6 ms·

But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gard

by stared 9mo 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 9mo ago
Does the vaccine guarantee immunity, by contrast?
- timr 9mo 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!
  - peab 9mo ago
    What if you're married? Does it still make sense, if you know you won't ever be sleeping with a new partner?
    - timr 9mo ago
      A question for your doctor and your partner (and of course, you can read the data in the link I posted above and use that to influence your conversation and decision!) I'm not being avoidant here -- medical decisions are always subjective and multi-factor, and I can't begin to tell you what you should do. (But I also sincerely believe that propagandists try to reduce nuanced data to talking points, which is equally wrong.) Please note the caveat about gender that I just added. The data for biological men and women are very different. Also, I haven't discussed risks at all, which is the other side of the ledger -- these vaccines are pretty darned safe, but everything comes with risk, and only you can decide what level of risk is appropriate for your life.
      - rawgabbit 9mo ago
        I usually am pro vaccine. But the HPV vaccine discussion seems politicized to me. As someone who is monogamous and over fifty, I had trouble following the risk vs reward discussion. The CDC says it is only recommended for young adults so I interpret that for my case the answer is negative.
        electriclove 9mo ago
        Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents.
        daveungerer 9mo ago
        > Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents. Did I read this correctly? You are going to decide for your children based on their plans to be monogamous? And you’re also going to decide for your parents? I can only assume you’re in the unfortunate situation where your parents are no longer capable of making decisions?
- tialaramex 9mo ago
  It's never a guarantee in practice, the CDC says "More than 98% of recipients develop an antibody response to HPV types included in the respective vaccines 1 month after completing a full vaccination series"

by stared 9mo ago

hammock 9mo ago

Does the vaccine guarantee immunity, by contrast?

timr 9mo 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!
- peab 9mo ago
  What if you're married? Does it still make sense, if you know you won't ever be sleeping with a new partner?
  - timr 9mo ago
    A question for your doctor and your partner (and of course, you can read the data in the link I posted above and use that to influence your conversation and decision!) I'm not being avoidant here -- medical decisions are always subjective and multi-factor, and I can't begin to tell you what you should do. (But I also sincerely believe that propagandists try to reduce nuanced data to talking points, which is equally wrong.) Please note the caveat about gender that I just added. The data for biological men and women are very different. Also, I haven't discussed risks at all, which is the other side of the ledger -- these vaccines are pretty darned safe, but everything comes with risk, and only you can decide what level of risk is appropriate for your life.
    - rawgabbit 9mo ago
      I usually am pro vaccine. But the HPV vaccine discussion seems politicized to me. As someone who is monogamous and over fifty, I had trouble following the risk vs reward discussion. The CDC says it is only recommended for young adults so I interpret that for my case the answer is negative.
      - electriclove 9mo ago
        Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents.
        daveungerer 9mo ago
        > Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents. Did I read this correctly? You are going to decide for your children based on their plans to be monogamous? And you’re also going to decide for your parents? I can only assume you’re in the unfortunate situation where your parents are no longer capable of making decisions?
tialaramex 9mo ago
It's never a guarantee in practice, the CDC says "More than 98% of recipients develop an antibody response to HPV types included in the respective vaccines 1 month after completing a full vaccination series"