17 ms·

HPV vaccination: How the world can eliminate cervical cancer

394 points by ZeroGravitas 2y ago

Qem 2y ago
> The virus is also responsible for a large share of other cancers, including anal cancer, penile cancer, vulval cancer, vaginal cancer, and some head and neck cancers. It would greatly reduce other types of cancer too. Men also benefit from it. Unfortunately the way campaigns market it causes many people to think it benefits ladies only.
- yieldcrv 2y ago
  I took one look at the initial FDA approvals and paid out of pocket for this vaccine. A cursory understanding of the virus, insurance, and the age bounding of getting vaccinated would lead anyone to the same conclusion. Unless they are allergic to the word “vaccine”. Basically, the vaccines dont work with prior exposure, and there is no test to know if men have been exposed. So thats why there is no focus on men, and why initially men were only approved for use if they were under 26 years old, based purely on probabilities they havent been exposed yet. This is a problem for insurance companies. Also at one point in time, it wasnt linked to cancers affecting men, and men were seen only as carriers. Now it seems any area of flesh exposed to HPV strains are at risk of cancer there. The age of male coverage has been expanded to like mid-40s by now. The abstinence crowd worried about anything that makes people feel safer engaging in sex will get you killed.
  - carlmr 2y ago
    >Basically, the vaccines dont work with prior exposure, and there is no test to know if men have been exposed. So thats why there is no focus on men, and why initially men were only approved for use if they were under 26 years old, based purely on probabilities they havent been exposed yet. The vaccine (Gardasil) protects against 9 strains. Even if you've been exposed to 1 strain, it protects against the other 8 strains. >Also at one point in time, it wasnt linked to cancers affecting men, and men were seen only as carriers. Now it seems any area of flesh exposed to HPV strains are at risk of cancer there. Even if it didn't do anything in men, it's stupid not to vaccinate as many people as possible to get herd immunity. We understand this for a hundred years now with other vaccines, why not this one? Apart from that it's not a bad guess to think that if it causes one cancer it will be causing other types of cancer as well. Absence of evidence is not evidence of absence. >The age of male coverage has been expanded to like mid-40s by now. Sadly in Germany it's still only for younger men. And older men weren't offered the vaccine at all when they were younger, so they never got the offer. I paid out of pocket for it, but it's still stupid that we're still putting a part of the population at unnecessary risk for cancer, and also decreasing herd immunity at the same time. Lack of HPV vaccination is just a symptom of lack of understanding of science and statistics in politics.
    - potato3732842 2y ago
      >Lack of HPV vaccination is just a symptom of lack of understanding of science and statistics in politics. At some point it stops being about science or understanding and starts being wholly about politics. There's a lot more "well these demographics or institutions f-ing hate me so I'm sure as shit not taking their word for anything" going around than there was a decade ago.
      - JumpCrisscross 2y ago
        > There's a lot more "well these demographics or institutions f-ing hate me so I'm sure as shit not taking their word for anything" This would be fine. It goes further: not only rejecting the institutions, but concluding adversely based on their advocating for something.
    - wkat4242 2y ago
      Just wondering how much did you pay for it? Here in Spain I also can't get it in my 40s and it costs 800 euro, which is a lot on a Spanish wage. And the doctors say there isn't much point because I've probably been exposed already (considering number of partners that's likely). And then the effectiveness is supposed to be massively reduced. Still, if it were 200€ I'd do it. There's only one place here where I can get it so I wonder if it's cheaper elsewhere.
      - carlmr 2y ago
        >Just wondering how much did you pay for it? 180€ per injection. The normal schedule is 3 injections. (first, 1 month, 6 month). However I checked and NHS (UK) did a study on it that showed a single injection provides the same protection as 3, so they changed their injection schedule to single injection for people under 25, and 2 injections (first + 6-24 months) for over 25s due to the expectation that older immune systems take longer to adapt. The German (StIKo) recommendation is still 3, but I prefer listening to the NHS here because they have been more scientific about this in the past and seem to be actively studying this stuff. I asked my doctor and they said I can pick the schedule I want, since it's not insured anyway. So I picked the two injection schedule. So that makes 360€ for me. If the NHS study holds you could probably pick a single injection and already have most or all of the protection. I picked two because I figured it's still recommended for my age group that way. >And the doctors say there isn't much point because I've probably been exposed already (considering number of partners that's likely). My doctor said the same, but the NHS says it's still useful from their studies. Especially since Gardasil protects against 9 variants. It's unlikely you've been exposed to all 9 variants. I am not a doctor, so I can only tell you what I've found helpful in making my decision.
  - theGnuMe 2y ago
    >Basically, the vaccines dont work with prior exposure The FDA recommends it for males under 45 now. It does prevent infection from new exposures. In time I bet that we will find it reduces cancer incidence even in those infected before vaccination. Those studies will take years to complete and it is too early to tell. When the vaccine was first available, it was rationed, and the highest priority was for young girls before they become sexually active since they have the highest benefit.
  - crossroadsguy 2y ago
    I had wart on my heel once - kinda annoyingly stubborn which finally removed/subdued by laser removal (nitrogen therapy did jacks). That’s HPV, right? And guess once inside you, it stays inside you, right?
    - bluGill 2y ago
      There are over 100 hpv strlins. Warts are one yes, butnot the strain in question (though there are reports the vaccine helps for warts too I have not seen science verify that)
    - tialaramex 2y ago
      HPV is a family of viruses. There are dozens and the vaccine targets, I think, nine. So, that probably was HPV, but it probably was not one of the members of the family which the vaccine targets, the vaccine is focused on the sexually transmitted variants, since these are associated with Cervical cancer in particular, and several other nasty cancers, plus the genital warts.
  - Nifty3929 2y ago
    >> Basically, the vaccines dont work with prior exposure This is a beef I have with a lot of medical thinking: that if it doesn't work it would be bad to do it. But that's not true at all - many things are good to do, if there is some chance it will help, even if most of the time it does nothing. You do have to weigh other negatives like cost, pain, hassle, or unknown side effects. But in general - if it might make me better and won't make me worse - then sign me up!
    - pbhjpbhj 2y ago
      Every vaccine (happy to get counter evidence) has negative side-effects, every injection is a risk. When you're injection multiple millions of your population on the off-chance it might help then you're going to get some very sick, or dead people. At 200€ a time (plus administration costs, plus lost work hours of those you're injecting), for millions of people that's also a lot of wasted funds that could be put into medicines that are known to be effective for the people they're treating. Why, for medicines that are highly available, that a doctor considers to be low risk, a sane adult can't just elect to pay for and take a medicine, that I am not sure of.
      - Nifty3929 2y ago
        Yep - I'm not saying society OWES me the treatment - just that I should be able to get it if I want and am willing to pay for it. I agree that we don't want all of society to be collectively paying for something that has large, clear costs, but dubious efficacy. Then again, COVID...
- pyuser583 2y ago
  Last I checked it wasn’t available for men.
  - bertylicious 2y ago
    What do you mean not available? It's the same vaccine for men and women AFAIK. Or do you mean it's usually not paid for by health insurance? I (male) don't remember if I had to pay for the vaccine myself when I got vaccinated, which to me indicates that it wasn't that expensive.
    - SoftTalker 2y ago
      I'm not a doctor nor particularly fond of them, but as I understand it older men who have been sexually active are likely already exposed, so doctors won't prescribe the vaccine nor will insurance cover the cost. I don't know if it's something you can just walk in to a clinic and ask for and pay cash. The big push lately has been to get kids vaccinated before they are teens, which mine (all males) were. I have not had this vaccine, but at my age and being married any new sexual contacts are pretty unlikely so not sure there's any benefit to me either way.
  - trescenzi 2y ago
    I’m getting my course of it now. I’m a ~30 year old man in the US. Maybe other countries haven’t expanded access? My doctor recommended it to me and it was covered by insurance. They said while it cannot protect you from previous exposure it’s pretty wide so it’s unlikely I have yet to encounter every HPV variation it protects against.
  - itishappy 2y ago
    You should check again! > The CDC suggests catch-up HPV vaccinations for all people through age 26 who aren't fully vaccinated. > The FDA approved the use of Gardasil 9 for males and females ages 9 to 45. https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292 https://www.mayoclinic.org/diseases-conditions/hpv-infection... > HPV vaccine is recommended for routine vaccination at age 11 or 12 years. (Vaccination can be started at age 9.) > ACIP also recommends vaccination for everyone through age 26 years if not adequately vaccinated when younger. HPV vaccination is given as a series of either two or three doses, depending on age at initial vaccination. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
- TZubiri 2y ago
  Well since the probabilities of infection is magnified by lesions, and those occur more often in the receptive partner, it will disproportionately affect women and gay men. As is the case for stds in general. The extent to which these vaccines would be helpful to mean is usually to avoid hurting women. Which is not minor at all, I would definitely get one for that reason alone. But I wouldn't be concerned for personal risks.
- Ponet1945 2y ago
  > Unfortunately the way campaigns market it causes many people to think it benefits ladies only. That's a pretty diplomatic way to say that they pretty much don't care about men being affected. In my region the vaccine is free for women but men have to pay despite >40% of cancers caused being in men and nobody even informs you of that.
TZubiri 2y ago
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- fragmede 2y ago
  https://xkcd.com/605/ https://xkcd.com/605/ edit: bonus https://xkcd.com/592/ https://xkcd.com/592/
  - TZubiri 2y ago
    Haha. In this case I comically extrapolated to denote a mathematical equation without doing the algebra that makes brain hurty at 1 am
- crimsoneer 2y ago
  I mean, you remember aids pandemic ? I don't think people (especially straight people) today realise just how devastating that was.
  - TZubiri 2y ago
    I don't, I wasn't born. But I read about it and its magnitude was conveyed. I do know that it was and is highly tied to promiscuity as a risk factor. I also know that since it's not as lethal now, some people in those risk groups just risk it more often, with condomless prep even. Also a pandemic is a spike in cases that needs to be considered over the long term. The risk of contracting diseases includes contracting a previously untestable slow onset disease and being an early patient of a pandemic, which usually happens to people with high partner count. It's like computer viruses, we fill a package.json with 100 dependencies which in turn have a supply chain (partner's partners) and install it on a vm anyways. That would be unthinkable 30 years ago, but now we have better cryptography, open source auditing OS level and kernel security. Yet ransomware attacks are not less common than the early trojans.
- yieldcrv 2y ago
  We’re reducing the strain on our health care system by reducing cancers The topic it overlaps with doesn’t matter Figure out your own sexual value system, we’re preventing cancers
stuaxo 2y ago
I really hope this happens, I'm a little cynical after hoping that we would come together and eradicate COVID 19.
- EricE 2y ago
  That would be pretty hard to do since the mRNA "vaccine" neither prevented infection or stopped the spread.
  - seattle_spring 2y ago
    I assume they're talking about attempts to eradicate it in the first few weeks when it was thought to only be present in a few people.
  - Krssst 2y ago
    It did for the first variants, but then Omicron happened. I see you're calling a vaccine a "vaccine". Noted.
    - WillPostForFood 2y ago
      MRNA vaccine is highly effective at reducing symptoms and saving lives of those at high risk (e.g., over 65), but it was never effective at preventing infection or stopping transmission. People who were saying that were somewhere between being over optimistic, and spreading disinformation to try to increase uptake.
      - gadders 2y ago
        It was also more dangerous to healthy young men than just getting COVID, due to myocarditis.
        Marsymars 2y ago
        This isn't generally true. It does seem wise to preferentially get the Pfizer boosters over the Moderna boosters for lower dosage though, particularly if you're a young man.
daggersandscars 2y ago
I was diagnosed and successfully treated for HPV+ oropharyngeal cancer in 2023. My treatment results were almost perfect, from a clinical perspective. I had transoral robotic surgery to remove the tumors in my mouth / throat, neck dissection to remove cancerous and non-cancerous lymph nodes, and radiation to treat the area after cancer was found to have escaped the lymph nodes. If I were 10-ish years younger, I wouldn't have gotten cancer. I was likely exposed to HPV in my early to mid 20s, where it hid in my tonsils for decades. In the US, almost anyone under 45 can get vaccinated. Please do. As another comment points out, they protect against multiple strains. It's unlikely you've been exposed to all of them. While HPV+ head and neck cancers are more easily and more successfully treated than HPV- ones, I do not recommend getting cancer. From the outside, I look like a normal person of late middle age. The two incision scars I have look like neck folds -- literally no one, including medical personnel outside of the cancer world, notices them. From the inside, tho: * Can no longer taste sugar, salt, chocolate, and a host of other, smaller things. Most other things have less taste and pretty much nothing has a flavor after a few bites. For some, this eventually stops -- I'm unlucky. (Radiation destruction of taste buds) * Significantly decreased saliva to the throat. Cannot eat without some liquid. The saliva that forms is thicker and sometimes causes problems swallowing. Some get this to the mouth and to a larger extreme -- I'm lucky. (Radiation) * Dental trauma, including teeth extraction / root canal / deep fillings, may cause spontaneous bone tissue death in the jaw. (Radiation) * Permanent sensation of partial numbness centered around my left ear and cheek. Touching that area produces a pins and needles sensation. (Neck dissection) * No feeling in a stripe about 1.5" (4cm) wide where the neck dissection scars are. (Neck dissection) * Changes in speech quality. These are not clinically significant but changed my voice from one people enjoyed listening to (asked to do voice over work, complemented, etc) to just another voice. (Surgery) * Tinnitus increased significantly and hearing has worsened. I was not given chemo, the normal cause of hearing loss. (Unsure cause) There's more, but those are some of the highlights. Get vaccinated, get your kids vaccinated, etc. HPV- head and neck cancers in the US are dropping as people quit smoking. HPV+ are on the rise for now, but will drop as the generations with vaccinations get older. I'm traveling today, but will look at this later today if anyone has a question to ask.
- nick_ 2y ago
w10-1 2y ago
The HPV vaccine has been a universal win for this generation. Screening (pap smear) is also highly effective, but requires constant effort. The remaining gaps in screening and vaccine uptake reflect broader lack of health-care capabilities that won't be solved with pushing the HPV vaccine alone. Changing from injectable to oral could help, but isn't on the table, and local populations and governments are likely to become increasingly resistant to outsiders waving their science authorities, particularly on family matters. Both authors are Phd's working in outreach - i.e., they seem to have no experience with deploying HPV campaigns.
- User23 2y ago
  HPV vaccine is also a big win for oral cancer, which pap smears and treatment didn't help with at all.
sam36 2y ago
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- jeffbee 2y ago
  Don't draw equivalence between peer-reviewed scientific data and some random blogs.
  - pessimizer 2y ago
    The entire antivax movement was started by an obviously awful paper published in The Lancet that they took 12 years to retract. Then, during the height of covid, they published an obviously fraudulent study ratifying the government wisdom about one of the most politicized treatments that some people had adopted. Lancet frauds have been for vaccines in the West like hiding the people searching for Bin Laden within a fake vaccination campaign was for vaccines in the Middle East. https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud https://en.wikipedia.org/wiki/Surgisphere#COVID-19_misconduct https://en.wikipedia.org/wiki/Surgisphere#COVID-19_misconduc... https://en.wikipedia.org/wiki/CIA_fake_vaccination_campaign_in_Pakistan https://en.wikipedia.org/wiki/CIA_fake_vaccination_campaign_... edit: I think everyone should take the HPV vaccine, and I posted the Scottish study in a sibling comment. I think the casual dismissal of things that are not peer-reviewed is not good, when peer-review completely failed about vaccines and vaccine-related subjects in a way that possibly is responsible for the deaths of millions. Peer-reviewed articles were responsible for the antivax movement. They should be treated individually.
    - jeffbee 2y ago
      While true, this one graph from the lancet is certainly not the only data we have on HPV. You can easily find dozens of studies and metastudies on PubMed.
    - deleted 2y ago
      [deleted]
    - Marsymars 2y ago
jeffbee 2y ago
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- verisimi 2y ago
  > end vaccinations That's not what happened in his last term though. He pushed the COVID vaccinations and it was the democrats who were saying that they wouldn't take a Trump vaccine - do you recollect?
  - deleted 2y ago
    [deleted]
  - jeffbee 2y ago
    It is a mistake to imbue the Trump regime with an underlying system of rules and reason. Everything Trump does is a personal transaction. RFK Jr. is loyal and brought some critical support to Trump, so Trump is going to let him do whatever he wants. Trump doesn't care about the outcomes.
  - krapp 2y ago
    And then the Democrats did take the vaccines. And then the Republicans made it their whole identity to not take the vaccine. in no small part because Trump mocked anyone who did take the vaccines, dismissed the severity and scale of the pandemic as "Democratic lies" and "fake news" (because he wanted to run on the economy) and refused to do so himself, lest the press see him as "weak." And now Trump, being Trump and going whichever way the wind blows, fully embraces anti-vaccine ideology by endorsing RFK - a well known antivaxxer and conspiracy theorist - and promising to give him "carte blanche" control over numerous health agencies and health policy in general. Do you recollect?
    - zxcvbnm69 2y ago
      [dead]
    - gadders 2y ago
      [flagged]
prepend 2y ago
I think it’s funny how in the US the vaccine schedule says not to get the HPV vaccine if you’re over 45. That means that insurance won’t cover it and I even struggle finding a doctor who will administer it because it goes against the guidelines. The rationale is that if you’re 45, you probably already have HPV. But that assumes that you’ve been sexually active all that time. It doesn’t take into account people who were monogamous until their 50s and then started having sex with new partners.
- opello 2y ago
  Exactly. It'd be nice if primary care physicians approached the request with an open mind and had the real conversation about any risk/reward. I don't know if there's any risk to taking the 9-valent version if you might have been exposed to one that it covers. But why isn't it valuable to have protection from the other 8? My bias is climbing the hill of convincing on this front 5 years ago and being on the receiving end of a pretty dismissive attitude. But I got my way and think it was the right choice.
  - 9x39 2y ago
    I had a similar experience with my GP. I was essentially dismissed outright (in surprising contrast to an otherwise dynamic/vigorous interest in my health) and am planning on revisiting this with a different GP soon. While I allow for myself just being ignorant, wrong and vulnerable to working myself up into health scares, I couldn’t help but wonder if men looking into HPV vaccines are brushing up against a doctrinal problem, in that whatever protocols and literature exist for the med field don’t study and don’t mention male-HPV interactions enough to warrant action (or even interest) from GPs as a group.
    - opello 2y ago
      I'd have hoped things improved in the last 5 years but maybe you can avoid the GP altogether and schedule it like a flu shot through the pharmacy? I noticed it was in the list at Walgreens this year anyway. Best of luck with it!
    - 2y ago
stared 2y ago
I am surprised that this study does not mention which vaccines are being used - as they vary by the number of HPV types they protect against. "Currently there are six licensed HPV vaccines: three bivalent (protect against two types of HPV), two quadrivalent (against four), and one nonavalent vaccine (against nine)" - https://en.wikipedia.org/wiki/HPV_vaccine https://en.wikipedia.org/wiki/HPV_vaccine
asah 2y ago
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- immibis 2y ago
  That's not true.
  - bqmjjx0kac 2y ago
    I think it remains to be seen.
  - knowaveragejoe 2y ago
    It's also not untrue, either, we don't know who will be taking that seat.
richrichie 2y ago
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- oezi 2y ago
  When the health authorities say that they don't recommend it because benefits do not outweigh risks they usually mean that the benefits aren't at least 2 magnitudes (100 times) bigger than the risks. Vaccination usually is highly beneficial, but as one ages the benefit does diminish. Agencies don't want to be stuck with vaccines which have large side effects.
  - richrichie 2y ago
    This suggestion was specific to HPV vaccination. I did appreciate his explaining risks and benefits.
- throwaway2037 2y ago
  > before vaccines became unquestionable cult drugs I don't understand your English. Can you explain it a different way?
  - richrichie 2y ago
    You know what it means.
bschmidt9 2y ago
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- tasty_freeze 2y ago
  How is this a helpful comment? It is just an insult. If you don't believe the article, state why, give evidence. Cheap cynicism helps nobody and doens't make you look smart or superior.
rawgabbit 2y ago
I remember when Gardasil was first introduced and the related controversy. I believe there were questions about its safety because at first it was targeted at 12 year old females. At one point the Japanese Ministry of Health suspended the vaccine and then later resumed it. For me the explanation of how this vaccine works still confuses me. For example while older people are advised to get Shringix to mitigate the consequences of a reactivated chickenpox virus. Older are advised not to get Gardasil because once you get HPV, the vaccine is ineffective? https://mainichi.jp/english/articles/20211115/p2a/00m/0op/003000c https://mainichi.jp/english/articles/20211115/p2a/00m/0op/00...
- Teever 2y ago
  As I understand it from talking with a healthcare worker it isn't so much that it's less effective if you already have the infection (though it is) it's more just a triage decision. People in various health care systems around the world have just done a cost benefit analysis and decided that it isn't worth paying for the vaccine for older people, that we'll just let them get cancer and go through treatment/die.
  - rawgabbit 2y ago
    The other confusing thing is the benefit to risk ratio. Looking at the WHO rates of cervical cancer for Canada with almost complete vaccination rate vs Japan with almost zero vaccination rate, you can argue the vaccine cuts cervical cancer by 2/3. But when you look at the numbers at a per annual basis, the probability of getting cervical cancer is 0.5 percent to 1.5 percent. https://www.who.int/publications/m/item/cervical-cancer-jpn-country-profile-2021 https://www.who.int/publications/m/item/cervical-cancer-jpn-... https://www.who.int/publications/m/item/cervical-cancer-can-country-profile-2021 https://www.who.int/publications/m/item/cervical-cancer-can-...
- vidarh 2y ago
  It was first largely triage. It had the highest odds of saving lives for young people and especially young girls. As more and more of the younger groups have been covered, the age recommendation has kept rising. At the same time the number of strains covered have gone up and that has also made it more worthwhile to vaccinate older groups. It's also down to evidence. It's not that the vaccine has been proven to be ineffective, but that the vaccine had not been proven to be effective enough to be worth it for older groups initially, in large part because it was not what they tested for.
123yawaworht456 2y ago
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Avalaxy 2y ago
I really wish we had therapeutic vaccines against HPV. As a man, I always got told "it's not for men", followed by "it is also for men, but only if you never had sex", followed by "it's also for men who had sex, but only to a limited age". As a male who meets all the criteria to be in a high risk group for HPV throat cancer, and who is dealing with a persistent HPV infection (as proved by warts that won't go away), I'm really sad that I may one day at a young age get cancer in my throat, and there is nothing I can do about it to prevent it. I wish we would put the same amount of energy into inventing vaccines that suppress the virus, or help the body to get rid of them.
- toomim 2y ago
  Go find a doctor who will prescribe it off-label. I was in a similar situation to you. The doctor said it wasn't indicated for me, but I said I wanted it anyway, and the doctor said ok, and it cleared up my existing HPV infections after dose #2.
- vidarh 2y ago
  It's a matter of cost-effectiveness and slowly increasing evidence. You can get it privately most places, and the age limits are likely to keep being pushed.
- sureIy 2y ago
  This pisses me off. I live in a part of the world that feels almost too liberal for drugs, but that also means that when I wanted to get the HPV vaccine, I walked into a clinic and got the shot. Then I went to a different country and got the second and third shots. What's the hold up? Please keep trying to get your Gardasil-9 shots even against their advice.
- deleted 2y ago
  [deleted]
ckw 2y ago
Sometimes anti-vaxxers will point to the ostensibly high rate of serious adverse events exhibited by study participants in HPV vaccine trials. For example, in the study 'A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women' published in The New England Journal of Medicine in 2015, in which the 9-Valent HPV vaccine was compared to the Quadrivalent version, the rate of serious adverse events was 3.3% and 2.6% respectively. This objection can be dismissed, as the study authors found that 0.0% of those serious adverse events were vaccine related. Anti-vaxxers also sometimes object to studies like these on the basis that no placebo arm was included, and thus the true safety profile of the vaccine cannot be ascertained, but this can be flatly rejected because, as the study authors point out, '[s]ince HPV vaccination is widely recommended and has been shown to prevent HPV disease related to oncogenic HPV types, the use of a placebo was not considered to be acceptable for ethical reasons.'
- tialaramex 2y ago
  Because HPV vaccination is relatively modern, there's trail where maybe the trial for the vaccine you can get today A, was A vs B, but then the previous B has a trial B v Placebo, or it might go back twice, A v B then B v C and C v placebo. There were placebo trials for the early HPV vaccines decades ago. I had Hodgkins Lymphoma (many years ago now when I was young) and we've been treating that for so long that the earliest curative treatments pre-date scientific medicine. So the trail dries up - we have no proof that the cures are better than nothing except, you know, circumstantially it sure does seem like the freaks who reject treatment just drop dead and I didn't so... They're still doing research, as with the HPV vaccines they do A v B trials as a placebo would be unethical - it's basically a death sentence. I actually wasn't selected for a trial comparing Stanford V (a new potential therapy from Stanford) against the current gold standard (which I was getting) ABVD. That was a long time ago, but I think the gold standard today is still ABVD.
  - User23 2y ago
    Calling cervical cancer a death sentence is a bit extreme. Regular pap smears and early treatment made it eminently survivable.
losvedir 2y ago
> especially through sex, kissing, or touching To what extent can it be transmitted via "touching"? And other mechanisms since it says "especially" implying there might be others. As a man approaching 40 I've never considered this vaccine because I've only ever been (and ever will be) sexually active in any way with my wife, who has been the same with me. Is there any reason to get the vaccine in my situation? I see a lot of comments here that we all should get it, but if it's just sexually transmitted I don't think there's a reason for me to.
- ejstronge 2y ago
  HPV causes multiple lesions in humans, including warts. Certain types of HPV are more associated with certain lesions over others, but the broad range of HPV targets means that dangerous HPV types could be transmitted through relatively innocuous means. Some context: https://www.ncbi.nlm.nih.gov/books/NBK448132/ https://www.ncbi.nlm.nih.gov/books/NBK448132/
  - sushid 2y ago
    Does that mean you can get certain HPVs via forms of non-sexual contact, such as handshakes, massages, etc.?
    - hammock 2y ago
      Yes, all warts are caused by HPV no matter where they appear
codeptualize 2y ago
I recently got the HPV vaccine (along with some other vaccines I didn't get as a child of anti vax parents). Vaccines are one of the most amazing inventions. The fact that they can eradicate entire categories of diseases and save so many people from suffering and death with such a simple intervention, is truly remarkable. It makes me very sad that as a society we are failing to simply take what's there. Maybe the biggest flaw of vaccines is that they are so effective that people don't remember how bad these diseases really were, and only know the minor side effects. Feeling bad for a couple of days instead of getting certain cancers, measles, hepatitis, and many other serious diseases is a great fucking deal. Also had almost no side effects from the hpv vaccine, 10/10 do recommend.
- mullingitover 2y ago
  The world put Pasteur on a pedestal for creating the rabies vaccine. He was a household name because rabies was a terrifying death sentence at the time. We're incredibly luck that today getting bit by a rabid animal is typically just an inconvenience. Vaccines are miracles. He also invented the pasteurization process, which has saved countless lives. Now we have a whole anti-pasteurization movement, because why not. Wild that education has failed so hard that we have large numbers turning their backs on these blessings we're fortunate enough to take for granted.
  - User23 2y ago
    > getting bit by a rabid animal is typically just an inconvenience Actually, in the USA it's a financial catastrophe if you're uninsured and of average means. You're looking at a $7,000 expense. Or you could spend like $1,000 on a ticket to Thailand or something and get it there for $70.
    - yakshaving_jgt 2y ago
      Oh dear, your connecting flight has been cancelled, so now you die.
    - throwaway2037 2y ago
Kuraj 2y ago
It would be great if I didn't have to pay the equivalent of 2000 USD for the full cycle where I live. Kids get it for free but if you're 30 you're shit out of luck
- throwaway2037 2y ago
  Where do you live? 2000 USD is crazy.
elif 2y ago
Unfortunately due to postrealist ideology supplanting fact-based reality, 40% of your scheduled elimination of disease will not be taking place as scheduled.
lettergram 2y ago
Reading about this is fascinating — Over here they claim HPV is the leading cause of throat cancer (not smoking) - https://www.cdc.gov/cancer/hpv/basic-information.html https://www.cdc.gov/cancer/hpv/basic-information.html Over here is the leading cause of cervical cancers world wide - https://www.cancer.gov/types/cervical/causes-risk-prevention https://www.cancer.gov/types/cervical/causes-risk-prevention Then over here: > Cervical cancer incidence rates decreased by more than half from the mid-1970s to the mid-2000s … in women ages 30-44, rates have increased 1.7% each year from 2012 to 2019. > Cervical cancer was once one of the most common causes of cancer death for American women. The cervical cancer death rate has dropped by more than half since the mid-1970s https://www.cancer.org/cancer/types/cervical-cancer/about/key-statistics.html https://www.cancer.org/cancer/types/cervical-cancer/about/ke... A vaccine for HPV became available in 2006 — https://en.m.wikipedia.org/wiki/HPV_vaccine https://en.m.wikipedia.org/wiki/HPV_vaccine So it seems cancer has increased since the introduction of the vaccine. Prior to that it was decreasing. Further, after reading about HPV generally, there’s no symptoms typically and most forms are not the cancer causing kind. Only certain HPV strains combined with a long term infection (if they estimate 20 years) cause cancer. IMO there’s a lot of correlation with frankly minimal and confusing causation. Combined with evidence the vaccines aren’t effective at changing the cancer rates at all, seems like a money grab by big pharma to me. “Get vaccinated to avoid this cancer you’re highly unlikely to get and won’t know if you do for 20 years” seems like a stretch…
- idunnoman1222 2y ago
  Nice to see people down voting you without saying why. I was gonna say in Sweden these early adopters have very high coverage rates for HPV vaccination. How is the cervical cancer rate there? In before confounding factors OK fine. do the placebo controlled trial.
Traubenfuchs 2y ago
Personally I am more excited about HPV caused cancers in my throat, anus and penis, because the only cervix I had contact with was my mothers. I do not understand this focus on women. Just tell the whole story, that your dick can fall off and every straight frat bro will get vaccinated tomorrow.
- Quarrel 2y ago
  There is also more of a spectrum between straight and gay than gets talked about at a high level in these discussions. Gay men & women often arrive at that position after having had hetero sex. Heterosexuals often "stray" or whatever other euphemism people care to use. Not all sex is as consensual as it should be, etc, etc.
  - Traubenfuchs 2y ago
    Straight men would „stray“ just as much, but they are confronted with dating economics where 80% of them are considered below average looking. In any case, what I want to say is: Whether you care about cancer in males or females, males must not be ignored and HPV must not be framed as female only issue. In other words, those 20% of straight men that have the option to stray must get vaccinated as well, if only to protect women.
    - Quarrel 2y ago
      > males must not be ignored and HPV must not be framed as female only issue hear, hear.
tucosan 2y ago
The vaccination campaign has solely been target at girls and women. Which is crazy, since boys and men can get cancer from HPV too. I really don't understand the bias in public health communication here. OWID is making the same mistake again. How are boys supposed to know that they should get the shot, if everybody public health professional fails to tell them? > HPV is also thought to cause about 95% of anal cancers, 75% of oropharyngeal cancers, 75% of vaginal cancers, 70% of vulvar cancers, and 60% of penile cancers.2 Low-risk or non-oncogenic genotypes (eg, types 6 and 11) cause anogenital warts, low-grade cervical disease, and recurrent respiratory papillomatosis. In the USA, the incidence of oropharyngeal cancer in men now exceeds that of cervical cancer in women, and by 2020 the annual number of HPV-associated oropharyngeal cancers will exceed that of cervical cancers. As a result, it is important to consider ways to expand our HPV prevention efforts to boys and men. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30314-2/abstract https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

394 points by ZeroGravitas 2y ago

Qem 2y ago

> The virus is also responsible for a large share of other cancers, including anal cancer, penile cancer, vulval cancer, vaginal cancer, and some head and neck cancers. It would greatly reduce other types of cancer too. Men also benefit from it. Unfortunately the way campaigns market it causes many people to think it benefits ladies only.

yieldcrv 2y ago
I took one look at the initial FDA approvals and paid out of pocket for this vaccine. A cursory understanding of the virus, insurance, and the age bounding of getting vaccinated would lead anyone to the same conclusion. Unless they are allergic to the word “vaccine”. Basically, the vaccines dont work with prior exposure, and there is no test to know if men have been exposed. So thats why there is no focus on men, and why initially men were only approved for use if they were under 26 years old, based purely on probabilities they havent been exposed yet. This is a problem for insurance companies. Also at one point in time, it wasnt linked to cancers affecting men, and men were seen only as carriers. Now it seems any area of flesh exposed to HPV strains are at risk of cancer there. The age of male coverage has been expanded to like mid-40s by now. The abstinence crowd worried about anything that makes people feel safer engaging in sex will get you killed.
- carlmr 2y ago
  >Basically, the vaccines dont work with prior exposure, and there is no test to know if men have been exposed. So thats why there is no focus on men, and why initially men were only approved for use if they were under 26 years old, based purely on probabilities they havent been exposed yet. The vaccine (Gardasil) protects against 9 strains. Even if you've been exposed to 1 strain, it protects against the other 8 strains. >Also at one point in time, it wasnt linked to cancers affecting men, and men were seen only as carriers. Now it seems any area of flesh exposed to HPV strains are at risk of cancer there. Even if it didn't do anything in men, it's stupid not to vaccinate as many people as possible to get herd immunity. We understand this for a hundred years now with other vaccines, why not this one? Apart from that it's not a bad guess to think that if it causes one cancer it will be causing other types of cancer as well. Absence of evidence is not evidence of absence. >The age of male coverage has been expanded to like mid-40s by now. Sadly in Germany it's still only for younger men. And older men weren't offered the vaccine at all when they were younger, so they never got the offer. I paid out of pocket for it, but it's still stupid that we're still putting a part of the population at unnecessary risk for cancer, and also decreasing herd immunity at the same time. Lack of HPV vaccination is just a symptom of lack of understanding of science and statistics in politics.
  - potato3732842 2y ago
    >Lack of HPV vaccination is just a symptom of lack of understanding of science and statistics in politics. At some point it stops being about science or understanding and starts being wholly about politics. There's a lot more "well these demographics or institutions f-ing hate me so I'm sure as shit not taking their word for anything" going around than there was a decade ago.
    - JumpCrisscross 2y ago
      > There's a lot more "well these demographics or institutions f-ing hate me so I'm sure as shit not taking their word for anything" This would be fine. It goes further: not only rejecting the institutions, but concluding adversely based on their advocating for something.
  - wkat4242 2y ago
    Just wondering how much did you pay for it? Here in Spain I also can't get it in my 40s and it costs 800 euro, which is a lot on a Spanish wage. And the doctors say there isn't much point because I've probably been exposed already (considering number of partners that's likely). And then the effectiveness is supposed to be massively reduced. Still, if it were 200€ I'd do it. There's only one place here where I can get it so I wonder if it's cheaper elsewhere.
    - carlmr 2y ago
      >Just wondering how much did you pay for it? 180€ per injection. The normal schedule is 3 injections. (first, 1 month, 6 month). However I checked and NHS (UK) did a study on it that showed a single injection provides the same protection as 3, so they changed their injection schedule to single injection for people under 25, and 2 injections (first + 6-24 months) for over 25s due to the expectation that older immune systems take longer to adapt. The German (StIKo) recommendation is still 3, but I prefer listening to the NHS here because they have been more scientific about this in the past and seem to be actively studying this stuff. I asked my doctor and they said I can pick the schedule I want, since it's not insured anyway. So I picked the two injection schedule. So that makes 360€ for me. If the NHS study holds you could probably pick a single injection and already have most or all of the protection. I picked two because I figured it's still recommended for my age group that way. >And the doctors say there isn't much point because I've probably been exposed already (considering number of partners that's likely). My doctor said the same, but the NHS says it's still useful from their studies. Especially since Gardasil protects against 9 variants. It's unlikely you've been exposed to all 9 variants. I am not a doctor, so I can only tell you what I've found helpful in making my decision.
- theGnuMe 2y ago
  >Basically, the vaccines dont work with prior exposure The FDA recommends it for males under 45 now. It does prevent infection from new exposures. In time I bet that we will find it reduces cancer incidence even in those infected before vaccination. Those studies will take years to complete and it is too early to tell. When the vaccine was first available, it was rationed, and the highest priority was for young girls before they become sexually active since they have the highest benefit.
- crossroadsguy 2y ago
  I had wart on my heel once - kinda annoyingly stubborn which finally removed/subdued by laser removal (nitrogen therapy did jacks). That’s HPV, right? And guess once inside you, it stays inside you, right?
  - bluGill 2y ago
    There are over 100 hpv strlins. Warts are one yes, butnot the strain in question (though there are reports the vaccine helps for warts too I have not seen science verify that)
  - tialaramex 2y ago
    HPV is a family of viruses. There are dozens and the vaccine targets, I think, nine. So, that probably was HPV, but it probably was not one of the members of the family which the vaccine targets, the vaccine is focused on the sexually transmitted variants, since these are associated with Cervical cancer in particular, and several other nasty cancers, plus the genital warts.
- Nifty3929 2y ago
  >> Basically, the vaccines dont work with prior exposure This is a beef I have with a lot of medical thinking: that if it doesn't work it would be bad to do it. But that's not true at all - many things are good to do, if there is some chance it will help, even if most of the time it does nothing. You do have to weigh other negatives like cost, pain, hassle, or unknown side effects. But in general - if it might make me better and won't make me worse - then sign me up!
  - pbhjpbhj 2y ago
    Every vaccine (happy to get counter evidence) has negative side-effects, every injection is a risk. When you're injection multiple millions of your population on the off-chance it might help then you're going to get some very sick, or dead people. At 200€ a time (plus administration costs, plus lost work hours of those you're injecting), for millions of people that's also a lot of wasted funds that could be put into medicines that are known to be effective for the people they're treating. Why, for medicines that are highly available, that a doctor considers to be low risk, a sane adult can't just elect to pay for and take a medicine, that I am not sure of.
    - Nifty3929 2y ago
      Yep - I'm not saying society OWES me the treatment - just that I should be able to get it if I want and am willing to pay for it. I agree that we don't want all of society to be collectively paying for something that has large, clear costs, but dubious efficacy. Then again, COVID...
pyuser583 2y ago
Last I checked it wasn’t available for men.
- bertylicious 2y ago
  What do you mean not available? It's the same vaccine for men and women AFAIK. Or do you mean it's usually not paid for by health insurance? I (male) don't remember if I had to pay for the vaccine myself when I got vaccinated, which to me indicates that it wasn't that expensive.
  - SoftTalker 2y ago
    I'm not a doctor nor particularly fond of them, but as I understand it older men who have been sexually active are likely already exposed, so doctors won't prescribe the vaccine nor will insurance cover the cost. I don't know if it's something you can just walk in to a clinic and ask for and pay cash. The big push lately has been to get kids vaccinated before they are teens, which mine (all males) were. I have not had this vaccine, but at my age and being married any new sexual contacts are pretty unlikely so not sure there's any benefit to me either way.
- trescenzi 2y ago
  I’m getting my course of it now. I’m a ~30 year old man in the US. Maybe other countries haven’t expanded access? My doctor recommended it to me and it was covered by insurance. They said while it cannot protect you from previous exposure it’s pretty wide so it’s unlikely I have yet to encounter every HPV variation it protects against.
- itishappy 2y ago
  You should check again! > The CDC suggests catch-up HPV vaccinations for all people through age 26 who aren't fully vaccinated. > The FDA approved the use of Gardasil 9 for males and females ages 9 to 45. https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292 https://www.mayoclinic.org/diseases-conditions/hpv-infection... > HPV vaccine is recommended for routine vaccination at age 11 or 12 years. (Vaccination can be started at age 9.) > ACIP also recommends vaccination for everyone through age 26 years if not adequately vaccinated when younger. HPV vaccination is given as a series of either two or three doses, depending on age at initial vaccination. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
TZubiri 2y ago
Well since the probabilities of infection is magnified by lesions, and those occur more often in the receptive partner, it will disproportionately affect women and gay men. As is the case for stds in general. The extent to which these vaccines would be helpful to mean is usually to avoid hurting women. Which is not minor at all, I would definitely get one for that reason alone. But I wouldn't be concerned for personal risks.
Ponet1945 2y ago
> Unfortunately the way campaigns market it causes many people to think it benefits ladies only. That's a pretty diplomatic way to say that they pretty much don't care about men being affected. In my region the vaccine is free for women but men have to pay despite >40% of cancers caused being in men and nobody even informs you of that.

TZubiri 2y ago

[flagged]

fragmede 2y ago
https://xkcd.com/605/ https://xkcd.com/605/ edit: bonus https://xkcd.com/592/ https://xkcd.com/592/
- TZubiri 2y ago
  Haha. In this case I comically extrapolated to denote a mathematical equation without doing the algebra that makes brain hurty at 1 am
crimsoneer 2y ago
I mean, you remember aids pandemic ? I don't think people (especially straight people) today realise just how devastating that was.
- TZubiri 2y ago
  I don't, I wasn't born. But I read about it and its magnitude was conveyed. I do know that it was and is highly tied to promiscuity as a risk factor. I also know that since it's not as lethal now, some people in those risk groups just risk it more often, with condomless prep even. Also a pandemic is a spike in cases that needs to be considered over the long term. The risk of contracting diseases includes contracting a previously untestable slow onset disease and being an early patient of a pandemic, which usually happens to people with high partner count. It's like computer viruses, we fill a package.json with 100 dependencies which in turn have a supply chain (partner's partners) and install it on a vm anyways. That would be unthinkable 30 years ago, but now we have better cryptography, open source auditing OS level and kernel security. Yet ransomware attacks are not less common than the early trojans.
yieldcrv 2y ago
We’re reducing the strain on our health care system by reducing cancers The topic it overlaps with doesn’t matter Figure out your own sexual value system, we’re preventing cancers

stuaxo 2y ago

I really hope this happens, I'm a little cynical after hoping that we would come together and eradicate COVID 19.

EricE 2y ago
That would be pretty hard to do since the mRNA "vaccine" neither prevented infection or stopped the spread.
- seattle_spring 2y ago
  I assume they're talking about attempts to eradicate it in the first few weeks when it was thought to only be present in a few people.
- Krssst 2y ago
  It did for the first variants, but then Omicron happened. I see you're calling a vaccine a "vaccine". Noted.
  - WillPostForFood 2y ago
    MRNA vaccine is highly effective at reducing symptoms and saving lives of those at high risk (e.g., over 65), but it was never effective at preventing infection or stopping transmission. People who were saying that were somewhere between being over optimistic, and spreading disinformation to try to increase uptake.
    - gadders 2y ago
      It was also more dangerous to healthy young men than just getting COVID, due to myocarditis.
      - Marsymars 2y ago
        This isn't generally true. It does seem wise to preferentially get the Pfizer boosters over the Moderna boosters for lower dosage though, particularly if you're a young man.

daggersandscars 2y ago

I was diagnosed and successfully treated for HPV+ oropharyngeal cancer in 2023. My treatment results were almost perfect, from a clinical perspective. I had transoral robotic surgery to remove the tumors in my mouth / throat, neck dissection to remove cancerous and non-cancerous lymph nodes, and radiation to treat the area after cancer was found to have escaped the lymph nodes. If I were 10-ish years younger, I wouldn't have gotten cancer. I was likely exposed to HPV in my early to mid 20s, where it hid in my tonsils for decades. In the US, almost anyone under 45 can get vaccinated. Please do. As another comment points out, they protect against multiple strains. It's unlikely you've been exposed to all of them. While HPV+ head and neck cancers are more easily and more successfully treated than HPV- ones, I do not recommend getting cancer. From the outside, I look like a normal person of late middle age. The two incision scars I have look like neck folds -- literally no one, including medical personnel outside of the cancer world, notices them. From the inside, tho: * Can no longer taste sugar, salt, chocolate, and a host of other, smaller things. Most other things have less taste and pretty much nothing has a flavor after a few bites. For some, this eventually stops -- I'm unlucky. (Radiation destruction of taste buds) * Significantly decreased saliva to the throat. Cannot eat without some liquid. The saliva that forms is thicker and sometimes causes problems swallowing. Some get this to the mouth and to a larger extreme -- I'm lucky. (Radiation) * Dental trauma, including teeth extraction / root canal / deep fillings, may cause spontaneous bone tissue death in the jaw. (Radiation) * Permanent sensation of partial numbness centered around my left ear and cheek. Touching that area produces a pins and needles sensation. (Neck dissection) * No feeling in a stripe about 1.5" (4cm) wide where the neck dissection scars are. (Neck dissection) * Changes in speech quality. These are not clinically significant but changed my voice from one people enjoyed listening to (asked to do voice over work, complemented, etc) to just another voice. (Surgery) * Tinnitus increased significantly and hearing has worsened. I was not given chemo, the normal cause of hearing loss. (Unsure cause) There's more, but those are some of the highlights. Get vaccinated, get your kids vaccinated, etc. HPV- head and neck cancers in the US are dropping as people quit smoking. HPV+ are on the rise for now, but will drop as the generations with vaccinations get older. I'm traveling today, but will look at this later today if anyone has a question to ask.

nick_ 2y ago

w10-1 2y ago

The HPV vaccine has been a universal win for this generation. Screening (pap smear) is also highly effective, but requires constant effort. The remaining gaps in screening and vaccine uptake reflect broader lack of health-care capabilities that won't be solved with pushing the HPV vaccine alone. Changing from injectable to oral could help, but isn't on the table, and local populations and governments are likely to become increasingly resistant to outsiders waving their science authorities, particularly on family matters. Both authors are Phd's working in outreach - i.e., they seem to have no experience with deploying HPV campaigns.

User23 2y ago
HPV vaccine is also a big win for oral cancer, which pap smears and treatment didn't help with at all.

sam36 2y ago

[flagged]

jeffbee 2y ago
Don't draw equivalence between peer-reviewed scientific data and some random blogs.
- pessimizer 2y ago
  The entire antivax movement was started by an obviously awful paper published in The Lancet that they took 12 years to retract. Then, during the height of covid, they published an obviously fraudulent study ratifying the government wisdom about one of the most politicized treatments that some people had adopted. Lancet frauds have been for vaccines in the West like hiding the people searching for Bin Laden within a fake vaccination campaign was for vaccines in the Middle East. https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud https://en.wikipedia.org/wiki/Surgisphere#COVID-19_misconduct https://en.wikipedia.org/wiki/Surgisphere#COVID-19_misconduc... https://en.wikipedia.org/wiki/CIA_fake_vaccination_campaign_in_Pakistan https://en.wikipedia.org/wiki/CIA_fake_vaccination_campaign_... edit: I think everyone should take the HPV vaccine, and I posted the Scottish study in a sibling comment. I think the casual dismissal of things that are not peer-reviewed is not good, when peer-review completely failed about vaccines and vaccine-related subjects in a way that possibly is responsible for the deaths of millions. Peer-reviewed articles were responsible for the antivax movement. They should be treated individually.
  - jeffbee 2y ago
    While true, this one graph from the lancet is certainly not the only data we have on HPV. You can easily find dozens of studies and metastudies on PubMed.
  - deleted 2y ago
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  - Marsymars 2y ago

jeffbee 2y ago

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verisimi 2y ago
> end vaccinations That's not what happened in his last term though. He pushed the COVID vaccinations and it was the democrats who were saying that they wouldn't take a Trump vaccine - do you recollect?
- deleted 2y ago
  [deleted]
- jeffbee 2y ago
  It is a mistake to imbue the Trump regime with an underlying system of rules and reason. Everything Trump does is a personal transaction. RFK Jr. is loyal and brought some critical support to Trump, so Trump is going to let him do whatever he wants. Trump doesn't care about the outcomes.
- krapp 2y ago
  And then the Democrats did take the vaccines. And then the Republicans made it their whole identity to not take the vaccine. in no small part because Trump mocked anyone who did take the vaccines, dismissed the severity and scale of the pandemic as "Democratic lies" and "fake news" (because he wanted to run on the economy) and refused to do so himself, lest the press see him as "weak." And now Trump, being Trump and going whichever way the wind blows, fully embraces anti-vaccine ideology by endorsing RFK - a well known antivaxxer and conspiracy theorist - and promising to give him "carte blanche" control over numerous health agencies and health policy in general. Do you recollect?
  - zxcvbnm69 2y ago
    [dead]
  - gadders 2y ago
    [flagged]

prepend 2y ago

I think it’s funny how in the US the vaccine schedule says not to get the HPV vaccine if you’re over 45. That means that insurance won’t cover it and I even struggle finding a doctor who will administer it because it goes against the guidelines. The rationale is that if you’re 45, you probably already have HPV. But that assumes that you’ve been sexually active all that time. It doesn’t take into account people who were monogamous until their 50s and then started having sex with new partners.

opello 2y ago
Exactly. It'd be nice if primary care physicians approached the request with an open mind and had the real conversation about any risk/reward. I don't know if there's any risk to taking the 9-valent version if you might have been exposed to one that it covers. But why isn't it valuable to have protection from the other 8? My bias is climbing the hill of convincing on this front 5 years ago and being on the receiving end of a pretty dismissive attitude. But I got my way and think it was the right choice.
- 9x39 2y ago
  I had a similar experience with my GP. I was essentially dismissed outright (in surprising contrast to an otherwise dynamic/vigorous interest in my health) and am planning on revisiting this with a different GP soon. While I allow for myself just being ignorant, wrong and vulnerable to working myself up into health scares, I couldn’t help but wonder if men looking into HPV vaccines are brushing up against a doctrinal problem, in that whatever protocols and literature exist for the med field don’t study and don’t mention male-HPV interactions enough to warrant action (or even interest) from GPs as a group.
  - opello 2y ago
    I'd have hoped things improved in the last 5 years but maybe you can avoid the GP altogether and schedule it like a flu shot through the pharmacy? I noticed it was in the list at Walgreens this year anyway. Best of luck with it!
  - 2y ago

stared 2y ago

I am surprised that this study does not mention which vaccines are being used - as they vary by the number of HPV types they protect against. "Currently there are six licensed HPV vaccines: three bivalent (protect against two types of HPV), two quadrivalent (against four), and one nonavalent vaccine (against nine)" - https://en.wikipedia.org/wiki/HPV_vaccine https://en.wikipedia.org/wiki/HPV_vaccine

asah 2y ago

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immibis 2y ago
That's not true.
- bqmjjx0kac 2y ago
  I think it remains to be seen.
- knowaveragejoe 2y ago
  It's also not untrue, either, we don't know who will be taking that seat.

richrichie 2y ago

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oezi 2y ago
When the health authorities say that they don't recommend it because benefits do not outweigh risks they usually mean that the benefits aren't at least 2 magnitudes (100 times) bigger than the risks. Vaccination usually is highly beneficial, but as one ages the benefit does diminish. Agencies don't want to be stuck with vaccines which have large side effects.
- richrichie 2y ago
  This suggestion was specific to HPV vaccination. I did appreciate his explaining risks and benefits.
throwaway2037 2y ago
> before vaccines became unquestionable cult drugs I don't understand your English. Can you explain it a different way?
- richrichie 2y ago
  You know what it means.

bschmidt9 2y ago

[flagged]

tasty_freeze 2y ago
How is this a helpful comment? It is just an insult. If you don't believe the article, state why, give evidence. Cheap cynicism helps nobody and doens't make you look smart or superior.

rawgabbit 2y ago

I remember when Gardasil was first introduced and the related controversy. I believe there were questions about its safety because at first it was targeted at 12 year old females. At one point the Japanese Ministry of Health suspended the vaccine and then later resumed it. For me the explanation of how this vaccine works still confuses me. For example while older people are advised to get Shringix to mitigate the consequences of a reactivated chickenpox virus. Older are advised not to get Gardasil because once you get HPV, the vaccine is ineffective? https://mainichi.jp/english/articles/20211115/p2a/00m/0op/003000c https://mainichi.jp/english/articles/20211115/p2a/00m/0op/00...

Teever 2y ago
As I understand it from talking with a healthcare worker it isn't so much that it's less effective if you already have the infection (though it is) it's more just a triage decision. People in various health care systems around the world have just done a cost benefit analysis and decided that it isn't worth paying for the vaccine for older people, that we'll just let them get cancer and go through treatment/die.
- rawgabbit 2y ago
  The other confusing thing is the benefit to risk ratio. Looking at the WHO rates of cervical cancer for Canada with almost complete vaccination rate vs Japan with almost zero vaccination rate, you can argue the vaccine cuts cervical cancer by 2/3. But when you look at the numbers at a per annual basis, the probability of getting cervical cancer is 0.5 percent to 1.5 percent. https://www.who.int/publications/m/item/cervical-cancer-jpn-country-profile-2021 https://www.who.int/publications/m/item/cervical-cancer-jpn-... https://www.who.int/publications/m/item/cervical-cancer-can-country-profile-2021 https://www.who.int/publications/m/item/cervical-cancer-can-...
vidarh 2y ago
It was first largely triage. It had the highest odds of saving lives for young people and especially young girls. As more and more of the younger groups have been covered, the age recommendation has kept rising. At the same time the number of strains covered have gone up and that has also made it more worthwhile to vaccinate older groups. It's also down to evidence. It's not that the vaccine has been proven to be ineffective, but that the vaccine had not been proven to be effective enough to be worth it for older groups initially, in large part because it was not what they tested for.

123yawaworht456 2y ago

[flagged]

Avalaxy 2y ago

I really wish we had therapeutic vaccines against HPV. As a man, I always got told "it's not for men", followed by "it is also for men, but only if you never had sex", followed by "it's also for men who had sex, but only to a limited age". As a male who meets all the criteria to be in a high risk group for HPV throat cancer, and who is dealing with a persistent HPV infection (as proved by warts that won't go away), I'm really sad that I may one day at a young age get cancer in my throat, and there is nothing I can do about it to prevent it. I wish we would put the same amount of energy into inventing vaccines that suppress the virus, or help the body to get rid of them.

toomim 2y ago
Go find a doctor who will prescribe it off-label. I was in a similar situation to you. The doctor said it wasn't indicated for me, but I said I wanted it anyway, and the doctor said ok, and it cleared up my existing HPV infections after dose #2.
vidarh 2y ago
It's a matter of cost-effectiveness and slowly increasing evidence. You can get it privately most places, and the age limits are likely to keep being pushed.
sureIy 2y ago
This pisses me off. I live in a part of the world that feels almost too liberal for drugs, but that also means that when I wanted to get the HPV vaccine, I walked into a clinic and got the shot. Then I went to a different country and got the second and third shots. What's the hold up? Please keep trying to get your Gardasil-9 shots even against their advice.
deleted 2y ago
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ckw 2y ago

Sometimes anti-vaxxers will point to the ostensibly high rate of serious adverse events exhibited by study participants in HPV vaccine trials. For example, in the study 'A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women' published in The New England Journal of Medicine in 2015, in which the 9-Valent HPV vaccine was compared to the Quadrivalent version, the rate of serious adverse events was 3.3% and 2.6% respectively. This objection can be dismissed, as the study authors found that 0.0% of those serious adverse events were vaccine related. Anti-vaxxers also sometimes object to studies like these on the basis that no placebo arm was included, and thus the true safety profile of the vaccine cannot be ascertained, but this can be flatly rejected because, as the study authors point out, '[s]ince HPV vaccination is widely recommended and has been shown to prevent HPV disease related to oncogenic HPV types, the use of a placebo was not considered to be acceptable for ethical reasons.'

tialaramex 2y ago
Because HPV vaccination is relatively modern, there's trail where maybe the trial for the vaccine you can get today A, was A vs B, but then the previous B has a trial B v Placebo, or it might go back twice, A v B then B v C and C v placebo. There were placebo trials for the early HPV vaccines decades ago. I had Hodgkins Lymphoma (many years ago now when I was young) and we've been treating that for so long that the earliest curative treatments pre-date scientific medicine. So the trail dries up - we have no proof that the cures are better than nothing except, you know, circumstantially it sure does seem like the freaks who reject treatment just drop dead and I didn't so... They're still doing research, as with the HPV vaccines they do A v B trials as a placebo would be unethical - it's basically a death sentence. I actually wasn't selected for a trial comparing Stanford V (a new potential therapy from Stanford) against the current gold standard (which I was getting) ABVD. That was a long time ago, but I think the gold standard today is still ABVD.
- User23 2y ago
  Calling cervical cancer a death sentence is a bit extreme. Regular pap smears and early treatment made it eminently survivable.

losvedir 2y ago

> especially through sex, kissing, or touching To what extent can it be transmitted via "touching"? And other mechanisms since it says "especially" implying there might be others. As a man approaching 40 I've never considered this vaccine because I've only ever been (and ever will be) sexually active in any way with my wife, who has been the same with me. Is there any reason to get the vaccine in my situation? I see a lot of comments here that we all should get it, but if it's just sexually transmitted I don't think there's a reason for me to.

ejstronge 2y ago
HPV causes multiple lesions in humans, including warts. Certain types of HPV are more associated with certain lesions over others, but the broad range of HPV targets means that dangerous HPV types could be transmitted through relatively innocuous means. Some context: https://www.ncbi.nlm.nih.gov/books/NBK448132/ https://www.ncbi.nlm.nih.gov/books/NBK448132/
- sushid 2y ago
  Does that mean you can get certain HPVs via forms of non-sexual contact, such as handshakes, massages, etc.?
  - hammock 2y ago
    Yes, all warts are caused by HPV no matter where they appear

codeptualize 2y ago

I recently got the HPV vaccine (along with some other vaccines I didn't get as a child of anti vax parents). Vaccines are one of the most amazing inventions. The fact that they can eradicate entire categories of diseases and save so many people from suffering and death with such a simple intervention, is truly remarkable. It makes me very sad that as a society we are failing to simply take what's there. Maybe the biggest flaw of vaccines is that they are so effective that people don't remember how bad these diseases really were, and only know the minor side effects. Feeling bad for a couple of days instead of getting certain cancers, measles, hepatitis, and many other serious diseases is a great fucking deal. Also had almost no side effects from the hpv vaccine, 10/10 do recommend.

mullingitover 2y ago
The world put Pasteur on a pedestal for creating the rabies vaccine. He was a household name because rabies was a terrifying death sentence at the time. We're incredibly luck that today getting bit by a rabid animal is typically just an inconvenience. Vaccines are miracles. He also invented the pasteurization process, which has saved countless lives. Now we have a whole anti-pasteurization movement, because why not. Wild that education has failed so hard that we have large numbers turning their backs on these blessings we're fortunate enough to take for granted.
- User23 2y ago
  > getting bit by a rabid animal is typically just an inconvenience Actually, in the USA it's a financial catastrophe if you're uninsured and of average means. You're looking at a $7,000 expense. Or you could spend like $1,000 on a ticket to Thailand or something and get it there for $70.
  - yakshaving_jgt 2y ago
    Oh dear, your connecting flight has been cancelled, so now you die.
  - throwaway2037 2y ago

Kuraj 2y ago

It would be great if I didn't have to pay the equivalent of 2000 USD for the full cycle where I live. Kids get it for free but if you're 30 you're shit out of luck

throwaway2037 2y ago
Where do you live? 2000 USD is crazy.

elif 2y ago

Unfortunately due to postrealist ideology supplanting fact-based reality, 40% of your scheduled elimination of disease will not be taking place as scheduled.

lettergram 2y ago

Reading about this is fascinating — Over here they claim HPV is the leading cause of throat cancer (not smoking) - https://www.cdc.gov/cancer/hpv/basic-information.html https://www.cdc.gov/cancer/hpv/basic-information.html Over here is the leading cause of cervical cancers world wide - https://www.cancer.gov/types/cervical/causes-risk-prevention https://www.cancer.gov/types/cervical/causes-risk-prevention Then over here: > Cervical cancer incidence rates decreased by more than half from the mid-1970s to the mid-2000s … in women ages 30-44, rates have increased 1.7% each year from 2012 to 2019. > Cervical cancer was once one of the most common causes of cancer death for American women. The cervical cancer death rate has dropped by more than half since the mid-1970s https://www.cancer.org/cancer/types/cervical-cancer/about/key-statistics.html https://www.cancer.org/cancer/types/cervical-cancer/about/ke... A vaccine for HPV became available in 2006 — https://en.m.wikipedia.org/wiki/HPV_vaccine https://en.m.wikipedia.org/wiki/HPV_vaccine So it seems cancer has increased since the introduction of the vaccine. Prior to that it was decreasing. Further, after reading about HPV generally, there’s no symptoms typically and most forms are not the cancer causing kind. Only certain HPV strains combined with a long term infection (if they estimate 20 years) cause cancer. IMO there’s a lot of correlation with frankly minimal and confusing causation. Combined with evidence the vaccines aren’t effective at changing the cancer rates at all, seems like a money grab by big pharma to me. “Get vaccinated to avoid this cancer you’re highly unlikely to get and won’t know if you do for 20 years” seems like a stretch…

idunnoman1222 2y ago
Nice to see people down voting you without saying why. I was gonna say in Sweden these early adopters have very high coverage rates for HPV vaccination. How is the cervical cancer rate there? In before confounding factors OK fine. do the placebo controlled trial.

Traubenfuchs 2y ago

Personally I am more excited about HPV caused cancers in my throat, anus and penis, because the only cervix I had contact with was my mothers. I do not understand this focus on women. Just tell the whole story, that your dick can fall off and every straight frat bro will get vaccinated tomorrow.

Quarrel 2y ago
There is also more of a spectrum between straight and gay than gets talked about at a high level in these discussions. Gay men & women often arrive at that position after having had hetero sex. Heterosexuals often "stray" or whatever other euphemism people care to use. Not all sex is as consensual as it should be, etc, etc.
- Traubenfuchs 2y ago
  Straight men would „stray“ just as much, but they are confronted with dating economics where 80% of them are considered below average looking. In any case, what I want to say is: Whether you care about cancer in males or females, males must not be ignored and HPV must not be framed as female only issue. In other words, those 20% of straight men that have the option to stray must get vaccinated as well, if only to protect women.
  - Quarrel 2y ago
    > males must not be ignored and HPV must not be framed as female only issue hear, hear.

tucosan 2y ago

The vaccination campaign has solely been target at girls and women. Which is crazy, since boys and men can get cancer from HPV too. I really don't understand the bias in public health communication here. OWID is making the same mistake again. How are boys supposed to know that they should get the shot, if everybody public health professional fails to tell them? > HPV is also thought to cause about 95% of anal cancers, 75% of oropharyngeal cancers, 75% of vaginal cancers, 70% of vulvar cancers, and 60% of penile cancers.2 Low-risk or non-oncogenic genotypes (eg, types 6 and 11) cause anogenital warts, low-grade cervical disease, and recurrent respiratory papillomatosis. In the USA, the incidence of oropharyngeal cancer in men now exceeds that of cervical cancer in women, and by 2020 the annual number of HPV-associated oropharyngeal cancers will exceed that of cervical cancers. As a result, it is important to consider ways to expand our HPV prevention efforts to boys and men. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30314-2/abstract https://www.thelancet.com/journals/lancet/article/PIIS0140-6...