5 ms·

PSA, everyone should be getting the HPV vaccine, regardless of age and gender. https://en.wikipedia.org/wiki/HPV_vaccine https://en.wikipedia.org/wiki/HPV_vacc

PSA, everyone should be getting the HPV vaccine, regardless of age and gender. https://en.wikipedia.org/wiki/HPV_vaccine https://en.wikipedia.org/wiki/HPV_vaccine https://www.mdanderson.org/publications/focused-on-health/what-men-need-to-know-about-hpv-related-throat-cancer.h12-1593780.html https://www.mdanderson.org/publications/focused-on-health/wh... https://www.cdc.gov/cancer/hpv/oropharyngeal-cancer.html https://www.cdc.gov/cancer/hpv/oropharyngeal-cancer.html

foenix 2y ago
Seconded! And I say this as a man who thought I didn't need it because I can't get cervical cancer. But it turns out oropharyngeal cancer might be just as preventable with the HPV vaccine.
0cf8612b2e1e 2y ago
Annoyed at how the guidance has changed on this over the years. At first it was just a narrow slice of 20 something women. Then girl teenagers. Then men and women under 30. Then under 40. If it has an association with preventing cancers, not sure why they were so reluctant to immediately open up the patient pool.
- razepan 2y ago
  This is how science works. Our understanding of a medication's efficacy evolves over time.
  - woleium 2y ago
    also availability. i recall the most effective way to distribute the covid vaccine would have been concentric circles from a central point. Obviously that was never going to happen.
  - colechristensen 2y ago
    No it's not, it's not science working. It is either A) underreporting risks or B) not acknowledging risk unknowns and plowing ahead with advice anyway. This was the major problem and behavior that CAUSED anti-vax opinions. They made safety claims that they couldn't logically make, because they couldn't know. A new vaccine using a new vaccine technology vs a new virus. They did not correctly report the amount of uncertainty and they lost trust. Then folks who "knew better" did their best to manipulate the narriative. And speaking of manipulating the narrative, you can't use google to find the bits of history that shows the CDC giving contradictory advice because the results aren't there any more. Nearly every result gives the same tone and they're almost all CDC links. This kind of information control and lack of transparency isn't science, it's power dictating truth. The actual truth is that the risk of cancers as a result of HPV have a pretty high chance of being prevented if young females get the vaccine, but as you get further away from that group the risk avoided by getting vaccinated gets progressively smaller and runs into the safety uncertainty of taking the vaccine. When you're doing population level risk management you also have to do things like comparing the risk of getting hit by a bus going to the clinic against whatever the clinic could do for you. It is often safer to do nothing than to avoid a very tiny risk because of the very mundane risks you face day to day.
    - const_cast 2y ago
      You're missing important stuff here, most notably that recommendations are also based on availability. As the vaccine became more available, more demographics were recommended to take it. Obviously, in the beginning, you want the highest risk groups to take it, then you grow the radius. They didn't use young girls as some safety experiment. They just had the largest benefit and so, in scarcity, they're prioritized. It's not that scarce anymore. As an aside, the HPV vaccine also prevents some male cancers, like penile cancer. It also prevents cosmetic, but relatively safe, conditions - like genital and anal warts. That's not the goal of the vaccine so it's not really taken into account. But you, someone who may take the vaccine, should consider it anyway.
- thrill 2y ago
  US citizens used to value the adults managing such science oriented endeavors actually doing their homework before making broad proclamations of efficacy. Lately, not so much.
  - bobmcnamara 2y ago
    Blame the cold war for that one.
- chimeracoder 2y ago
  > If it has an association with preventing cancers, not sure why they were so reluctant to immediately open up the patient pool. Because approval involves evaluating a risk-benefit tradeoff, and the benefits for those groups are wildly different, as are the risk profiles, due to the way HPV strains[0] work. If they tested against a wide and heterogenous population from the start, it would risk demonstrating insufficient effect, which would eliminate the possibility of the vaccine for everyone. Instead, by testing against the group most likely to benefit from it (women, and specifically women of the age to have no prior exposure to HPV) they can see whether the vaccine has any potential at all, and expand from there. As it turns out, the vaccine was incredibly effective for them, and as we studied it further, it turned out that other groups which had potentially lower benefits (men, older women) or higher potential risks (teenage girls) had a risk-benefit tradeoff that still overwhelmingly supported approval for those groups. [0] yes, plural, because there are hundrends, and the vaccines (again, plural, because there are more than one) protect against a handful of them (although that fortunately includes the strains that account for 80-90% of HPV-caused cancers
- hermannj314 2y ago
  I am not sure why all the replies are indicating you are anti-science or anti-vax. It is annoying to be told something from your doctor, internalize it, have your doctor suggest flu and covid vaccine for years but never HPV, and then be told on HackerNews "you should have the HPV" and now I am supposed to tell my doctor I can do his job better than him because I read something on the internet even though most doctors specifically grimace when you do that? I think their Epic Health computer system that needs me to confirm my date of birth every 6 weeks can find some time to suggest the HPV vaccine if it is so damn medically necessary.
  - chimeracoder 2y ago
    > I think their Epic Health computer system that needs me to confirm my date of birth every 6 weeks can find some time to suggest the HPV vaccine if it is so damn medically necessary. You're assuming that the purpose of the EHR (Epic) is to implement public health recommendations or to establish minimum standards of care. That's a reasonable assumption for someone who doesn't work in the field, but unfortunately it's incorrect: neither of those are top-level goals for EHRs.
    - Henchman21 2y ago
      What are? Let me make a cynical guess: 1. Reducing costs by hiring fewer people. 2. Increasing profits by decreasing care. Did I nail it or what?
      - thunderfork 2y ago
        [dead]
      - Fishkins 2y ago
        You're on the right track with money, but that's not exactly how I'd describe the goals. My impression is the primary goals are getting things coded and billed properly and thoroughly, and getting things documented in a way that minimizes legal liability.
    - 2y ago
- tialaramex 2y ago
  Medical ethics focus on the benefit to a specific individual - your patient. This defuses the "Should I kill one to save ten?" moral dilemma - the individual is your patient, even if the other ten are also your patients, you must not harm the one. But for vaccines it also means that the wider societal implications are not ethically relevant So, medics won't recommend that you give patient A an intervention which is of no benefit to A but is really helpful for everybody else. For example, that you vaccinate teenage boys in the expectation that this way they won't infect teenage girls (with whom statistically many of them will have sex) with an STI that harms those girls. As a result, the guidance cared about proven benefits to you even though taken neutrally you might have been enthusiastic about a vaccine that might or might not protect you but is definitely a good idea for the wider population. The initial studies understandably focused on the numerically larger problem: If we vaccine young female patients does that prevent relevant HPV infections, and then, as a proxy we might assume they also won't get cancer. Such studies can't tell you whether it prevents men getting cancer because that wasn't measured. So the recommendation to vaccinate boys was delayed because first somebody has to study what might seem obvious - does the vaccine also prevent HPV related cancers in males? It is, after all, possible that some subtle mechanism means the vaccine isn't effective for this purpose, and it would not be ethical to give schools full of boys a vaccine that they personally do not benefit from having - even if societally maybe that's a good choice. Beyond the female/ male differential, for adults and older, it's basically a stats game. Most adults have sex. Having sex means you're likely to contract HPV, more sex, more exposure. Is it worth getting vaccinated when there's a 50% chance it's useless? How about 95%? 99.5%? Do you always wait for the crossing lights? Did you ever drink beer or eat bacon ?
  - odyssey7 2y ago
    You're not wrong about ethical considerations, but the CDC operates socially and politically as well. Back when the vaccine was new, an objection from some parents was that the vaccine might be viewed as a license or permission for their daughters to be promiscuous. There was a substantial headwind. The public wasn't yet generally aware that HPV could cause head, neck, and anal cancers in men. If a doctor approached a parent back in 2010 and said they wanted to vaccinate their son against head, neck, and anal cancer, that advice wouldn't have been heeded in many cases, and would have cost the CDC some amount of its standing with the public. When you hear something from the CDC, there's a decent possibility that it's a blend of medical advice that's been compromised with some value judgements that haven't been expressed to the listener.
- iamtheworstdev 2y ago
  With regards to HPV, when they tried recommmending (and even making it mandatory) for young print the Christian-right cried foul pretty hard. The Texas Governor got a heap of shit over it at the time because abstinence is the only thing teenagers should know about.
- mschuster91 2y ago
  > If it has an association with preventing cancers, not sure why they were so reluctant to immediately open up the patient pool. Multiple reasons. The first one is basic ethics. Similar on how you should do rolling upgrades of your SaaS software to catch errors before everything goes down, you got to do the same with vaccines. For there, go for the target group with the highest risk and highest potential of averting damage - and for the HPV vaccine, mid-20 women are the best such group: young enough that they might be lucky and not exposed yet, old enough to fall out of the scope of the usual ethics bureaucracy that (rightfully) comes with doing experimental research involving minors, and not so old that they definitely got exposed and making the effort moot. Then it got rolled out to teenage girls as it was proven safe, and eventually to men as well because we can be asymptomatic carriers (as we are for a lot of STDs). Obviously if you got the speed of Covid vaccines in mind as a comparison, the HSV vaccine appears slow in rollout speed - but please do not forget, the Covid vaccines went through very speedy trials. We were extremely lucky it worked out the way it did. The second one is availability. Again, unless it's Covid where everything went into full production power in a matter of months, production has to be ramped up carefully, matching rollout strategies - it doesn't make sense to have a mismatch into either direction. And the third one is time. With Covid, it was easy to prove effectiveness: the people that got the shot got Covid at waaaay lower rates than the control population (and the risks of side effect were way less than the risk of severe Covid). But with something like HPV that can have years if not decades worth of time between exposure and symptoms, it becomes harder to reasonably judge effectiveness and safety.
- stubish 2y ago
  You can only sell medication after trials. The first trials were on young women, and later trials on other groups. Nobody wanted to pay for trials on all demographics before there was evidence it worked from cheaper, more focused trial. There are also barriers to doing trials on high risk groups like the elderly without first testing on lower risk demographics. This is one reason why so much medication not to be used by pregnant women. The trials have not been done, and trials involving pregnant women are particularly expensive and risky.
- drew870mitchell 2y ago
  My guess is it's cost driven? IIRC insurance would not pay for mine when i was out of the recommendation pool but they did (were legally required to afaik) when the pool expanded to include my age group.
hgomersall 2y ago
Is the vaccine still useful post infection?
- mv 2y ago
  yes. many different strains and even if your body clears infection with one doesn’t protect against other strains
- Traubenfuchs 2y ago
  Anecdotal evidence of curative effects even for long term symptomatic infection exists.
basisword 2y ago
I know very little about this so excuse me if this is a stupid question. In my country all teenage girls have been getting the vaccine for at least the last 15-20 years. Therefore all of the women I'm likely to sleep with are vaccinated. Does it still make sense as a man to get it?
- 0cf8612b2e1e 2y ago
  I guess I am a weirdo, but vaccines are the closest thing we have to space magic. Generally, they are very safe and prevent some of the most devastating diseases. All for the most minor discomfort. I want everything I can get, even if I am unlikely to be exposed to the real infectious agent.
  - kstrauser 2y ago
    Same. And while the shingles vaccine isn't fun, I've known enough people who described their bouts with shingles as "nearly suicide inducing" that I'll take a temporary minor discomfort that prevents me from ever having to deal with it.
- kstrauser 2y ago
  "All". Even if that's true, some time you might travel and be around women who aren't vaccinated, and you get an infection with something bearing the lovely name "genital warts". It has the long-term complications of "cancer of the cervix, vulva, vagina, penis, anus, mouth, tonsils, or throat". And you can give it to any other women you get with for the next few years, potentially giving them any of those relevant cancers. So yes. It absolutely makes sense for a man to get it. For selfish reasons, you probably don't want penis cancer. For non-selfish ones, you don't want give other partners cervical cancer.
- bawolff 2y ago
  Vaccines aren't 100% effective. I'm not sure what the effectiveness of the hpv vaccine is, but if it was 95% effective (totally made up number, i dont know what the real one is), then there is a 1 in 20 chance it wont work for someone. If both of you have the vaccine then the chance of both failing would go down to 1 in 400. That seems worthwhile to me, given there is basically no downside. (I guess this doesn't account for the affects of herd immunity)
yjftsjthsd-h 2y ago
What if I'm monogamous?
- SketchySeaBeast 2y ago
  That's what I'm wondering as well. I've been monogamous for a decade and a half now. If that changes I'll get the vaccine, but right now if either of us had it we both do.
- apt-apt-apt-apt 2y ago
  Even if you are, your partner may not be. Or, god forbid, you could be sexually assaulted. Low, but non-zero chances.
- pitpatagain 2y ago
  Obviously then your risks are lower, but even then not zero. A dear friend of mine went through stage 4 HPV related cancer after a long "monogamous" marriage. It turned out that it wasn't actually monogamous on the part of her (now ex) husband. It's excessive to say literally everyone should get the vaccine: if you are especially low risk and don't want to bother, sure. But it's a very easy, safe vaccine. Most people engaging in some average amount of life-time serial monogamy (or with a partner who engaged in serial monogamy) would be better off just getting the vaccine than spending any mental energy on trying to figure out exactly the degree to which they need it.
amanaplanacanal 2y ago
The CDC is still not recommending the vaccine for people over 45.
robotnikman 2y ago
I've thought about getting one myself, since I identify as a gay man. Though last I checked it was not covered by my insurance...
- arcmechanica 2y ago
  https://www.goodrx.com/gardasil-9 https://www.goodrx.com/gardasil-9
unavoidable 2y ago
While this advice is good, the article is discussing HSV (herpes simplex virus), not HPV (human papilloma virus), which have quite different symptoms and epidemiology. There are, as yet, no approved HSV vaccines.
- sitkack 2y ago
  Second part of the PSA, one should keep prophylactic antiviral medication on hand incase you get exposed to someone with HSV. With 60% of the population positive for HSV, everyone should have an antiviral on hand. acyclovir, famciclovir and valaciclovir https://www.ncbi.nlm.nih.gov/books/NBK525787/ https://www.ncbi.nlm.nih.gov/books/NBK525787/
  - OutOfHere 2y ago
    And where/how does one acquire them from?
    - yakshaving_jgt 2y ago
      They’re available OTC basically everywhere.
      - OutOfHere 2y ago
        They're not OTC medicines. They are prescription-only medicines.
        sitkack 2y ago
        Prescriptions are easy to come by. Talk to people, their signature unlocks worlds.
        dylanmulvaney 2y ago
        [dead]
        2y ago
offmycloud 2y ago
> PSA, everyone should be getting the HPV vaccine, regardless of age and gender. This is false, please don't take medical advice from an HN post. CDC guidelines do include quite a bit of discussion of patient age. [1] 1. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
- colechristensen 2y ago
  Either the vaccine has notable safety issues or it should be at least fine to get the vaccine at an older age. The reason many people don't trust the CDC's advice is they don't really tell you why or why not. If you're over 26 you're pretty likely to already be exposed to HPV but not necessarily every strain which would be protected by the vaccine (as it says in the article). So this pushes the question: why shouldn't I get it even if there's only a small chance it will be beneficial at my age? Is there really a risk they're not telling me about or are they giving bullshit answers? There isn't a third direction.
  - js2 2y ago
    Vaccine recommendations are based on more than just safety. Efficacy, cost, availability, and prioritization are also considerations. > Compared with the benefit of the existing HPV vaccination program for adolescents and young adults through age 26 years, the additional benefit of vaccinating people age 27 through 45 years would be minimal. > Given abundant evidence for safety of HPV vaccines, undesirable anticipated effects are minimal. Also, anticipated population-level benefits are minimal for vaccinating adults over age 26 years. In this scenario, other considerations including cost-effectiveness play an important role in guiding policy-making. https://www.cdc.gov/acip/evidence-to-recommendations/HPV-adults-etr.html https://www.cdc.gov/acip/evidence-to-recommendations/HPV-adu... Elsewhere: > There’s not a safety issue past age 45. We just aren’t sure how much the vaccine will help men and women who are past that age, because so many of us have acquired HPV by that point, and because it takes many years for cancer to develop after acquiring the virus. However, as the average life expectancy increases, it may benefit the population to increase the age limit for HPV vaccination as well. https://www.mskcc.org/news/think-you-re-too-old-get-hpv-vaccine-prevent-cancer-maybe-not https://www.mskcc.org/news/think-you-re-too-old-get-hpv-vacc...
Rendello 2y ago
I decided to get it and saw it listed as $160 per dose on the health provider's website. I decided to bite the bullet and get it. When I got the prescription filled at the pharmacy, it was $265 for the first round of three. I want the next two but it's crazy to think I'd be paying like $800 (Canada).

foenix 2y ago

Seconded! And I say this as a man who thought I didn't need it because I can't get cervical cancer. But it turns out oropharyngeal cancer might be just as preventable with the HPV vaccine.

0cf8612b2e1e 2y ago

Annoyed at how the guidance has changed on this over the years. At first it was just a narrow slice of 20 something women. Then girl teenagers. Then men and women under 30. Then under 40. If it has an association with preventing cancers, not sure why they were so reluctant to immediately open up the patient pool.

razepan 2y ago
This is how science works. Our understanding of a medication's efficacy evolves over time.
- woleium 2y ago
  also availability. i recall the most effective way to distribute the covid vaccine would have been concentric circles from a central point. Obviously that was never going to happen.
- colechristensen 2y ago
  No it's not, it's not science working. It is either A) underreporting risks or B) not acknowledging risk unknowns and plowing ahead with advice anyway. This was the major problem and behavior that CAUSED anti-vax opinions. They made safety claims that they couldn't logically make, because they couldn't know. A new vaccine using a new vaccine technology vs a new virus. They did not correctly report the amount of uncertainty and they lost trust. Then folks who "knew better" did their best to manipulate the narriative. And speaking of manipulating the narrative, you can't use google to find the bits of history that shows the CDC giving contradictory advice because the results aren't there any more. Nearly every result gives the same tone and they're almost all CDC links. This kind of information control and lack of transparency isn't science, it's power dictating truth. The actual truth is that the risk of cancers as a result of HPV have a pretty high chance of being prevented if young females get the vaccine, but as you get further away from that group the risk avoided by getting vaccinated gets progressively smaller and runs into the safety uncertainty of taking the vaccine. When you're doing population level risk management you also have to do things like comparing the risk of getting hit by a bus going to the clinic against whatever the clinic could do for you. It is often safer to do nothing than to avoid a very tiny risk because of the very mundane risks you face day to day.
  - const_cast 2y ago
    You're missing important stuff here, most notably that recommendations are also based on availability. As the vaccine became more available, more demographics were recommended to take it. Obviously, in the beginning, you want the highest risk groups to take it, then you grow the radius. They didn't use young girls as some safety experiment. They just had the largest benefit and so, in scarcity, they're prioritized. It's not that scarce anymore. As an aside, the HPV vaccine also prevents some male cancers, like penile cancer. It also prevents cosmetic, but relatively safe, conditions - like genital and anal warts. That's not the goal of the vaccine so it's not really taken into account. But you, someone who may take the vaccine, should consider it anyway.
thrill 2y ago
US citizens used to value the adults managing such science oriented endeavors actually doing their homework before making broad proclamations of efficacy. Lately, not so much.
- bobmcnamara 2y ago
  Blame the cold war for that one.
chimeracoder 2y ago
> If it has an association with preventing cancers, not sure why they were so reluctant to immediately open up the patient pool. Because approval involves evaluating a risk-benefit tradeoff, and the benefits for those groups are wildly different, as are the risk profiles, due to the way HPV strains[0] work. If they tested against a wide and heterogenous population from the start, it would risk demonstrating insufficient effect, which would eliminate the possibility of the vaccine for everyone. Instead, by testing against the group most likely to benefit from it (women, and specifically women of the age to have no prior exposure to HPV) they can see whether the vaccine has any potential at all, and expand from there. As it turns out, the vaccine was incredibly effective for them, and as we studied it further, it turned out that other groups which had potentially lower benefits (men, older women) or higher potential risks (teenage girls) had a risk-benefit tradeoff that still overwhelmingly supported approval for those groups. [0] yes, plural, because there are hundrends, and the vaccines (again, plural, because there are more than one) protect against a handful of them (although that fortunately includes the strains that account for 80-90% of HPV-caused cancers
hermannj314 2y ago
I am not sure why all the replies are indicating you are anti-science or anti-vax. It is annoying to be told something from your doctor, internalize it, have your doctor suggest flu and covid vaccine for years but never HPV, and then be told on HackerNews "you should have the HPV" and now I am supposed to tell my doctor I can do his job better than him because I read something on the internet even though most doctors specifically grimace when you do that? I think their Epic Health computer system that needs me to confirm my date of birth every 6 weeks can find some time to suggest the HPV vaccine if it is so damn medically necessary.
- chimeracoder 2y ago
  > I think their Epic Health computer system that needs me to confirm my date of birth every 6 weeks can find some time to suggest the HPV vaccine if it is so damn medically necessary. You're assuming that the purpose of the EHR (Epic) is to implement public health recommendations or to establish minimum standards of care. That's a reasonable assumption for someone who doesn't work in the field, but unfortunately it's incorrect: neither of those are top-level goals for EHRs.
  - Henchman21 2y ago
    What are? Let me make a cynical guess: 1. Reducing costs by hiring fewer people. 2. Increasing profits by decreasing care. Did I nail it or what?
    - thunderfork 2y ago
      [dead]
    - Fishkins 2y ago
      You're on the right track with money, but that's not exactly how I'd describe the goals. My impression is the primary goals are getting things coded and billed properly and thoroughly, and getting things documented in a way that minimizes legal liability.
  - 2y ago
tialaramex 2y ago
Medical ethics focus on the benefit to a specific individual - your patient. This defuses the "Should I kill one to save ten?" moral dilemma - the individual is your patient, even if the other ten are also your patients, you must not harm the one. But for vaccines it also means that the wider societal implications are not ethically relevant So, medics won't recommend that you give patient A an intervention which is of no benefit to A but is really helpful for everybody else. For example, that you vaccinate teenage boys in the expectation that this way they won't infect teenage girls (with whom statistically many of them will have sex) with an STI that harms those girls. As a result, the guidance cared about proven benefits to you even though taken neutrally you might have been enthusiastic about a vaccine that might or might not protect you but is definitely a good idea for the wider population. The initial studies understandably focused on the numerically larger problem: If we vaccine young female patients does that prevent relevant HPV infections, and then, as a proxy we might assume they also won't get cancer. Such studies can't tell you whether it prevents men getting cancer because that wasn't measured. So the recommendation to vaccinate boys was delayed because first somebody has to study what might seem obvious - does the vaccine also prevent HPV related cancers in males? It is, after all, possible that some subtle mechanism means the vaccine isn't effective for this purpose, and it would not be ethical to give schools full of boys a vaccine that they personally do not benefit from having - even if societally maybe that's a good choice. Beyond the female/ male differential, for adults and older, it's basically a stats game. Most adults have sex. Having sex means you're likely to contract HPV, more sex, more exposure. Is it worth getting vaccinated when there's a 50% chance it's useless? How about 95%? 99.5%? Do you always wait for the crossing lights? Did you ever drink beer or eat bacon ?
- odyssey7 2y ago
  You're not wrong about ethical considerations, but the CDC operates socially and politically as well. Back when the vaccine was new, an objection from some parents was that the vaccine might be viewed as a license or permission for their daughters to be promiscuous. There was a substantial headwind. The public wasn't yet generally aware that HPV could cause head, neck, and anal cancers in men. If a doctor approached a parent back in 2010 and said they wanted to vaccinate their son against head, neck, and anal cancer, that advice wouldn't have been heeded in many cases, and would have cost the CDC some amount of its standing with the public. When you hear something from the CDC, there's a decent possibility that it's a blend of medical advice that's been compromised with some value judgements that haven't been expressed to the listener.
iamtheworstdev 2y ago
With regards to HPV, when they tried recommmending (and even making it mandatory) for young print the Christian-right cried foul pretty hard. The Texas Governor got a heap of shit over it at the time because abstinence is the only thing teenagers should know about.
mschuster91 2y ago
> If it has an association with preventing cancers, not sure why they were so reluctant to immediately open up the patient pool. Multiple reasons. The first one is basic ethics. Similar on how you should do rolling upgrades of your SaaS software to catch errors before everything goes down, you got to do the same with vaccines. For there, go for the target group with the highest risk and highest potential of averting damage - and for the HPV vaccine, mid-20 women are the best such group: young enough that they might be lucky and not exposed yet, old enough to fall out of the scope of the usual ethics bureaucracy that (rightfully) comes with doing experimental research involving minors, and not so old that they definitely got exposed and making the effort moot. Then it got rolled out to teenage girls as it was proven safe, and eventually to men as well because we can be asymptomatic carriers (as we are for a lot of STDs). Obviously if you got the speed of Covid vaccines in mind as a comparison, the HSV vaccine appears slow in rollout speed - but please do not forget, the Covid vaccines went through very speedy trials. We were extremely lucky it worked out the way it did. The second one is availability. Again, unless it's Covid where everything went into full production power in a matter of months, production has to be ramped up carefully, matching rollout strategies - it doesn't make sense to have a mismatch into either direction. And the third one is time. With Covid, it was easy to prove effectiveness: the people that got the shot got Covid at waaaay lower rates than the control population (and the risks of side effect were way less than the risk of severe Covid). But with something like HPV that can have years if not decades worth of time between exposure and symptoms, it becomes harder to reasonably judge effectiveness and safety.
stubish 2y ago
You can only sell medication after trials. The first trials were on young women, and later trials on other groups. Nobody wanted to pay for trials on all demographics before there was evidence it worked from cheaper, more focused trial. There are also barriers to doing trials on high risk groups like the elderly without first testing on lower risk demographics. This is one reason why so much medication not to be used by pregnant women. The trials have not been done, and trials involving pregnant women are particularly expensive and risky.
drew870mitchell 2y ago
My guess is it's cost driven? IIRC insurance would not pay for mine when i was out of the recommendation pool but they did (were legally required to afaik) when the pool expanded to include my age group.

hgomersall 2y ago

Is the vaccine still useful post infection?

mv 2y ago
yes. many different strains and even if your body clears infection with one doesn’t protect against other strains
Traubenfuchs 2y ago
Anecdotal evidence of curative effects even for long term symptomatic infection exists.

basisword 2y ago

I know very little about this so excuse me if this is a stupid question. In my country all teenage girls have been getting the vaccine for at least the last 15-20 years. Therefore all of the women I'm likely to sleep with are vaccinated. Does it still make sense as a man to get it?

0cf8612b2e1e 2y ago
I guess I am a weirdo, but vaccines are the closest thing we have to space magic. Generally, they are very safe and prevent some of the most devastating diseases. All for the most minor discomfort. I want everything I can get, even if I am unlikely to be exposed to the real infectious agent.
- kstrauser 2y ago
  Same. And while the shingles vaccine isn't fun, I've known enough people who described their bouts with shingles as "nearly suicide inducing" that I'll take a temporary minor discomfort that prevents me from ever having to deal with it.
kstrauser 2y ago
"All". Even if that's true, some time you might travel and be around women who aren't vaccinated, and you get an infection with something bearing the lovely name "genital warts". It has the long-term complications of "cancer of the cervix, vulva, vagina, penis, anus, mouth, tonsils, or throat". And you can give it to any other women you get with for the next few years, potentially giving them any of those relevant cancers. So yes. It absolutely makes sense for a man to get it. For selfish reasons, you probably don't want penis cancer. For non-selfish ones, you don't want give other partners cervical cancer.
bawolff 2y ago
Vaccines aren't 100% effective. I'm not sure what the effectiveness of the hpv vaccine is, but if it was 95% effective (totally made up number, i dont know what the real one is), then there is a 1 in 20 chance it wont work for someone. If both of you have the vaccine then the chance of both failing would go down to 1 in 400. That seems worthwhile to me, given there is basically no downside. (I guess this doesn't account for the affects of herd immunity)

yjftsjthsd-h 2y ago

What if I'm monogamous?

SketchySeaBeast 2y ago
That's what I'm wondering as well. I've been monogamous for a decade and a half now. If that changes I'll get the vaccine, but right now if either of us had it we both do.
apt-apt-apt-apt 2y ago
Even if you are, your partner may not be. Or, god forbid, you could be sexually assaulted. Low, but non-zero chances.
pitpatagain 2y ago
Obviously then your risks are lower, but even then not zero. A dear friend of mine went through stage 4 HPV related cancer after a long "monogamous" marriage. It turned out that it wasn't actually monogamous on the part of her (now ex) husband. It's excessive to say literally everyone should get the vaccine: if you are especially low risk and don't want to bother, sure. But it's a very easy, safe vaccine. Most people engaging in some average amount of life-time serial monogamy (or with a partner who engaged in serial monogamy) would be better off just getting the vaccine than spending any mental energy on trying to figure out exactly the degree to which they need it.

amanaplanacanal 2y ago

The CDC is still not recommending the vaccine for people over 45.

robotnikman 2y ago

I've thought about getting one myself, since I identify as a gay man. Though last I checked it was not covered by my insurance...

arcmechanica 2y ago
https://www.goodrx.com/gardasil-9 https://www.goodrx.com/gardasil-9

unavoidable 2y ago

While this advice is good, the article is discussing HSV (herpes simplex virus), not HPV (human papilloma virus), which have quite different symptoms and epidemiology. There are, as yet, no approved HSV vaccines.

sitkack 2y ago
Second part of the PSA, one should keep prophylactic antiviral medication on hand incase you get exposed to someone with HSV. With 60% of the population positive for HSV, everyone should have an antiviral on hand. acyclovir, famciclovir and valaciclovir https://www.ncbi.nlm.nih.gov/books/NBK525787/ https://www.ncbi.nlm.nih.gov/books/NBK525787/
- OutOfHere 2y ago
  And where/how does one acquire them from?
  - yakshaving_jgt 2y ago
    They’re available OTC basically everywhere.
    - OutOfHere 2y ago
      They're not OTC medicines. They are prescription-only medicines.
      - sitkack 2y ago
        Prescriptions are easy to come by. Talk to people, their signature unlocks worlds.
        dylanmulvaney 2y ago
        [dead]
      - 2y ago

offmycloud 2y ago

> PSA, everyone should be getting the HPV vaccine, regardless of age and gender. This is false, please don't take medical advice from an HN post. CDC guidelines do include quite a bit of discussion of patient age. [1] 1. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...

colechristensen 2y ago
Either the vaccine has notable safety issues or it should be at least fine to get the vaccine at an older age. The reason many people don't trust the CDC's advice is they don't really tell you why or why not. If you're over 26 you're pretty likely to already be exposed to HPV but not necessarily every strain which would be protected by the vaccine (as it says in the article). So this pushes the question: why shouldn't I get it even if there's only a small chance it will be beneficial at my age? Is there really a risk they're not telling me about or are they giving bullshit answers? There isn't a third direction.
- js2 2y ago
  Vaccine recommendations are based on more than just safety. Efficacy, cost, availability, and prioritization are also considerations. > Compared with the benefit of the existing HPV vaccination program for adolescents and young adults through age 26 years, the additional benefit of vaccinating people age 27 through 45 years would be minimal. > Given abundant evidence for safety of HPV vaccines, undesirable anticipated effects are minimal. Also, anticipated population-level benefits are minimal for vaccinating adults over age 26 years. In this scenario, other considerations including cost-effectiveness play an important role in guiding policy-making. https://www.cdc.gov/acip/evidence-to-recommendations/HPV-adults-etr.html https://www.cdc.gov/acip/evidence-to-recommendations/HPV-adu... Elsewhere: > There’s not a safety issue past age 45. We just aren’t sure how much the vaccine will help men and women who are past that age, because so many of us have acquired HPV by that point, and because it takes many years for cancer to develop after acquiring the virus. However, as the average life expectancy increases, it may benefit the population to increase the age limit for HPV vaccination as well. https://www.mskcc.org/news/think-you-re-too-old-get-hpv-vaccine-prevent-cancer-maybe-not https://www.mskcc.org/news/think-you-re-too-old-get-hpv-vacc...

Rendello 2y ago

I decided to get it and saw it listed as $160 per dose on the health provider's website. I decided to bite the bullet and get it. When I got the prescription filled at the pharmacy, it was $265 for the first round of three. I want the next two but it's crazy to think I'd be paying like $800 (Canada).