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.
By pm90 13 hours ago
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.
By arjie 11 hours ago
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.
By Aurornis 8 hours ago
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.
By WarOnPrivacy 3 hours ago
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.
By BobAliceInATree 8 hours ago
What’s the procedure of getting Cervavac in india?
By rishikeshs 7 hours ago
You can pretty much walk into any decent clinic and just ask for one.
By unmole 5 hours ago
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.
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.
By xkbarkar 2 hours ago
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.
By tordrt 2 hours ago
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.
By mailund 39 minutes ago
It is like Pokemon, got to collect them all! And for all booster shots you get extra golden star!
I love medical discussion on HN! Your GP knows shit, does not matter if you are young or old, you must get this super medical stuff from India!
By throw738488 3 minutes ago
And note i believe they just increased the recommended age of administration up to ~40yo? Throat cancer sucks. Get the vax.
By rtaylorgarlock 13 hours ago
Why is there an age limit on an all encompassing vax, wasn't the famous posterchild for this disease Michael Douglas?
By sillyfluke 13 hours ago
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.
By ZeroGravitas 12 hours ago
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).
By OneDeuxTriSeiGo 9 hours ago
> 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.)
By JumpCrisscross 12 hours ago
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.
By loeg 11 hours ago
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?
By _heimdall 5 hours ago
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.
By LorenPechtel 12 hours ago
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.
By BjoernKW 8 hours ago
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.
By JohnTHaller 12 hours ago
Already exposed without having any issues from it.
By codr7 11 hours ago
That last part doesn't matter. You can develop cancer later.
By tehjoker 9 hours ago
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.
By colingauvin 8 hours ago
To be blunt: Cost-effectiveness.
By Fomite 12 hours ago
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 :)
By fsckboy 8 hours ago
Conspiracy theory: they want old people to die.
By phkahler 8 hours ago
Finally, affordable housing!
By user432678 8 hours ago
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.
By pixelpoet 4 hours ago
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.
By comrade1234 13 hours ago
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.
(had three doses in my 30s via Planned Parenthood)
By toomuchtodo 13 hours ago
> 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.
By myself248 8 hours ago
Yes.
By toomuchtodo 6 hours ago
Doctor recommended it to me when I was almost 30. So yeah, I'd say still go for it.
By Insanity 12 hours ago
Note that the modern vaccine covers 9 different strains.
By tonfa 13 hours ago
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.
By dashundchen 6 hours ago
Not sure but theres zero downside to getting it
By Obscurity4340 13 hours ago
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.
If it's similar to placebo, doesn't that imply that it's pretty much non-existent?
By freedomben 7 hours ago
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.
By toast0 6 hours ago
If you’re not sexually active, is it still worth doing?
By rogerrogerr 12 hours ago
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].
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.
By toasterlovin 11 hours ago
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
By bluGill 7 hours ago
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.
By Modified3019 12 hours ago
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.
By pitpatagain 12 hours ago
Life is long and unpredictable, while the cost is very low.
By toomuchtodo 12 hours ago
If you ever intend to be, yes.
By Fomite 12 hours ago
Yes.
By hedora 12 hours ago
Why?
By CGMthrowaway 12 hours ago
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.
By vhcr 12 hours ago
Probably in reverse order
By airstrike 9 hours ago
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.
By yladiz 12 hours ago
rape
By bdangubic 12 hours ago
Huh.
By agons 12 hours ago
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.)
By LorenPechtel 12 hours ago
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
By peterlk 9 hours ago
That's interesting and I would like to take, can you give me a link/ ref for citation?
By v3ss0n 3 hours ago
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.
By p1necone 11 hours ago
If you’re having casual sex at 45+ you probably already carry HPV.
By finghin 11 hours ago
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.
By phkahler 9 hours ago
Sure, but you probably don't already have all the strains which can cause cancer.
By pcthrowaway 9 hours ago
Yeah that makes much more sense as an explanation than OP.
By p1necone 10 hours ago
Maybe, but all 9 cancer causing strains covered by the vaccine? HPV also clears on its own usually after some time afaik.
By tehjoker 9 hours ago
It's not "recommended" but your PCP can prescribe it off-label if you ask -- just ask.
By loeg 11 hours ago
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.
By al_borland 11 hours ago
The issue is getting it covered by insurance. Otherwise it can cost over $1,000 for the full course of shots.
By pimlottc 10 hours ago
You can get costs down somewhat (half that) even uninsured with GoodRx.
By loeg 10 hours ago
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.
By pyuser583 10 hours ago
This is very different from recommending horse dewormer; if you can't tell the difference, I'm sorry.
By loeg 10 hours ago
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.
By pyuser583 10 hours ago
Ivermectin is also used by dermatologists to fight face parasites that cause bad acne.
By mensetmanusman 5 hours ago
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”
By Spooky23 9 hours ago
> 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.
By iamtheworstdev 9 hours ago
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.
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.
By yieldcrv 7 hours ago
"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.
By Fomite 5 hours ago
> 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.
By elric 2 hours ago
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.
By yieldcrv 2 hours ago
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.
By mgiampapa 7 hours ago
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).
By hedora 12 hours ago
Kaiser is continuing to cover it for everyone.
By arcticbull 12 hours ago
You might not have the same experience in OK or FL
By insane_dreamer 4 hours ago
If you live outside of the US, you should get vaccine too. Even one dose is effective.
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!
By p1dda 3 hours ago
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.
By dreamcompiler 2 hours ago
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.
By boxed 3 hours ago
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.
By pyuser583 10 hours ago
In most countries it's recommended for everyone. It just isn't in the US because they don't want to pay for it.
By SchemaLoad 10 hours ago
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?
By pyuser583 9 hours ago
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?
By OkayPhysicist 9 hours ago
If I was told by my doctor I shouldn’t get the vaccine I wouldn’t get it.
By pyuser583 7 hours ago
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.
By dreamcompiler 2 hours ago
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.
By shirro 6 hours ago
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.
By illiac786 5 hours ago
No one mentioned the US before you did.
By boxed 3 hours ago
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.
By shirro an hour ago
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?
By illiac786 3 hours ago
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.
By shirro 4 hours ago
This discovery, and generally the ground breaking connection between a virus and cancer, was awarded the Nobel Prize in 2008.
Good to hear what's happening in the more advanced countries.
By Animats 11 hours ago
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:
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!
By blindriver 13 hours ago
> it was to decrease cervical cancer
HPV can cause cancers in the cervix, vulva, vagina, penis, anus and back of the throat [1].
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.
By grumbelbart2 3 hours ago
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.
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.
By olivia-banks 4 hours ago
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.
By syntaxing 10 hours ago
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].
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.
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.
By epistasis 5 hours ago
No, it's targeted against those most associated with cancer.
By Fomite 5 hours ago
Potentially, yes. HPV infections are cleared over time, and there are many strains of HPV.
By Fomite 13 hours ago
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.
By pitpatagain 12 hours ago
> 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.
By Fomite 12 hours ago
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.
By tialaramex 13 hours ago
It should be noted that the decision to vaccinate younger children is a combination of disease prevention and cost, not just vaccine effectiveness.
By Fomite 13 hours ago
And access! If you vaccinate in earlier grades of school, the kids haven’t had a chance to drop out yet.
By Scoundreller 6 hours ago
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.
By giantg2 13 hours ago
The key is you want it to clear as quickly as possible.
By Fomite 13 hours ago
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?
By v3ss0n 3 hours ago
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.
By navi0 3 hours ago
There some circumstantial evidence it could help with plantar warts, too.
By mrtesthah an hour ago
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.
By 0xTJ 9 hours ago
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.
By YeahThisIsMe 13 hours ago
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.
Sort of similar in most EU countries. I could get it in Austria but it's prohibitively expensive.
By odiroot an hour ago
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)
By dTP90pN 10 hours ago
Can you pay for it?
By n1b0m 13 hours ago
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.
By riggsdk 13 hours ago
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.
By Fomite 13 hours ago
But from a personal POV it is very cost-effective! Even if it is not so at the population at as large group.
By DownGoat 2 hours ago
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.
By whycome 4 hours ago
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.
By respondo2134 10 hours ago
Indeed. Generally for HPV, there were modeling studies showing this was probably a good idea before trials started.
By Fomite 6 hours ago
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.
By bartman 13 hours ago
By way of contrast, America's current top "doctor" organized a class-action lawsuit against the HPV vaccine.
> "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"
By perihelions 13 hours ago
It's okay, he'll have us treat cervical cancer with a juice cleanse and vibes.
By api 12 hours ago
Don't forget prayer--the ultimate solution to everything!
By ryandrake 10 hours ago
Also the juice is whale juice.
By antonvs 9 hours ago
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.
By unethical_ban 12 hours ago
Rick Perry?
By digianarchist 3 hours ago
We have the first leaders.
By etchalon 13 hours ago
In the US, there is no male test for HPV
By Kalanos 6 hours ago
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.
By deadbabe 7 hours ago
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.
By somenameforme 4 hours ago
> 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.
By thaumasiotes an hour ago
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.
There will never be a single cure to all cancers. Different cancers have different underlying mechanisms and affect different tissues.
By thfuran 5 hours ago
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.
By somenameforme 4 hours ago
Maybe.
The fact that some animals are especially immune to cancers suggest there are ways to prevent the outcome (cell replication/mutation).
By whycome 4 hours ago
Are they immune to cancer, or do they simply not live long enough to develop them? AFAIK, only plants are immune to cancer.
Cervical cancer (uterus), not skin cancer from a bad papillomas as I thought after looking up what HPV meant
By NooneAtAll3 13 hours ago
Also throat, mouth, tongue, anal and penile cancers.
By mitb6 13 hours ago
Add in anal cancer too
By astura 6 hours ago
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.
By tialaramex 12 hours ago
Humans (and most animals) are just tubes with extra bits.
By Fomite 12 hours ago
"Denmark completely autistic." -Unnamed US federal government secretary
By floppiplopp 3 hours ago
and why do we trust gavi?
By attila-lendvai 2 hours ago
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.
By inglor_cz 13 hours ago
Amazing how badly the United States is regressing. Literally measles is making a comeback due to idiots like RFK.
By chris_wot 13 hours ago
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.
By _moof 13 hours ago
"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."
By Fomite 13 hours ago
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" ?
By tialaramex 12 hours ago
I always thought "Cervical cancer is a just punishment for my daughter's mistakes" (leaving aside if it is a mistake) was horrific.
By Fomite 12 hours ago
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.
By Spivak 12 hours ago
Teenagers are notorious for making decisions based on consequences that are decades away from manifesting.
By Fomite 12 hours ago
"you never want grandchildren?"
By 8note 10 hours ago
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.
By braincat31415 6 hours ago
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 ?
By boxerab 11 hours ago
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.
By kentm 10 hours ago
For just being "against *unsafe* vaccines" they sure tend to have some very weird ideas of what a safe vaccine is.
By dotnet00 10 hours ago
"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
By 8note 10 hours ago
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.
By boxerab 7 hours ago
> "anti-vax" is a term used to dismiss dissident without having to deal with their arguments i.e an ad hominem.
A slur.
By delichon 11 hours ago
We've been dealing with anti-vaxxers for years. I've yet to see an argument from one that holds any water.
By chris_wot 9 hours ago
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.
By antonvs 9 hours ago
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.
By inglor_cz 13 hours ago
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.
By 8note 10 hours ago
> 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.
By squigz 13 hours ago
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.
By inglor_cz 13 hours ago
Back then we had the National Enquirer and Weekly World News and similar for all the obscure conspiracy news you wanted.
By SoftTalker 12 hours ago
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.
By squigz 13 hours ago
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.
By p1dda 3 hours ago
Unlike the measles, HPV is not a good eradication candidate due to the existence of non-human reservoirs.
By giantg2 13 hours ago
I think you said that backwards. HPV does not have non-human reservoirs, per Wikipedia. (Do you have evidence that it's wrong?)
By AnimalMuppet 13 hours ago
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.
By giantg2 13 hours ago
Hence the "H"
By russdill 13 hours ago
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.
By serial_dev 12 hours ago
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.
By russdill 4 hours ago
the
By sincerely 6 hours ago
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.
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.
By duffpkg 10 hours ago
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.
By amluto 10 hours ago
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.
By pitpatagain 9 hours ago
> 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.
By atombender 10 hours ago
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.
By illiac786 5 hours ago
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.
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