- 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.
"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.
> 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
>> 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.
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!
> 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.
>>>>> 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.
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.
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).
You are giving some honestly really bad and dangerous info.
The HPV strains that cause cancer and the ones that cause genital warts are different. The strains that cause cancer do not cause warts.
So you can very much have HPV without genital warts.
And conversely, while having genital warts tells you you are infected with the low risk strains, it does not guarantee you that it is the only strain you are carrying.
Thus you cannot rely on the presence of genital warts to know if you are or are not infected with the high risk strains, they are completely uncorellated.
The cancer-causing strains cause no symptoms and can only be detected by getting tested for them.
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.
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.
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.
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.
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.
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
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!
> - 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.
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)
Yeah, one downside to giving this vaccine to your kids is you're basically telling them you expect they won't do this, even if they plan to (and you planned to, and in fact did). But pediatricians talk about how you really have to do it young, before they're going to be sexually active, and how it's hard to get later (not entirely true, as demonstrated by the comments here).
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.
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.
> 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.
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.
I understand why it wouldn't be recommended in policy but individually, provided you are rich enough to waste a hundred bucks, worse case is it's useless, best case you are 1-5% likely to spread a bad strain dangerous to yourself or to your partners, right ?
The age 45 bit isn't actually a guideline. Rather, finding naive but at risk individuals over 45 is quite difficult. They did not test it on anyone over 45, thus the FDA approval cuts off at 45.
1) Surrogate endpoint only — HPV PCR positivity is not a clinical outcome; no CIN2/3, no cancer, no mortality measured
2) Correlation ≠ causation — HPV-cancer link is epidemiological association; Koch's postulates not fulfilled in traditional sense; detecting DNA doesn't prove pathogenic activity
3) PCR detection ≠ disease — Transient HPV infections are common and clear spontaneously; most HPV-positive women never develop lesions or cancer
4) Type replacement signal ignored — 66% higher incidence of non-vaccine HR types in vaccinated group is dismissed rather than investigated as potential clinical concern
5) No long-term clinical follow-up — Cervical cancer takes 15-30 years to develop; this 7-year study cannot assess actual cancer prevention
6) Confounding in vaxxed vs unvaxxed comparison — Unvaccinated group is small (n=859), likely differs in health behaviors, screening adherence, socioeconomic factors
7) Circular reasoning — Vaccine "works" because it reduces detection of the types it targets; says nothing about whether those types were actually causing disease in this population
8) Assumes HPV16/18 reduction = cancer reduction — Untested assumption; clinical benefit must be demonstrated, not inferred from PCR
9) High baseline HR-HPV in vaccinated group unexplained — 32% prevalence of other HR types suggests substantial ongoing oncogenic exposure despite vaccination
10) Genome validity unestablished — HPV reference genomes are in-silico constructs assembled computationally; never validated by sequencing purified, isolated viral particles; PCR/sequencing performed on mixed clinical samples where true origin of amplified fragments is indeterminate
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.
In the 1960s, more than 900 people were diagnosed with cervical cancer each year, corresponding to more than 40 cases per 100,000 Danes.
Today, that number is below 10 per 100,000 nationwide – and among women aged 20 to 29, only 3 out of 100,000 are affected. This is below the WHO’s threshold for elimination of the disease.
Just a quick point as an American living in Denmark, one of the reasons government programs like this work so well is everything is delivered digitally. We have "e-boks" https://en.digst.dk/systems/digital-post/about-the-national-... official government facilitated inboxes so when they need to notify you of vaccinations or whatever else, it arrives to your inbox. And basically 100% of residents use these systems.
This HPV vaccine was part of the children vaccination program (børnevaccinationsprogram) which kindly asks the parents to vaccinate their children.
While we have some anivaxxers here in DK, most people (90%, I believe) are sane and follow the recommendations.
The vaccinations start while the children are small and continue while they grow up .. the last one is when they are 12.5 years old.
The notifications are delivered in eboks or by mail if you don't want to use eboks. Everything from the state is delivered like this. There is nothing special about how the information is delivered. The SMS/e-mail notifications are just about hwo sent you something and not about what it is. At least for me.
I don't see how the use of eboks makes this work better. It would work just as well without eboks. People listen to doctors and the MAGA like shitheads we do have don't have a lot of influence.
This is why I posted it from the perspective as an American. We don't have anything remotely comparable. Vaccinations are delivered by private doctors and public schools often require vaccinations or exemptions but the system works entirely differently. If you homeschooled your kids and if your doctor didn't mention it, you'd never even know that vaccinations were available.
I fail to see how e-boks makes this work. Younger people check their e-boks less frequently than average, so sending a physical letter to their address would work just as well if not better.
e-boks sends a text message to the phone, so I see it much faster than a paper mail.
e-boks is like gmail (and others) in that it keeps your old mail. So you can easily find old stuff, a great improvement on paper mail.
I don't even check my physical mailbox once a week.
Denmark is one of the very most digital countries. Physical mail is very much on the way out. We no longer has mailboxes to send mail, you have to go to a shop to send letters, which now cost at last $6 per letter due to the low amount of mail sent.
It is only a matter of less than 10 years before letters will be fully gone.
Okay, well Ireland has similar vaccination rates, broader childhood vaccination coverage, and no central medical records at all, so while e-boks may assist administration, it's certainly not necessary.
Which is bad, we definitely should have them. Referral data appears to be managed through Healthlink, which may just be a privatised not always used medical record system.
I don’t get it. Everyone online gives advice like “Ask your doctor to get the vaccine even if you’re male” but the pharmacies here in SF refused to give it to me. They said that it’s not indicated for a 35+ yo male.
So I get the theory of this thing. But has anyone actually tried this? Finally I got OneMedical to prescribe it for me for some $1.2k at which point I decided I’ll just get it abroad during some planned travel.
I decided years ago I’d do this because I was going to have girls and I wanted to minimize my daughters’ risk of cancer.
Over a decade ago I tried getting the HPV vaccine in my early 20s, but the doctor told me it wasn't recommended for men and that insurance won't cover it. I was young and didn't have the money to pay out of pocket.
I went to Planned Parenthood and got the vaccine last year. At some point they changed the recommendation to men under 45 now and I got all 3 shots free.
Honestly, though I'm glad to have finally got the vaccine it's been a pretty frustrating experience.
The FDA has approved it for men up to age 45. I myself got it in my late thirties at a pharmacy. For one of the shots, the pharmacist hassled me a little, asking if I was high risk, but acquiesced when I told them I was. For the other two, they just gave me the shot. It was also covered by my insurance.
> I decided years ago I’d do this because I was going to have girls and I wanted to minimize my daughters’ risk of cancer.
I don't understand: how would your daughters be more/less likely to get cancer based on whether you were vaccinated? There's obviously the (hopefully extremely) roundabout way in which there is a direct path of sexual partners leading from you to your future daughters, but is there something else I'm missing?
And if you don't have it by age 35 (and married, per your comment below), how likely are you to even get it at this point? Are you thinking you could hypothetically pass it to them by kissing your babies on the mouth, after contracting it in the future?
The vaccine is likely to do very little damage to me, but cervical cancer is a big bad. I think I'm just accounting for some risk that we discover a non-sexual mode of transmission.
Carrier screening revealed a shared genetic risk so my wife and I decided to do IVF and PGT qualified our female embryos as unaffected (coincidentally, it’s autosomal recessive).
My reading of the following is that the cost of each additional quality adjusted life year would be over $100,000, rather than that each vaccination prompts $100k in economic value
> Including preadolescent boys in a routine vaccination programme for preadolescent girls resulted in higher costs and benefits and generally had cost effectiveness ratios that exceeded $100 000 per QALY across a range of HPV related outcomes, scenarios for cervical cancer screening, and assumptions of vaccine efficacy and duration
Lots of viruses are really oncogenic. The real success here is the ability of Denmark to track effectiveness. It sounds crazy but most countries do not have electronic health record capability to measure the effect of many interventions at population scale. Once good EHRs are rolled out, we will be able to double down on effective interventions, like this one, and vice versa.
A lot of viruses insert themselves into your DNA, they may mess up the 3D structure, or during DNA repair result in misrepair / duplications, or simply insert somewhere and break something important. All of these are ways that can contribute to kickstarting or accelerating cancerous growth.
Sadly, no matter how good the data is, some societies will value opinions of uninformed celebrities above facts and reason, leading to a resurgence of preventable diseases.
The numbers are quite solid. People who don't want to accept the numbers, need to come up with an explanation why the data can not be trusted. With regard to oncogenic HPV, I think the data is very convincing. To me it was a lot more convincing than the SARS covid datapoints (e. g. the media constantly shifted; I noticed this with regard to Sweden, which had a bad early data due to barely any protection of the elderly, but lateron it still had better data than e. g. Austria which went into lockdown - so Austria had worse data points than Sweden overall. Japan or Taiwan had excellent data points, so the respective governments were much better than either Sweden or Austria. The most incompetent politicans acted in Austria during that time, replacing facts with promo and propaganda. The data points, though, were always solid. I remember I compared this about weekly and it was interesting to me when Austria suddenly surpassed Sweden negatively; the media here in Austria critisized Sweden early on, but once Sweden outperformed Austria in a better, more positive manner, suddenly the media no longer reported that. Private media simply can not be trusted.)
Anecdote time (and some info from real life EMTs and Oncologist). I just recently “won” the cancer lottery related to this.
Never had the HPV vaccine. Honestly thought it was only for young girls (didn’t spare topic a thought, zero time investigating).
80-90% of adults gets some form of HPV during lifetime. Often several strains. Each have different risks of cancer. Even if you’re married - if you or your partner experience a severely stressful period- it might reactivate.
Most people’s immune systems clears HPV, and makes it dormant. (Mine likely doesn’t see HPV as a threat.
Long term (10y+?) exposure to active HPV cause cancer.
If you can, at least do your very best to avoid the cancer nightmare. Take the vaccine. Worst case it protects you from being a vector.
It’s an imperfect insurance from 3-4 months in/out of hospitals, scans, blood work, from chronic dry mouth,all food tasting very bad, issues with energy, possible bone death (that you suddenly have to monitor every day for the test. Oh, and any alcohol or smoking after having had this increases risk of recurrence by 30-50%
A comment with an article citing published medical literature on risks associated with this type of vaccine was flagged and hidden. Why? I don't know the author nor am I a medical doctor to understand the topic at depth, so it's a genuine question. Was it misleading? If so, how? That's what the comment was asking, actually, if there were counter-points to the text, which was favorable to live vaccines (e.g. shingles) but critical of those developed with other methods. Is there no merit to that? I genuinely don't know, and since it seems impossible to discuss the topic, it's hard to say.
I sometimes vouch for incorrectly flagged posts. You got me curious, so I took a look. What I found was a blog from an anonymous conspiracist vaccine opponent claiming to be a doctor. He's a decent writer but in my estimation a loon.
So I'm fine with it being flagged and decline to vouch for it.
For the HPV section specifically, there were at least two major omissions.
First, in his table showing autoimmune adverse effects, he has chosen to crop out the next column in the table containing the control conditions - which show very similar rates of adverse effects to the vaccine condition.
Secondly, when discussing negative efficacy in the case of existing persistent infection, he only quotes the data from one of three studies that the linked report covers. The linked report indeed covers the negative efficacy in study 013 as an area of concern. However, study 015 (which had roughly twice the number of total participants as study 013) showed no real evidence of negative efficacy. When all 3 studies are pooled together, the point estimate still says negative efficacy, (at ~-12%), however the error bars are quite wide.
Why this is tragic, is because these two omissions do actually point to failures in public communication about the vaccine. For example, the control condition in the Merck trials were a mix of saline injections (this is the traditional placebo), as well as injections with just the adjuvant (AAHS). This is less standard, and raises legitimate questions about why Merck used an adjuvant as the control, instead of just saline. There a cynical/conspiratorial angle to this question, which I think would be directionally correct.
The second omission is because I think there is a reasonable question of "are there extra risks associated with getting the HPV vaccine while having an active persistence infection", even when taking into account the different and larger study populations within the original trial data. Once again, I think the idea that both companies and public health agencies don't want to deal with a vaccine that requires testing before hand is true. I also believe that on a population level, even if there was a modest increase in risk in that specific subgroup, it makes sense to implement broad vaccination campaigns.
That said, I think the unwillingness of public health agencies to engage with this tricky area of communication and education creates these types of opening for anti-vaccine messaging. If you want a sense of "conspiracy" - here's a random review study - https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
Notice that when reporting results, the groupings for HPV status at enrollment time are "naive" and "irrespective" - the "test positive" grouping isn't broken out.
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Signaling your alignment to the public-facing opinions of your social betters is the modern ersatz religion for atheists. The television is the temple, the pundits the priests. Apostates and heretics are not welcome here. Now, my child, you would not want your words to inadvertently cause the faithful to stray. Would you? Just think of what the late night comedians would say if they could hear you cast doubt on their sponsor Pfizer? Perhaps you would rather join our hate session on the pagans in flyover country?
Readit News
- 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.
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.
So, NOT in fact “just as well”.
Dead Comment
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.
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!
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.
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.
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.
- 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).
The HPV strains that cause cancer and the ones that cause genital warts are different. The strains that cause cancer do not cause warts.
So you can very much have HPV without genital warts.
And conversely, while having genital warts tells you you are infected with the low risk strains, it does not guarantee you that it is the only strain you are carrying.
Thus you cannot rely on the presence of genital warts to know if you are or are not infected with the high risk strains, they are completely uncorellated.
The cancer-causing strains cause no symptoms and can only be detected by getting tested for them.
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.
I wish more people would get vaccinated.
Why is this different? Why is pestering a doctor to give me a medicine they don't recommend a good idea?
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
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!
However, the vaccination is expensive (~1k) and it is difficult to find doctors who will do non-recommended vaccinations for self-payers.
YCMV
Depends entirely on where you are and what your healthcare situation is. Mine cost me ~100eur.
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)
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
Or you (and your future partner) practice abstinence until you're ready to commit to a lifelong monogamous relationship.
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.
Weaknesses / Counters:
1) Surrogate endpoint only — HPV PCR positivity is not a clinical outcome; no CIN2/3, no cancer, no mortality measured
2) Correlation ≠ causation — HPV-cancer link is epidemiological association; Koch's postulates not fulfilled in traditional sense; detecting DNA doesn't prove pathogenic activity
3) PCR detection ≠ disease — Transient HPV infections are common and clear spontaneously; most HPV-positive women never develop lesions or cancer
4) Type replacement signal ignored — 66% higher incidence of non-vaccine HR types in vaccinated group is dismissed rather than investigated as potential clinical concern
5) No long-term clinical follow-up — Cervical cancer takes 15-30 years to develop; this 7-year study cannot assess actual cancer prevention
6) Confounding in vaxxed vs unvaxxed comparison — Unvaccinated group is small (n=859), likely differs in health behaviors, screening adherence, socioeconomic factors
7) Circular reasoning — Vaccine "works" because it reduces detection of the types it targets; says nothing about whether those types were actually causing disease in this population
8) Assumes HPV16/18 reduction = cancer reduction — Untested assumption; clinical benefit must be demonstrated, not inferred from PCR
9) High baseline HR-HPV in vaccinated group unexplained — 32% prevalence of other HR types suggests substantial ongoing oncogenic exposure despite vaccination
10) Genome validity unestablished — HPV reference genomes are in-silico constructs assembled computationally; never validated by sequencing purified, isolated viral particles; PCR/sequencing performed on mixed clinical samples where true origin of amplified fragments is indeterminate
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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.
In the 1960s, more than 900 people were diagnosed with cervical cancer each year, corresponding to more than 40 cases per 100,000 Danes.
Today, that number is below 10 per 100,000 nationwide – and among women aged 20 to 29, only 3 out of 100,000 are affected. This is below the WHO’s threshold for elimination of the disease.
While we have some anivaxxers here in DK, most people (90%, I believe) are sane and follow the recommendations.
The vaccinations start while the children are small and continue while they grow up .. the last one is when they are 12.5 years old.
The notifications are delivered in eboks or by mail if you don't want to use eboks. Everything from the state is delivered like this. There is nothing special about how the information is delivered. The SMS/e-mail notifications are just about hwo sent you something and not about what it is. At least for me.
I don't see how the use of eboks makes this work better. It would work just as well without eboks. People listen to doctors and the MAGA like shitheads we do have don't have a lot of influence.
What makes it work is the public registers.
e-boks is like gmail (and others) in that it keeps your old mail. So you can easily find old stuff, a great improvement on paper mail.
I don't even check my physical mailbox once a week.
Denmark is one of the very most digital countries. Physical mail is very much on the way out. We no longer has mailboxes to send mail, you have to go to a shop to send letters, which now cost at last $6 per letter due to the low amount of mail sent.
It is only a matter of less than 10 years before letters will be fully gone.
Which is bad, we definitely should have them. Referral data appears to be managed through Healthlink, which may just be a privatised not always used medical record system.
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So I get the theory of this thing. But has anyone actually tried this? Finally I got OneMedical to prescribe it for me for some $1.2k at which point I decided I’ll just get it abroad during some planned travel.
I decided years ago I’d do this because I was going to have girls and I wanted to minimize my daughters’ risk of cancer.
Over a decade ago I tried getting the HPV vaccine in my early 20s, but the doctor told me it wasn't recommended for men and that insurance won't cover it. I was young and didn't have the money to pay out of pocket.
I went to Planned Parenthood and got the vaccine last year. At some point they changed the recommendation to men under 45 now and I got all 3 shots free.
Honestly, though I'm glad to have finally got the vaccine it's been a pretty frustrating experience.
I don't understand: how would your daughters be more/less likely to get cancer based on whether you were vaccinated? There's obviously the (hopefully extremely) roundabout way in which there is a direct path of sexual partners leading from you to your future daughters, but is there something else I'm missing?
And if you don't have it by age 35 (and married, per your comment below), how likely are you to even get it at this point? Are you thinking you could hypothetically pass it to them by kissing your babies on the mouth, after contracting it in the future?
If you want to read more: https://wiki.roshangeorge.dev/w/IVF
https://pmc.ncbi.nlm.nih.gov/articles/PMC2759438/
Want to boost the economy massively at next to no cost? HPV vaccinations are incredible.
My reading of the following is that the cost of each additional quality adjusted life year would be over $100,000, rather than that each vaccination prompts $100k in economic value
> Including preadolescent boys in a routine vaccination programme for preadolescent girls resulted in higher costs and benefits and generally had cost effectiveness ratios that exceeded $100 000 per QALY across a range of HPV related outcomes, scenarios for cervical cancer screening, and assumptions of vaccine efficacy and duration
Hmm. Compared to what measurement? Most viruses are actually not oncogenic.
From cancer causes, oncogenic viruses are thought to be responsible for about 12% of human cancers worldwide:
https://www.mdpi.com/2079-7737/14/7/797
From what I remember, most viruses are not oncogenic in nature, so I am unsure whether the statement made is correct.
E.g. EBV is strongly associated with several lymphomas.
There are other significant clinical associations for HPV, HBV, HCV, HTLV-1, HHV-8, and many others.
I'm a proponent of EHRs, but the key value is at patient-level, not population level where other approaches perform equally well.
80-90% of adults gets some form of HPV during lifetime. Often several strains. Each have different risks of cancer. Even if you’re married - if you or your partner experience a severely stressful period- it might reactivate. Most people’s immune systems clears HPV, and makes it dormant. (Mine likely doesn’t see HPV as a threat. Long term (10y+?) exposure to active HPV cause cancer.
If you can, at least do your very best to avoid the cancer nightmare. Take the vaccine. Worst case it protects you from being a vector. It’s an imperfect insurance from 3-4 months in/out of hospitals, scans, blood work, from chronic dry mouth,all food tasting very bad, issues with energy, possible bone death (that you suddenly have to monitor every day for the test. Oh, and any alcohol or smoking after having had this increases risk of recurrence by 30-50%
So I'm fine with it being flagged and decline to vouch for it.
For the HPV section specifically, there were at least two major omissions.
First, in his table showing autoimmune adverse effects, he has chosen to crop out the next column in the table containing the control conditions - which show very similar rates of adverse effects to the vaccine condition.
Secondly, when discussing negative efficacy in the case of existing persistent infection, he only quotes the data from one of three studies that the linked report covers. The linked report indeed covers the negative efficacy in study 013 as an area of concern. However, study 015 (which had roughly twice the number of total participants as study 013) showed no real evidence of negative efficacy. When all 3 studies are pooled together, the point estimate still says negative efficacy, (at ~-12%), however the error bars are quite wide.
Why this is tragic, is because these two omissions do actually point to failures in public communication about the vaccine. For example, the control condition in the Merck trials were a mix of saline injections (this is the traditional placebo), as well as injections with just the adjuvant (AAHS). This is less standard, and raises legitimate questions about why Merck used an adjuvant as the control, instead of just saline. There a cynical/conspiratorial angle to this question, which I think would be directionally correct.
The second omission is because I think there is a reasonable question of "are there extra risks associated with getting the HPV vaccine while having an active persistence infection", even when taking into account the different and larger study populations within the original trial data. Once again, I think the idea that both companies and public health agencies don't want to deal with a vaccine that requires testing before hand is true. I also believe that on a population level, even if there was a modest increase in risk in that specific subgroup, it makes sense to implement broad vaccination campaigns.
That said, I think the unwillingness of public health agencies to engage with this tricky area of communication and education creates these types of opening for anti-vaccine messaging. If you want a sense of "conspiracy" - here's a random review study - https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
Notice that when reporting results, the groupings for HPV status at enrollment time are "naive" and "irrespective" - the "test positive" grouping isn't broken out.
EDIT: The article that we're discussing is https://www.midwesterndoctor.com/p/the-perils-of-vaccinating...
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Signaling your alignment to the public-facing opinions of your social betters is the modern ersatz religion for atheists. The television is the temple, the pundits the priests. Apostates and heretics are not welcome here. Now, my child, you would not want your words to inadvertently cause the faithful to stray. Would you? Just think of what the late night comedians would say if they could hear you cast doubt on their sponsor Pfizer? Perhaps you would rather join our hate session on the pagans in flyover country?