine anyway but other than that, the situation is the same. for men's age the utility of the vaccine is based on probability alone, as its a waste of resources to even attempt checking for prior/current exposure |
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| ▲ | anderber an hour ago | parent | prev | next [-] | | Europe approved it for males at the same time as for females. | |
| ▲ | codesnik 8 hours ago | parent | prev [-] | | this is what I don't understand, why is it useless? there're multiple variants, vaccination could create reaction to a different part of the virus, etc. |
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| ▲ | osakasake an hour ago | parent | prev | next [-] |
| What are the chances that you develop cancer if you get infected by the worst HPV strain? |
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| ▲ | wolvoleo 4 hours ago | parent | prev | next [-] |
| Yeah I just did it at 50. Only got 2 gardasil shots though. They're so expensive because only young people get them subsidized. I heard 1 shots already conveys a lot of protection so I'm wondering whether to take the third. I'm a bit late with it too |
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| ▲ | kace91 8 hours ago | parent | prev | next [-] |
| Is there any issue for adult males vaccinating ? I seem to remember some mention of risk by my doctor when I asked about it, but I might be misremembering. |
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| ▲ | donohoe 8 hours ago | parent | next [-] | | No vaccine is without risk, but the vaccine approach is based on that risk being so low (but not zero) in comparison to the risk of not vaccinating that it is vastly the better choice. | | |
| ▲ | kace91 7 hours ago | parent [-] | | Ok that was a bad question, let me rephrase: isn't there something particularly bad about this one for males that are already adults that makes it not recommended by doctors by default? | | |
| ▲ | okaram 5 hours ago | parent [-] | | There's nothing particularly bad for adult males. The benefits may be statistically lower, since you may have been infected by some of the variants already, older males may have fewer sexual partners in the future, and cancer takes a while to develop. In the USA, it is recommended by default for adults up to 26 and kinda for 27-45. |
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| ▲ | hammock 8 hours ago | parent | prev [-] | | There is currently no vaccine that is zero risk | | |
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| ▲ | timr 7 hours ago | parent | prev | next [-] |
| > While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/ The study you've quoted here is not definitive evidence of the claim you're making, and that claim is...let's just say that it's controversial. Conventional wisdom is that you're unlikely to benefit from HPV vaccination unless you have not already seroconverted for at least one of the 9 strains (6, 11, 16, 18, 31, 33, 45, 52, 58) in the current vaccine. There's not much hard evidence to suggest that vaccination for HPV has strong ability to protect you from a strain after you've already been infected with that strain [1], as the best available data shows a substantial decline in efficacy for women over age 26 and for women of any age who had prior documented infection [2]. This study is small, unrandomized, and the measured primary outcome (anti-HPV IgG) doesn't really tell you anything about relative effectiveness at clearing an infection. The only real evidence they advance for this claim is: > Persistent HPV infection after vaccination was significantly less frequent in the nine-valent vaccinated group (23.5%) compared to the control group (88.9%; p < 0.001). ...but again, this is a small, unrandomized trial. We don't know how these 60 people differ from the typical HPV-positive case. You can't rely on this kind of observational data to claim causality. Vaccination is great, but let's not exaggerate or spread inaccurate claims in a fit of pro-vaccine exuberance. The HPV vaccine has age range recommendations [3] for a reason. [1] For the somewhat obvious reason that your immune system has already seen the virus. [2] See tables 2 and 3 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/ It's also worth calling out table 4, which shows the (IMO bad) efficacy data for biological men, which is why I only talk about women, above, and why anyone who recommends vaccination without mentioning this factor is not being entirely forthright. Few people are rushing to give older men the HPV vaccine because it's not really supported by data! [3] I believe the current guideline is under age 45 in the USA. |
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| ▲ | formerly_proven 8 hours ago | parent | prev | next [-] |
| > - Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive. However, the vaccination is expensive (~1k) and it is difficult to find doctors who will do non-recommended vaccinations for self-payers. YCMV |
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| ▲ | elric 8 hours ago | parent | next [-] | | > However, the vaccination is expensive (~1k) Depends entirely on where you are and what your healthcare situation is. Mine cost me ~100eur. | | |
| ▲ | oblio 8 hours ago | parent [-] | | This is ultimately an American site so you can assume 80%+ of comments come from a US background (I'm not American, I've just been here longer than I should have). (even for rest-of-the-world topics) | | |
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| ▲ | nerdjon 7 hours ago | parent | prev [-] | | Are there insurance plans that won't cover it? I know that a lot of plans love not paying for things but vaccines seem to be the one thing that they all at least seem fairly good at (at least in my experience). I am currently getting the HPV series and I only had to pay my copay for the first appointment have nothing for the second one (I am assuming it will be the same for the third) | | |
| ▲ | whimsicalism 5 hours ago | parent [-] | | are you under the age of 27? this is the key difference in cost of HPV vaccination |
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| ▲ | stefantalpalaru 3 hours ago | parent | prev | next [-] |
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| ▲ | gnerd00 7 hours ago | parent | prev | next [-] |
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| ▲ | miroljub 6 hours ago | parent | prev | next [-] |
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| ▲ | OkayPhysicist 6 hours ago | parent | next [-] | | Venereal diseases have been a significant cause of human mortality for ages. The first outbreak of Syphilis in Europe killed ~7% of the population. The only thing that broke up that state of affairs was the advent of antibiotics. | |
| ▲ | wat10000 5 hours ago | parent | prev | next [-] | | And if it turns out you weren’t a perfect judge of character and your partner cheats on you, then fuck you, right? I guess you deserved to die from cancer because you couldn’t read your fiancé’s mind. Or maybe it’s your fault for not being a good enough spouse. | |
| ▲ | andrepd 6 hours ago | parent | prev [-] | | You're replying on a post that shows a literal >16x reduction in prevalence, with "just don't be a slut, worked for thousands of years". I'd invite you to look up the prevalence of STDs during the most puritanical eras and places, maybe you'd change that stupid take. | | |
| ▲ | miroljub 5 hours ago | parent [-] | | [flagged] | | |
| ▲ | wat10000 2 hours ago | parent | next [-] | | Why is a marginal benefit bad? | |
| ▲ | andrepd 3 hours ago | parent | prev [-] | | Chastity is 100% effective at preventing STDs exactly like living in a plastic bubble is 100% effective at preventing the flu (incidentally, it's also 100% effective at preventing humanity from existing within 80 years...). The fact that people throughout history, even in the most repressive times when "adulterers" were stoned or forced to marry rapists, have had much higher rates of STDs than we do today, shows that reality, rather than an abstract ideal case, is what matters in terms of public health. Put another way: a "slut" practicing safe sex today will have fewer chances to contract an STD than a regular married woman in Victorian times. > stupid man without any arguments Seriously? Your argument is "damn those slut whores" and you're pretending to have an intellectual high ground...? Have a good weekend. |
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| ▲ | GlibMonkeyDeath 5 hours ago | parent | prev [-] |
| > Unless you plan to remain completely celibate Uh, monogamy of both partners is also an option, not just celibacy. Not common in these times, I know, but you don't have to completely abstain from sex to be safe. |
