7 ms·

>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. This statistic seems to be used by some people to avoid

by phkahler 10mo ago

>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common.

michaelrpeskin 10mo ago
Yeah, I only read the abstract and looked at the plots, but this is what I hate about public health papers: They say the prevalence of virus is down. They don't say that the cancer rate is down (granted too early to tell), nor do they talk about any adverse events or all cause mortality differences (again, probably too early to tell) The only thing they can conclude is that the treatment given to stop the virus, stops the virus. But they don't mention any tradeoffs. Not trying to be an anti-vaxxer conspiracy theorist, but good science needs to talk about the whole picture.
- gizmo686 10mo ago
  Research papers are not literature reviews. This paper reports on the results of this study. And that study only investigated what it investigated. In the case of public health, there are a bunch of organizations that keep on top of the research and maintain a more comprehensive view of their perception of the current consensus. For day to day guidance, individuals should be referring to either those sources, or healthcare professionals. If people are looking at individual studies like this to make decisions, something has gone very wrong.
- wat10000 10mo ago
  You can’t talk about the whole picture unless you have all the parts. There’s no reason all of those parts have to come from the same study. The first thing on your list of complaints is something that by your own admission cannot yet be determined. If you’re not trying to be an anti-vaxxer, you’re doing a bad job of it.
- okaram 10mo ago
  This is one research paper reporting on particular results. It is DEFINITELY not too early to tell. Cervical cancer rates in Australia, which adopted the vaccine widely and early have decreased, and it has been widely reported ( https://www.canceraustralia.gov.au/cancer-types/cervical-cancer/cervical-cancer-australia-statistics https://www.canceraustralia.gov.au/cancer-types/cervical-can... )
- deleted 10mo ago
  [deleted]
stared 10mo ago
But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gardasil-9, which I took as a male at age 35) protects against nine specific strains. Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body). People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case!
- hammock 10mo ago
  Does the vaccine guarantee immunity, by contrast?
  - timr 10mo ago
    Parent is overstating the case. Neither infection nor vaccination provides sterilizing immunity [1], but the general reasons to prefer vaccination are (in order of descending quality of evidence & reasoning): 1) you probably haven't had all N strains yet. 2a) you likely haven't been infected with the ones that cause cancer, because they're relatively rare. 2b) ...that is especially true if you're young and not sexually active. 2) being infected with one strain does not provide sterilizing cross-immunity against the other strains. 3) even if you've been infected with a strain, some of the vaccines have been shown to prevent reinfection and reactivation better than natural infection alone. 4) in general, the vaccination-mediated immunity might last longer or be "stronger" than the natural version, since the vaccines are pretty immunogenic, and the viruses are not. But for point 4, it's well-known that vaccine efficacy is lower for people who have already seroconverted (cf [1]), so there's clearly some amount of practical immunity provided by infection. [1] The vaccines are roughly 90% effective for the major cancer-causing strains, but it's not a simple answer, and varies a lot by how you frame the question. See table 2 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/ Also be sure to see table 4 if you're a man. The data for biological men and women are surprisingly different!
    - 10mo ago
hammock 10mo ago
What about the people who know they have 16 or 18? Should they still get it?
- 0ld 10mo ago
  Yes. It would still protect you from the other strains and reduce risks of reinfection by the strains you already have, which is the main issue preventing your immune system from clearing the infection up by itself https://www.sciencedirect.com/science/article/pii/S0264410X23009908#:~:text=Abstract,not%20benefit%20from%20prophylactic%20vaccines. https://www.sciencedirect.com/science/article/pii/S0264410X2...
TuringNYC 10mo ago
>>>>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. >> This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common. As people cite these statistics, it would be useful to distinguish exposure to HPV causing foot warts, etc from the much more dangerous variants. I rarely see any statistics do this sort of segmentation.
- stared 10mo ago
  > I rarely see any statistics do this sort of segmentation. There are multiple publications. THe easiest way to find is Gemini 3 Pro or ChatGPT Thinking + find for publications (go to link, not just rely on summary). They differ by population and methodology. For example, here is "Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia", 2023, https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/
kevin_thibedeau 10mo ago
> This statistic seems to be used by some people to avoid the vaccine The FDA itself restricted access to the vaccine on the basis of age. Given that virions aren't even involved in the production process, its safety should have been deemed good enough for the entire population early on.
- bboygravity 10mo ago
  The reason it's not recommended for all ages is money. Not safety concerns. Same reason you can't get Shingrix under a certain age.
  - lotsofpulp 10mo ago
    I would happily pay for Shingrix.
    - anjel 10mo ago
      Prepare your happy for a very profit-laden high three-figure bill.
      - lotsofpulp 10mo ago
        Luckily, I can afford $999 to avoid experiencing Shingles.
      - CydeWeys 10mo ago
        Your average HN reader can absolutely afford paying a few hundred bucks to avoid getting a potentially life-changing disease, and should. I know multiple young adults who got messed up by shingles.
      - happymellon 10mo ago
        You can get it in the UK, unsubsidised from a profit driven private company, for a mid-three figure amount. https://www.boots.com/online/pharmacy-services/shingles-vaccination-service https://www.boots.com/online/pharmacy-services/shingles-vacc... > Price per dose:£230 > Full course (2 doses):£460
loeg 10mo ago
I mostly hear this from healthcare-fatalists arguing against people in their 40s+ getting the vaccine later in life.

michaelrpeskin 10mo ago

Yeah, I only read the abstract and looked at the plots, but this is what I hate about public health papers: They say the prevalence of virus is down. They don't say that the cancer rate is down (granted too early to tell), nor do they talk about any adverse events or all cause mortality differences (again, probably too early to tell) The only thing they can conclude is that the treatment given to stop the virus, stops the virus. But they don't mention any tradeoffs. Not trying to be an anti-vaxxer conspiracy theorist, but good science needs to talk about the whole picture.

gizmo686 10mo ago
Research papers are not literature reviews. This paper reports on the results of this study. And that study only investigated what it investigated. In the case of public health, there are a bunch of organizations that keep on top of the research and maintain a more comprehensive view of their perception of the current consensus. For day to day guidance, individuals should be referring to either those sources, or healthcare professionals. If people are looking at individual studies like this to make decisions, something has gone very wrong.
wat10000 10mo ago
You can’t talk about the whole picture unless you have all the parts. There’s no reason all of those parts have to come from the same study. The first thing on your list of complaints is something that by your own admission cannot yet be determined. If you’re not trying to be an anti-vaxxer, you’re doing a bad job of it.
okaram 10mo ago
This is one research paper reporting on particular results. It is DEFINITELY not too early to tell. Cervical cancer rates in Australia, which adopted the vaccine widely and early have decreased, and it has been widely reported ( https://www.canceraustralia.gov.au/cancer-types/cervical-cancer/cervical-cancer-australia-statistics https://www.canceraustralia.gov.au/cancer-types/cervical-can... )
deleted 10mo ago
[deleted]

stared 10mo ago

But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gardasil-9, which I took as a male at age 35) protects against nine specific strains. Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body). People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case!

hammock 10mo ago
Does the vaccine guarantee immunity, by contrast?
- timr 10mo ago
  Parent is overstating the case. Neither infection nor vaccination provides sterilizing immunity [1], but the general reasons to prefer vaccination are (in order of descending quality of evidence & reasoning): 1) you probably haven't had all N strains yet. 2a) you likely haven't been infected with the ones that cause cancer, because they're relatively rare. 2b) ...that is especially true if you're young and not sexually active. 2) being infected with one strain does not provide sterilizing cross-immunity against the other strains. 3) even if you've been infected with a strain, some of the vaccines have been shown to prevent reinfection and reactivation better than natural infection alone. 4) in general, the vaccination-mediated immunity might last longer or be "stronger" than the natural version, since the vaccines are pretty immunogenic, and the viruses are not. But for point 4, it's well-known that vaccine efficacy is lower for people who have already seroconverted (cf [1]), so there's clearly some amount of practical immunity provided by infection. [1] The vaccines are roughly 90% effective for the major cancer-causing strains, but it's not a simple answer, and varies a lot by how you frame the question. See table 2 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/ Also be sure to see table 4 if you're a man. The data for biological men and women are surprisingly different!
  - 10mo ago

hammock 10mo ago

What about the people who know they have 16 or 18? Should they still get it?

0ld 10mo ago
Yes. It would still protect you from the other strains and reduce risks of reinfection by the strains you already have, which is the main issue preventing your immune system from clearing the infection up by itself https://www.sciencedirect.com/science/article/pii/S0264410X23009908#:~:text=Abstract,not%20benefit%20from%20prophylactic%20vaccines. https://www.sciencedirect.com/science/article/pii/S0264410X2...

TuringNYC 10mo ago

>>>>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. >> This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common. As people cite these statistics, it would be useful to distinguish exposure to HPV causing foot warts, etc from the much more dangerous variants. I rarely see any statistics do this sort of segmentation.

stared 10mo ago
> I rarely see any statistics do this sort of segmentation. There are multiple publications. THe easiest way to find is Gemini 3 Pro or ChatGPT Thinking + find for publications (go to link, not just rely on summary). They differ by population and methodology. For example, here is "Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia", 2023, https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/

kevin_thibedeau 10mo ago

> This statistic seems to be used by some people to avoid the vaccine The FDA itself restricted access to the vaccine on the basis of age. Given that virions aren't even involved in the production process, its safety should have been deemed good enough for the entire population early on.

bboygravity 10mo ago
The reason it's not recommended for all ages is money. Not safety concerns. Same reason you can't get Shingrix under a certain age.
- lotsofpulp 10mo ago
  I would happily pay for Shingrix.
  - anjel 10mo ago
    Prepare your happy for a very profit-laden high three-figure bill.
    - lotsofpulp 10mo ago
      Luckily, I can afford $999 to avoid experiencing Shingles.
    - CydeWeys 10mo ago
      Your average HN reader can absolutely afford paying a few hundred bucks to avoid getting a potentially life-changing disease, and should. I know multiple young adults who got messed up by shingles.
    - happymellon 10mo ago
      You can get it in the UK, unsubsidised from a profit driven private company, for a mid-three figure amount. https://www.boots.com/online/pharmacy-services/shingles-vaccination-service https://www.boots.com/online/pharmacy-services/shingles-vacc... > Price per dose:£230 > Full course (2 doses):£460

loeg 10mo ago

I mostly hear this from healthcare-fatalists arguing against people in their 40s+ getting the vaccine later in life.