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.
I also got the vaccine at 44 (years later than it is recommended where I live in Europe), because:
- It targets multiple HPV strains, and even though I've been sexually active, I'm probably unlikely to have all of them, so there is some future protection
- It helps prevent reinfection
- There is evidence that it helps reduce the risk of progression to a cancerous state, which is also something that can happen for males
I didn't even bother to talk to a doctor, I just called a women's clinic, made an appointment, and paid for it myself. They were surprised, but super happy and supportive.
All three injections cost me the equivalent of 160 US$.
I remember reading about this about a year ago, so I'm not sure what the source was and how reliable it was, but I found this meta-analysis of studies researching the effect of the vaccine on people who had previously already received treatment for HPV:
https://pmc.ncbi.nlm.nih.gov/articles/PMC8879645/
This seems to indicate that the vaccine reduces the risk of finding abnormal cells and precancerous lesions for people who already have HPV.
> called a women's clinic, made an appointment, and paid for it myself
Planned Parenthood is great for this kind of thing in the US. I don't know what they charge but just checked and at least the one I've gone to in the past has it.
I got it when I was around 40. Before getting the three doses, I would get 3-4 nasty viral sore throats per year (white blistery lesions, very painful). Now I get zero. I was probably on my way to getting throat cancer like Michael Douglas. Hopefully I have avoided or at least forestalled that.
I don't think it's been tested in studies, but I can offer that I had hand warts for 7 years until I got the HPV vaccine, and the hand warts suddenly disappeared after dose 2.
HPV functions by cloaking itself from your immune system. The reason why treatments like freezing work is not by removing the HPV -- it's by stimulating your immune system to look at the area around the wart. Then your immune system can get past the cloaking, and recognize the HPV, and then it destroys it.
So functionally, it makes total sense that the HPV vaccine would clear existing infections, and anecdotally, lots of patients (such as myself) have seen HPV clear after getting the vaccine. It's a shame that our bureaucracy doesn't have the incentives to run the studies to acknowledge it institutionally.
From my understanding most vaccines have never been compared against placebo trials, but would be happy to be proven wrong, e.g. if you can find a study on HPV vaccine.
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.
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.
I live out of the country and visit once per year. I'm 49 and it was absolutely impossible to receive the shingles vaccination, even if I paid cash. Ridiculous.
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.
I feel annoyed that it seems the system conflates guidelines due to economic reasons with medically indicated ones. And with the HPV vax they keep upping the age limit. Bonus was the British study that showed a clear decline in dementia in elderly that got the shingles vax. Shows up because almost everyone born before a hard date got it and no one after did.
Agreed. And by the logic whereby everybody over a certain age is more likely to already have HPV if they were "active", vaccination should be even more recommended to people >45 who start dating again after a monogamous life, right? Because the assumption would be that they don't have it yet, and they are now starting to have sexual encounters with people who are more likely to have it.
More couples are divorcing after age 50 than ever before, so this is not just abstract theory.
Also last time I checked the statistics for HPV strains like HPV-6 or HPV-16, only 5% or less of males were infected by that specific strain. So on a single-strain basis it's not quite "you probably already have it". Cumulatively, it is no doubt higher considering all strains, but the argument against vaccination for all strains on the basis that recipients may already have a few of those strains seems flawed.
As I male, I paid for mine (Gardasil-9, protecting against 9 types of HPV).
There are two reasons: one is for personal protection (and most throat cancers are caused by HPV, odds which are likely much more skewed if one does not smoke), and the other is epidemiological - protecting other people, dear ones directly, and the rest of the population by extension.
The myth that it is "only for teenagers" or "before sexual interactions" is a myth. I mean, the ideal scenario is to vaccinate before any potential for infection. Yet, plans to have any sex life it is beneficial. AFAIK, it even helps to clear out existing infections (and well, 80% of men and 90% of women get HPV at least once in their lifetime).
>schedule says not to get the HPV vaccine if you’re over 45. That means that insurance won’t cover it
If it makes you feel any better I live in an EU country with one of the best healthcare systems, or so we keep hearing, and here the public health insurance only covers it for those under 30. What a joke.
And Europeans keep saying how much worse the American system is.
Here it actually depends on which pseudo-private-public insurer you have. Most have age limits for coverage, the most common one being 25 or 26. The lowest seems to be 19 (what a joke, it's in the catalog for <=18), many don't cover it at all. Total cost (no discounts, since not covered) seems to be about 700-800 €.
> And Europeans keep saying how much worse the American system is.
There's a reason the comparison is always the average/median situation in the EU vs. the worst possible situation you could be in the US.
You can almost certainly obtain it privately and still pay far less for healthcare than the Americans, given under the US system they pay more in taxes towards healthcare per capita than most of the rest of the world - including many European countries - and still need private insurance.
In most of Europe you can also still get increased private cover on top of the public cover if you choose and still end up paying a fraction of what the average American pays - you're just always guaranteed a baseline cover.
While that might be literally true depending how it’s measured, a majority of employees (especially professional types) don’t pay for their insurance unless they want to cover their family.
Like with anything in American healthcare, it’s complicated:
I don't know about the quality of our local healthcare system, but I'm a little annoyed that I didn't qualify for the free HPV vaccination but people two years younger than me did. The government invited anyone born in an 8 year period and about 20% responded. I wish they'd given me the option to take part in the program even if I wasn't actively invited, it's not like there's a shortage because of high demand; even among kids the vaccination rates are only at 50% to 60% thanks to the rise of antivax parents and covid misinformation.
I'm not going to start a fight with the local healthcare call center to let me pay the 200-300 euros for a vaccination they think I shouldn't be getting according to every piece of information they publish about it. I know the government is trying to cut costs on healthcare and all, but the resistance the idea that someone without a cervix may benefit from a HPV vaccination annoys me to no end.
Out of all possible healthcare cost cutting measures, charging hundreds for vaccines against diseases that are widely present within the borders of the country must be the stupidest.
That said, I'd much rather take the annoying European healthcare system over the American one. I can get every vaccine out of pocket twice a year and still be cheaper off than with your average American health insurance.
Your profile indicates you’re Dutch, so you can just ask your huisarts or local GGD for the vaccine, no fighting necessary. I did this myself a few years ago.
Are you suggesting you’re going to be having multiple partners while in that relationship? If so then sure it might be a benefit (assuming neither was already infected) though having her get the shot would still be a good idea even if you had already received it.
Anyway, at 45+ we are talking something in the range of 10’s of million dollars per cancer case prevented depending on assumptions. That doesn’t mean it’s a terrible idea, just that there’s probably somewhere more productive to do with those resources.
Who’s to say? Maybe I’m a swinger? Maybe I’m divorced? Maybe I’m dating a few people? Maybe that relationship will run its course?
HPV isn’t an STD that condoms address from a risk mitigation perspective. If I’m an adult and identify a risk to my doctor, why shouldn’t a cheap safe and reliable preventative measure not be accessible?
It’s a bizarre proposition to be tabulating the potential future value in this conversation. I can casually ask my doctor for a cialis prescription, which has a similar cost and it will be covered, no problem. If i have a wart caused by an HPV variant, it will be frozen off for a few hundred bucks, no problem.
I think the reality is that the age ranges were picked because for the purposes of the trial process, it was the most convenient.
> If I’m an adult and identify a risk to my doctor, why shouldn’t a cheap safe and reliable preventative measure not be accessible?
I wouldn’t call it cheap, but it is available unsubsidized. Which makes sense from the perspective of society in terms of cost vs benefits. Your personal income and risk profile may mean spending money on this is worth it to you, but society is just focusing on averages.
You may think it bizarre but consider this logic.
Let’s suppose for the average 12 year old the number works out to 1 million dollars per cancer prevented. But for 60 year olds it’s 100 million dollars prevents a single cancer on average. The difference coming from reduced future partners, prior exposure, and reduced remaining lifespan. (By reduced future partners, I mean most people have partners between the ages of 12 and 60, so a 12 year old is taking those risks plus the risks from partners after 60.)
Now a billionaire may be happy at even 100 million per prevented cancer, but I think the general public would prefer lower premiums/taxes instead. 45 years old isn’t some magic number it’s just somewhere between extremes. Other countries are using much younger ages.
Im not talking about mandatory vaccination - just allowing it to happen.
We don’t apply this logic for most other conditions. I was able to get vaccinated for pneumonia in my 30s because I was a caregiver for my ailing father. It’s not a requirement to get that vaccination, but it made sense given the risk to my father.
So I guess I don’t understand why risk to my 80 year dad was worthy of preventative vaccination, but cancer risk to my current or future partners (or their partners) is not. It’s not cost, as given his health at the time, my dad would be dead in days with pneumonia.
> Im not talking about mandatory vaccination - just allowing it to happen.
It is allowed, however it isn’t subsidized because there is a high cost and minimal benefit. The pneumonia vaccine on the other hand is cheap and has a much larger benefit.
People over 45 are very likely to already infected with one or more strains at which point the vaccine does almost nothing. It’s far better to give that shot to the younger partner in such relationships because they are at risk either way.
Not medically necessary is a statement about cost vs utility.
Many vaccines such as for rabies fall into that category for the general public. Rabies is one of the deadliest diseases on the planet and the vaccine works just fine, but not enough people get infected each year to be worth it without some other risk factor.
PS: That sounded judgmental, I simply meant as a vaccine it doesn’t remove an existing infection. So multiple partners post 45 need to happen before it’s going to make a difference, but people with active sex lives are very likely already infected.
I consider this idiotic policy close to a public health scandal because:
- There are 200+ HPV strains, the vaccine is directed against the worst 9 but even provides cross protection to some more. You might have some of the magnificent 9, but not all.
- HPV strains can be overcome by the immune system and leave your body. You might get the vaccine while you currently have none of them.
- There is tentative evidence that the vaccine has curative effects.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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
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
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.
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.
> 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.
Sure, also amazing, pain management is really important. In tier list of amazing things I would put them below vaccines as preventing the disease is better than managing the symptoms, plus certain NSAIDs (usually when taken in higher doses or longer terms) can have real adverse effects.
Not sure what point you are trying to make with a banned medicine that causes heart problems. (Most) vaccines are proven to be incredibly safe, they are likely one of the most researched and rigorously tested medical interventions we have. If certain vaccines would have effects like Rofecoxib they would get banned as well (likely before reaching the public), that's how this works..
Unfortunately due to postrealist ideology supplanting fact-based reality, 40% of your scheduled elimination of disease will not be taking place as scheduled.
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.
I am now 31, was diagnosed stage 4b oral cancer in 2022 when I was 28 - underwent the same general surgery as parent comment to remove positive margins left after the initial biopsy of my tongue and almost all lymph nodes in the left side of my neck. I also underwent 6 weeks of radiation. I was not HPV positive and don't smoke or drink so doctors are still clueless as to why I developed cancer.
Can confirm radiation is brutal and almost indescribable. Everything tasted bitter and sulfurous for 6 months, even water. I had a feeding tube placed after not eating for 3 weeks and losing 25% of my body weight (roughly 35 pounds). I was days away from death. I would wake up every night with blood pouring out of my nose and was not able to open my jaw for almost a week. 2 years later, after many iterations of lymphedema, physical and speech therapy I am still in significant pain every day and cannot even swallow my own spit unless I am on narcotics around the clock. That in itself is a nightmare because finding a provider that will prescribe a steady supply of narcotics instead of pushing expensive procedures so they can get rich is difficult. I am routinely drug tested so I can get medications that prevent me from starving to death. It is humiliating.
I am lucky in that my speech is virtually the same as before treatment which is rare, and my taste has returned to normal. I would die of starvation without narcotics and I don't know if I will ever gain the energy and stamina to have children, and yet I still consider myself extremely well off compared to other survivors.
Please get vaccinated for HPV and lower your risk factors for oral cancer in general. It is one of the worst late stage cancers to recover from. You may be alive after the treatments but radiation will destroy your quality of life and you will likely be dependent on doctors for basic tasks for a long time, if not the rest of your existence. I don't want to think about what my life will be like if my cancer ever returns.
Wow that's brutal. I always thought of these cancers in terms of mortality, but for every lethal case there have to be dozens of hundreds of people that are non-lethally damaged by the disease.
The CDC does not "recommend" vaccinations over 45, mostly due to previous exposure. I suspect one can find doctors willing to do the vaccination for those over 45, though one may need to convince them.
Whether this is useful depends. HPV 16 and 18 are the "high risk" strains most associated with cancer. Depending on your sexual history, getting vaccinated at 45+ may be useful. Unfortunately, there's no reliable test for HPV 16 and 18 for those who have already had it.
The FDA approval is up to age 45, any use after 45 is off-label. Off-label prescribing is perfectly legal, but it might be difficult to find a medical provider willing to do it. You might have the best luck going to a place that specializes in sexual health (like Planned Parenthood).
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.
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.
COVID-19 is also transmissible to a lot of animals [1]. The Wikipedia link says "Most animal species that can get the virus have not been proven to be able to spread it back to humans", though I don't know if that's still the current consensus:
I thought we could have cut the entire thing short by vaccinating everyone who wanted it, and letting them quarantine, while at the same time encouraging everyone who didn't want to be vaccinated to socialize as much as possible (while watching hospital capacities carefully.)
There was this strange determination at the time, from every media and government outlet, not to accept that having had covid was as (or more) effective than taking the vaccine. And also not to accept that mass lockdowns were destructive. My grandfather was a victim of the lockdowns (as one of the many with vascular dementia who were kept going by being stimulated by family.) After 93 years of raising a family, he got to die alone, confused and isolated.
edit: it's all of the authoritative disinformation during covid that's threatening cervical cancer vaccination. It brought the thoroughly discredited anti-vaxxers of yore back into the (numerical) mainstream, and respected as heroes (JFK, Jr. for one example.) Wakefield's paper is just as stupid as it ever was, but now you will never convince the majority of Americans that vaccines don't cause autism. The Lancet is trash.
> I thought we could have cut the entire thing short by vaccinating everyone who wanted it, and letting them quarantine, while at the same time encouraging everyone who didn't want to be vaccinated to socialize as much as possible (while watching hospital capacities carefully.)
We sort of did do that because of how much policies varied from state to state and even from county to county or city to city within a state. For nearly any aspect of of pandemic response it is possible to find demographically similar counties that differed on that particular are and compare outcomes.
The current mRNA vaccines are moderately effective at preventing Covid infections, about on par with current flu vaccines.
Not all vaccines are equally effective, but none of them are 100% effective at preventing infections. The only thing vaccines do is prepare the immune system for an infection. Since SARS-CoV-2 mutations happen a lot faster than (for example) measles, Covid vaccines are a lot less effective - by the time you're infected, the infection is dissimilar enough to what the immune system was prepared for that the preparation is no longer optimal.
And yet there are still people that think it was supposed to in the first place. Thinking that makes it a failure, at least you don't think it's full of mind control tracking nanobots though. :D
Or maybe you are, since you used scare quotes. It's probably too late to share any facts with you at this point...
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.
Studies showed it decreased infection and transmission against the original strain of Covid.[0]
It lost effectiveness against delta and then became nearly ineffective against Omicron (although still helping with reduction of hospitalizations and deaths).
Non-mRNA vaccine is available now (Novavax) and the effectiveness, or lack thereof, seems similar.
"It is now clear for men <40, dose 2 and dose 3 of Pfizer have more myocarditis than sars-cov-2 infection, and this is true for dose 1 and dose 2 of Moderna."
You need to analyze the total risk of both options to state that getting vaccinated is more dangerous, not just the risk of myocarditis following each.
If you want to say you are doing science, then yes, you need to define what you mean by "healthy" and make the case that the harm from vaccination was greater in your group than the harm from infection.
If you want to say your subjective group is self evidently better off with some option, then don't say you are making a scientific argument.
Unfortunately I don't have the budget to fund a large RCT. It is also worrying that the companies and health authorities with the budgets haven't done so either.
Unless there is some unknown, long term effect from COVID that is yet to manifest itself, it is self-evident that the comment that "It was also more dangerous to healthy young men than just getting COVID, due to myocarditis." is "Absolutely not true" is incorrect.
You don't need an RCT. You need a study that compares COVID's many consequences and sequlae to the vaccine's myocarditis. Not COVID's myocarditis rate to the vaccine's myocarditis rate.
I can't find age-breakdown data of which specific complication causes the most death in COVID patients, but for the population broadly, it is multiple organ failure, then pneumonia and related pulmonary problems. Not myocarditis.
So if you're excluding the primary causes of death of COVID then sure, the tradeoff gets a lot less clear.
But the rate of myocarditis, even using the upper end numbers for the highest risk group, is also “effectively zero”! That pre-print shows myocarditis rate of 0.01% for men under 40.
The IFR for men between 35-39 is five and half times higher than that.
I wouldn’t mind common sense, but in lieu of that, some basic numeracy would be helpful.
Not sure but CV risk is the primary comorbidity that matters for young people wrt COVID, which is also the main contributing factor to myocarditis risk. So no reason to believe there’s a huge difference here.
> 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.
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.
>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.
>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.
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.
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.
Aha thank you! I really appreciate your feedback here. It's a bit more expensive here, just over 200 per injection but that sounds about right then. I will see about getting the 1 or 2 then!
I made the mistake of arguing with a somebody on facebook about Gardasil once. In the end I asked her flat out would she rather her daughter got cervical cancer, or had the vaccine. She said she chose cancer.
Some people you just can't reach. I stopped arguing at that point.
Do you think part of their resistance to the vaccine is that HPV is a sexually transmitted disease? The parent probably wants to believe that their daughter can avoid STIs ... because magically thinking.
If it is a pure STI it can be avoided by celibacy. This is not a protocol most humans are comfortable with though. Unfortunately most disease are just mainly spread through sexual contact and have additional vectors so vaccination might still be preferable
>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.
>> 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!
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.
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...
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?
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.
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)
> 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.
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.
> 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.
I’m a 38 year old male in the USA and I’ve had two out of three shots of gardasil 9, with my third (final) in a few months. There are multiple strains, so even if you have one, the vaccine will protect against the others.
You have to bring it up to the doctor yourself though.
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.
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.
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.
I was going to be traveling overseas, and was worried it would be required by a foreign country. I wanted all vaccines handled by my American GP, so the records would be in one place. I was very insistent: "Give me every vaccine for every country."
He said if I wanted the vaccine that bad, I'd have to get it overseas.
It wasn't approved by the FDA for those over 27 until October 2018. Now that it is, I think technically you need a prescription but requesting it through Walgreens/CVS/etc. means they handle that for you. (COVID/flu are similar - if I look at the records for CVS they show a "prescribing doctor" I've never seen.)
Interesting, at the Walgreens portal I don't see any prescribing doctor listed for any of the vaccinations I've gotten there.
In looking at the little pharmacy receipt they give you, there's certainly a prescription number, and a note that says "DR. AUTH REQUIRED" and at the top of the printout there's a field for "DOCTOR" but no value (like there is for "PATIENT"). I guess I have a question for next year, if I can remember!
I did find out that my state has a law that allows administration of flu vaccine by pharmacists without a prescription. That doesn't account for COVID not having one listed, but maybe that's still part of the emergency use authorization?
> 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
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…
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.
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.'
How are the authors able to discern between vaccine related events, and non-vaccine related events? There is no oracle one can consult to determine this. That’s the entire point of having a second group which was not treated - to have a reference that one can compare against to determine if outcomes were correlated with the treatment. Even then, one cannot say with certainty if the events were caused by the treatment, or simply correlated; to say that all 231 distinct serious outcomes were not caused by the vaccine seems a very extreme statement to make, and can almost be disregarded prima facie; if the researchers were infallibly able to determine what adverse events were caused by the treatment, then why would they need another group to compare to?
Similarly, while there may be ethical concerns with using a placebo, statistics and biology do not care about ethical concerns. There are real results which come from medical treatments, and ignoring them does not make them go away; it just makes us ignorant of them.
You can just read the text, you know. It's fully and freely available online.
> None of the deaths were considered by the study investigators to be vaccine-related. The five deaths in the 9vHPV vaccine group were the result of suicide (15 days after vaccination dose 1), acute lymphocytic leukemia (diagnosed 27 days after vaccination dose 3), traffic accident (226 days after vaccination dose 3), hypovolemic shock and septic shock (531 days after vaccination dose 3), and sudden death (678 days after vaccination dose 3). The five deaths in the qHPV vaccine group were the result of accidental death (airplane accident 7 days after vaccination dose 3), spinal cord injury (141 days after vaccination dose 3), gastric adenocarcinoma (diagnosed 403 days after vaccination dose 3), cervical spinal cord injury (811 days after vaccination dose 3), and cerebral hemorrhage (1114 days after vaccination dose 3).
Yup! That’s exactly why they initially list every bad outcome before trying to rule it in/out.
For example, you might be tempted to dismiss deaths due to traffic accidents as being obviously unrelated to a drug. However, if there were a lot of them, it would be prudent to check for potential effects on reaction times or judgement.
My grandmother died of a cerebral hemorrhage. It wasn't because of the cholesterol medication she took. It was because she was on blood thinners, was old, and tripped and hit her head on the dresser while preparing for church.
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.
I can see how you'd end up with that interpretation but I was actually talking about Hodgkins, so in that case the placebo arm would in fact be basically a death sentence. You've got an aggressive cancer, and you've decided (or your treatment arm has decided) to just let it take its course.
> the use of a placebo was not considered to be acceptable for ethical reasons
The same bullshit reason they used to not do a controlled trial for COVID-19 vaccines. That's pseudo science.
I can't prove the efficacy and the safety so let me find a reason to remove any form of control to make more money and avoid class action lawsuits. The heath agencies have been completed hijacked.
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.
Would you please stop taking HN threads into hellish flamewar? It's not ok here, and your account unfortunately has a long history of doing a lot of it. I really don't want to ban you, but if you keep doing this, we're going to end up having to.
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?
The previous comment is very likely talking about RFK Jr. Trump promised him "a major health role" in his administration, and Kennedy already announced on Twitter that he plans to push Trump to make aggressive changes. Based on his views, it's not difficult to predict what they might mean for vaccines.
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.
Trump undermined initial vaccination efforts, defunded health agencies and downplayed the severity of the pandemic[0..2] and then took credit for all of it. He mocked masks and refused to wear a mask or get vaccinated[3..5], then he got vaccinated. And just days ago he said he would consider defunding schools that required vaccines[6].
No one is going to buy this narrative that Democrats were the anti-vaxxers all along and Trump and the Republicans were always pro-vaccine. All of this is recent history. It wasn't that long ago. We were all there. We remember how it was.
>>No one is going to buy this narrative that Democrats were the anti-vaxxers all along and Trump and the Republicans were always pro-vaccine. All of this is recent history. It wasn't that long ago. We were all there. We remember how it was.
No-one is saying that. It's just as false as it is to say the Republicans (and Trump) were never pro-vaccine. They were, but once a) the lack of severity of COVID was better understood, and b) the lack of effectiveness and the side effects of the vaccine became known, they became more sceptical.
And masks still don't work, and are a waste of time. The science tells us that.
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.
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.
"A CDC study examining HPV prevalence among sexually active females aged 14 to 24 demonstrated no net change in overall HPV infection rates following the introduction of the vaccine."
Not all HPV strains cause cancer, so it's not surprising that a vaccine that targets cancer-causing strains would decrease the prevalence of those strains, and, as a side effect, increase the prevalence of other strains. This is not a bug, this is the whole point.
"An exciting new study from Public Health Scotland (PHS), in collaboration with the Universities of Strathclyde and Edinburgh, shows that no cervical cancer cases have been detected in fully vaccinated women following the human papillomavirus (HPV) immunisation at age 12-13 since the programme started in Scotland in 2008. "
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.
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.
> 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.
It's wild that we've collectively passed that over. Heads should have rolled for that, all the way to the top of whoever had knowledge of that campaign.
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.
You're not the first to think this, but there isn't evidence for it - in fact there is evidence of less risky sex + less teen sex.
If we are just coming up with theories before looking at evidence you would imagine STDs benefitting from more risky sexual behaviour as it would be an advantage to them spreading.
It does to voters. Reducing the workload for healthcare providers is great if you believe in science, but half of voters in the US think they can cure COVID with a horse dewormer because they read it on the internet somewhere.
as HPV isn’t solely an STD, promiscuity isn’t required for exposure and is a red herring to being inoculated against it
I’m guessing your reply was about quantifying “strain on the healthcare system”, frequency of positive STD diagnosis and treatment is not as stressful as frequency of cancer diagnosis and treatment
HPV inoculation mitigates several cancers from manifesting and subsequently advancing, no matter how promiscuous people choose to be
on an individual basis, it is a low effort thing to take an HPV vaccine, no different than the regime for inoculating against chicken pox. its wild to think that if chickenpox was linked to cancers where genitalia happens to be and go, that developed nations around the world would have had issues rolling it out, like, get over it? People can consider changing their relationship with the government if they think state involvement is the same as its endorsement of contributing activities
"as HPV isn’t solely an STD, promiscuity isn’t required for exposure and is a red herring to being inoculated against it"
"HPV inoculation mitigates several cancers from manifesting and subsequently advancing, no matter how promiscuous people choose to be"
Right, there's different strains of HPV, often called types, and since the article focuses on their effect on cervical cancers, we are focused on the ones that are transmitted sexually, as those are the ones that cause cervical cancer.
"on an individual basis, it is a low effort thing to take an HPV vaccine, no different than the regime for inoculating against chicken pox. its wild to think that if chickenpox was linked to cancers where genitalia happens to be and go, that developed nations around the world would have had issues rolling it out, like, get over it? People can consider changing their relationship with the government if they think state involvement is the same as its endorsement of contributing activities"
I'm not familiar with how HPV relates to the state. But I would like to make clear that the locus of the cancer and the transmission route of the pathogen are NOT coincidences. Pathogens enter the body either through abrasions, and less commonly through mucous membrane absorption. The damage is caused not necessarily by the resources the pathogen parasites, but by the collateral damage the pathogen causes to enter the body. At any rate the damage is localized to the site the infection occured.
So yes, to the extent that HPV causes cervical cancer, it's an std. To the extent that it's not an std it doesn't cause cervical cancer.
There's other types of cancer that cause oropharyngeal cancer and are related to oral sex by the way. Same mechanism, so PSA if you love your partner don't be rough with them, you can literally hurt them in irreversible lasting ways.
You're assuming that STDs are the only thing keeping everyone from having 'infinite worldwide orgies'. That's certainly not the case. I think that's a very minor factor considering a condom takes most of that worry away already and most people never participate in an orgy in their life.
I do but I'm pretty kinky (and poly) :P but most people have pretty monogamous sex lives. It's societal standards that stop people from doing this, or they simply have no interest.
It's not like most married or dating couples are like "Hey will we do a movie or an orgy tonight? Let's do the movie because I'm worried about STDs". Could you really imagine that? Most people abhor the idea of having sex with lots of random people :)
In a society that didn't have all this ingrained religious programming that sex is somehow bad it might be true but this is not our reality.
Oh yeah, it was just hyperbole. I really do think that natural human promiscuity áttern involves more a facade of monogamy and "cheating" than simultaneous sex (I do think it's an event, and it has been claimed to be related to the mushroom shape of the glans).
Cheating promsicuity is probably the case for most primates, and certainly the case for many mammals as shown by their preference to mate during the dark.
It relates to paternity certainty and mate jealousy/protection, which is again, present in most species.
Ah yes the old "we shouldn't fix anything because people will do it more and it'll be a wash" argument. Complete nonsense. Your argument is, essentially, saying that we shouldn't make airplanes safer because if we did more people would fly and the deaths would remain the same. Does that pass the sniff test to you? Of course not. It only seems to make sense to you because of the little sprinkling of irrational puritanism you're including with your argument.
First of all calm down. Read what is there, not what you imagine to be there, or what you would like to be there so you can enter your rage trance.
I never said we shouldn't be making the vaccines or curing diseases or making airplines safer, just suggested that the death rate could remain constant.
"Wouldn’t this mean that promiscuity was increasing?"
Maybe it would mean that? I see the logic, we have more vaccines and cures now so to reach the same risk there would need to be more sex, according to the theory.
But it doesn't mean it is increasing now or that it generally increases over time.
As the risk of stds fluctuate, so would promiscuity, albeit with a time displacement and inversely of course.
So that's what the hypothesis would predict. A steep decrease in promiscuity following a pandemic, and then a gradual growth as a cure for it or vaccine is found.
Regarding the present time. I think we would be in a promiscuous phase, yes, the std risks are quite low.
Evidence? How about dropping marriage and increasing divorce rates? Divorces even peak in the aids pandemic. The effect of cures for gonorrhea ,clam etc.. I don't know exact dates, but generally it does coincide that we've been curing them for the past century and marriage is becoming less prevalent.
I offered marriage data, you rejected that, what is your threshold of evidence, do you want me to install cctvs and record people fucking? You tell me what type of evidence would satisfy you?
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.
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.
I also got the vaccine at 44 (years later than it is recommended where I live in Europe), because:
- It targets multiple HPV strains, and even though I've been sexually active, I'm probably unlikely to have all of them, so there is some future protection
- It helps prevent reinfection
- There is evidence that it helps reduce the risk of progression to a cancerous state, which is also something that can happen for males
I didn't even bother to talk to a doctor, I just called a women's clinic, made an appointment, and paid for it myself. They were surprised, but super happy and supportive.
All three injections cost me the equivalent of 160 US$.
What country is that? I'm 42, male/ Spain, and I also have to pay for them out of pocket, but it's around 190€ EACH of the three doses.
It's similarly expensive here in Singapore, so I got just one dose.
Some studies have suggested that even one dose of Gardasil 9 is enough:
https://www.thelancet.com/journals/langlo/article/PIIS2214-1...
https://pmc.ncbi.nlm.nih.gov/articles/PMC7455166/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10480621/
It's possible that I'm misremembering the cost and confusing the cost for a single injection with the total cost. It was a while ago.
> There is evidence that it helps reduce the risk of progression to a cancerous state
I have not been able to find this. Do you happen to have a link to a paper?
I remember reading about this about a year ago, so I'm not sure what the source was and how reliable it was, but I found this meta-analysis of studies researching the effect of the vaccine on people who had previously already received treatment for HPV: https://pmc.ncbi.nlm.nih.gov/articles/PMC8879645/
This seems to indicate that the vaccine reduces the risk of finding abnormal cells and precancerous lesions for people who already have HPV.
> called a women's clinic, made an appointment, and paid for it myself
Planned Parenthood is great for this kind of thing in the US. I don't know what they charge but just checked and at least the one I've gone to in the past has it.
70 eur in Slovenia: https://www.zd-lj.si/zdlj/index.php?option=com_content&view=...
>All three injections cost me the equivalent of 160 US$.
Oh wow in Germany it's 180€ a pop.
[flagged]
I got it when I was around 40. Before getting the three doses, I would get 3-4 nasty viral sore throats per year (white blistery lesions, very painful). Now I get zero. I was probably on my way to getting throat cancer like Michael Douglas. Hopefully I have avoided or at least forestalled that.
Thought it doesn't help against the strains that you're already infected with? Hence the min and max ages in the guidance.
There is some evidence that it can help against self inoculation and immune response to an existing infection
https://www.frontiersin.org/journals/immunology/articles/10....
https://www.sciencedirect.com/science/article/abs/pii/S00908...
From what I’ve seen, it’s been shown to be effective against existing infections, as well as preventing it from progressing to cancer.
I can't find anything about this, do you have any papers?
I don't think it's been tested in studies, but I can offer that I had hand warts for 7 years until I got the HPV vaccine, and the hand warts suddenly disappeared after dose 2.
HPV functions by cloaking itself from your immune system. The reason why treatments like freezing work is not by removing the HPV -- it's by stimulating your immune system to look at the area around the wart. Then your immune system can get past the cloaking, and recognize the HPV, and then it destroys it.
So functionally, it makes total sense that the HPV vaccine would clear existing infections, and anecdotally, lots of patients (such as myself) have seen HPV clear after getting the vaccine. It's a shame that our bureaucracy doesn't have the incentives to run the studies to acknowledge it institutionally.
From my understanding most vaccines have never been compared against placebo trials, but would be happy to be proven wrong, e.g. if you can find a study on HPV vaccine.
First hit on DDG: https://www.nejm.org/doi/full/1
Page doesn't seem to work.
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.
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.
I live out of the country and visit once per year. I'm 49 and it was absolutely impossible to receive the shingles vaccination, even if I paid cash. Ridiculous.
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!
I feel annoyed that it seems the system conflates guidelines due to economic reasons with medically indicated ones. And with the HPV vax they keep upping the age limit. Bonus was the British study that showed a clear decline in dementia in elderly that got the shingles vax. Shows up because almost everyone born before a hard date got it and no one after did.
Agreed. And by the logic whereby everybody over a certain age is more likely to already have HPV if they were "active", vaccination should be even more recommended to people >45 who start dating again after a monogamous life, right? Because the assumption would be that they don't have it yet, and they are now starting to have sexual encounters with people who are more likely to have it.
More couples are divorcing after age 50 than ever before, so this is not just abstract theory.
Also last time I checked the statistics for HPV strains like HPV-6 or HPV-16, only 5% or less of males were infected by that specific strain. So on a single-strain basis it's not quite "you probably already have it". Cumulatively, it is no doubt higher considering all strains, but the argument against vaccination for all strains on the basis that recipients may already have a few of those strains seems flawed.
As I male, I paid for mine (Gardasil-9, protecting against 9 types of HPV).
There are two reasons: one is for personal protection (and most throat cancers are caused by HPV, odds which are likely much more skewed if one does not smoke), and the other is epidemiological - protecting other people, dear ones directly, and the rest of the population by extension.
The myth that it is "only for teenagers" or "before sexual interactions" is a myth. I mean, the ideal scenario is to vaccinate before any potential for infection. Yet, plans to have any sex life it is beneficial. AFAIK, it even helps to clear out existing infections (and well, 80% of men and 90% of women get HPV at least once in their lifetime).
>schedule says not to get the HPV vaccine if you’re over 45. That means that insurance won’t cover it
If it makes you feel any better I live in an EU country with one of the best healthcare systems, or so we keep hearing, and here the public health insurance only covers it for those under 30. What a joke.
And Europeans keep saying how much worse the American system is.
Here it actually depends on which pseudo-private-public insurer you have. Most have age limits for coverage, the most common one being 25 or 26. The lowest seems to be 19 (what a joke, it's in the catalog for <=18), many don't cover it at all. Total cost (no discounts, since not covered) seems to be about 700-800 €.
> And Europeans keep saying how much worse the American system is.
There's a reason the comparison is always the average/median situation in the EU vs. the worst possible situation you could be in the US.
You can almost certainly obtain it privately and still pay far less for healthcare than the Americans, given under the US system they pay more in taxes towards healthcare per capita than most of the rest of the world - including many European countries - and still need private insurance.
In most of Europe you can also still get increased private cover on top of the public cover if you choose and still end up paying a fraction of what the average American pays - you're just always guaranteed a baseline cover.
Americans have their insurance paid by their employer.
In 2022, the average employee contribution to "employer-sponsored" healthcare in the US was $6400/year.
While that might be literally true depending how it’s measured, a majority of employees (especially professional types) don’t pay for their insurance unless they want to cover their family.
Like with anything in American healthcare, it’s complicated:
https://www.forbes.com/advisor/health-insurance/health-insur...
How much more disposable income does the average American have VS the average European? Americans spend more but they also have a lot more to spend.
I don't know about the quality of our local healthcare system, but I'm a little annoyed that I didn't qualify for the free HPV vaccination but people two years younger than me did. The government invited anyone born in an 8 year period and about 20% responded. I wish they'd given me the option to take part in the program even if I wasn't actively invited, it's not like there's a shortage because of high demand; even among kids the vaccination rates are only at 50% to 60% thanks to the rise of antivax parents and covid misinformation.
I'm not going to start a fight with the local healthcare call center to let me pay the 200-300 euros for a vaccination they think I shouldn't be getting according to every piece of information they publish about it. I know the government is trying to cut costs on healthcare and all, but the resistance the idea that someone without a cervix may benefit from a HPV vaccination annoys me to no end.
Out of all possible healthcare cost cutting measures, charging hundreds for vaccines against diseases that are widely present within the borders of the country must be the stupidest.
That said, I'd much rather take the annoying European healthcare system over the American one. I can get every vaccine out of pocket twice a year and still be cheaper off than with your average American health insurance.
Your profile indicates you’re Dutch, so you can just ask your huisarts or local GGD for the vaccine, no fighting necessary. I did this myself a few years ago.
You’ll have to pay for it yourself, though.
Info: https://www.rivm.nl/hpv-humaan-papillomavirus/vaccinatie-hpv...
Huh, every time I ask my huisarts for anything I get a dose of condescension and paracetamol.
> 200-300 euro
That cheap? In Austria it's 600 Euros. We're being ripped the fuck off.
It’s not just that older people are more likely to have HPV but also there’s significantly less time for it to progress to cancer at that age.
45 may be young enough to be worth it if the treatment was free, but at ~1,000$ the net benefit is more questionable.
I’m 47. My girlfriend is 32. Wouldn’t be nice to not unknowingly infect her with a virus that I cannot detect or control?
Are you suggesting you’re going to be having multiple partners while in that relationship? If so then sure it might be a benefit (assuming neither was already infected) though having her get the shot would still be a good idea even if you had already received it.
Anyway, at 45+ we are talking something in the range of 10’s of million dollars per cancer case prevented depending on assumptions. That doesn’t mean it’s a terrible idea, just that there’s probably somewhere more productive to do with those resources.
I didn’t read it judgmentally.
Who’s to say? Maybe I’m a swinger? Maybe I’m divorced? Maybe I’m dating a few people? Maybe that relationship will run its course?
HPV isn’t an STD that condoms address from a risk mitigation perspective. If I’m an adult and identify a risk to my doctor, why shouldn’t a cheap safe and reliable preventative measure not be accessible?
It’s a bizarre proposition to be tabulating the potential future value in this conversation. I can casually ask my doctor for a cialis prescription, which has a similar cost and it will be covered, no problem. If i have a wart caused by an HPV variant, it will be frozen off for a few hundred bucks, no problem.
I think the reality is that the age ranges were picked because for the purposes of the trial process, it was the most convenient.
> If I’m an adult and identify a risk to my doctor, why shouldn’t a cheap safe and reliable preventative measure not be accessible?
I wouldn’t call it cheap, but it is available unsubsidized. Which makes sense from the perspective of society in terms of cost vs benefits. Your personal income and risk profile may mean spending money on this is worth it to you, but society is just focusing on averages.
You may think it bizarre but consider this logic.
Let’s suppose for the average 12 year old the number works out to 1 million dollars per cancer prevented. But for 60 year olds it’s 100 million dollars prevents a single cancer on average. The difference coming from reduced future partners, prior exposure, and reduced remaining lifespan. (By reduced future partners, I mean most people have partners between the ages of 12 and 60, so a 12 year old is taking those risks plus the risks from partners after 60.)
Now a billionaire may be happy at even 100 million per prevented cancer, but I think the general public would prefer lower premiums/taxes instead. 45 years old isn’t some magic number it’s just somewhere between extremes. Other countries are using much younger ages.
Im not talking about mandatory vaccination - just allowing it to happen.
We don’t apply this logic for most other conditions. I was able to get vaccinated for pneumonia in my 30s because I was a caregiver for my ailing father. It’s not a requirement to get that vaccination, but it made sense given the risk to my father.
So I guess I don’t understand why risk to my 80 year dad was worthy of preventative vaccination, but cancer risk to my current or future partners (or their partners) is not. It’s not cost, as given his health at the time, my dad would be dead in days with pneumonia.
> Im not talking about mandatory vaccination - just allowing it to happen.
It is allowed, however it isn’t subsidized because there is a high cost and minimal benefit. The pneumonia vaccine on the other hand is cheap and has a much larger benefit.
People over 45 are very likely to already infected with one or more strains at which point the vaccine does almost nothing. It’s far better to give that shot to the younger partner in such relationships because they are at risk either way.
No, it’s not covered because it’s deemed to be not medically necessary. I have to find a doctor to write a script off label and pay.
Your argument is logical, but isn’t the logic used for this purpose.
Not medically necessary is a statement about cost vs utility.
Many vaccines such as for rabies fall into that category for the general public. Rabies is one of the deadliest diseases on the planet and the vaccine works just fine, but not enough people get infected each year to be worth it without some other risk factor.
PS: That sounded judgmental, I simply meant as a vaccine it doesn’t remove an existing infection. So multiple partners post 45 need to happen before it’s going to make a difference, but people with active sex lives are very likely already infected.
I consider this idiotic policy close to a public health scandal because:
- There are 200+ HPV strains, the vaccine is directed against the worst 9 but even provides cross protection to some more. You might have some of the magnificent 9, but not all.
- HPV strains can be overcome by the immune system and leave your body. You might get the vaccine while you currently have none of them.
- There is tentative evidence that the vaccine has curative effects.
The typical Hacker News reader probably spends $180 on restaurants and takeout per week.
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.
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.
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.
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.
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.
HPV vaccine is also a big win for oral cancer, which pap smears and treatment didn't help with at all.
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/00...
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.
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.
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-...
https://www.who.int/publications/m/item/cervical-cancer-can-...
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/PIIS0140-6...
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.
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.
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.
> males must not be ignored and HPV must not be framed as female only issue
hear, hear.
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
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
Where do you live? 2000 USD is crazy.
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.
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.
> 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.
Rabies vaccine is about 10 USD in Thailand.
Source: https://www.thaitravelclinic.com/cost.html
I have first hand experience at this clinic. It is part of an excellent medical school in Bangkok.
Oh dear, your connecting flight has been cancelled, so now you die.
> Vaccines are one of the most amazing inventions
Sure, and so are NSAIDs, but I'm still not taking Rofecoxib (Vioxx).
> but I'm still not taking Rofecoxib
It's not that hard to avoid a drug withdrawn from the market 20 years ago though ..
Sure, also amazing, pain management is really important. In tier list of amazing things I would put them below vaccines as preventing the disease is better than managing the symptoms, plus certain NSAIDs (usually when taken in higher doses or longer terms) can have real adverse effects.
Not sure what point you are trying to make with a banned medicine that causes heart problems. (Most) vaccines are proven to be incredibly safe, they are likely one of the most researched and rigorously tested medical interventions we have. If certain vaccines would have effects like Rofecoxib they would get banned as well (likely before reaching the public), that's how this works..
Unfortunately due to postrealist ideology supplanting fact-based reality, 40% of your scheduled elimination of disease will not be taking place as scheduled.
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.
I am now 31, was diagnosed stage 4b oral cancer in 2022 when I was 28 - underwent the same general surgery as parent comment to remove positive margins left after the initial biopsy of my tongue and almost all lymph nodes in the left side of my neck. I also underwent 6 weeks of radiation. I was not HPV positive and don't smoke or drink so doctors are still clueless as to why I developed cancer.
Can confirm radiation is brutal and almost indescribable. Everything tasted bitter and sulfurous for 6 months, even water. I had a feeding tube placed after not eating for 3 weeks and losing 25% of my body weight (roughly 35 pounds). I was days away from death. I would wake up every night with blood pouring out of my nose and was not able to open my jaw for almost a week. 2 years later, after many iterations of lymphedema, physical and speech therapy I am still in significant pain every day and cannot even swallow my own spit unless I am on narcotics around the clock. That in itself is a nightmare because finding a provider that will prescribe a steady supply of narcotics instead of pushing expensive procedures so they can get rich is difficult. I am routinely drug tested so I can get medications that prevent me from starving to death. It is humiliating.
I am lucky in that my speech is virtually the same as before treatment which is rare, and my taste has returned to normal. I would die of starvation without narcotics and I don't know if I will ever gain the energy and stamina to have children, and yet I still consider myself extremely well off compared to other survivors.
Please get vaccinated for HPV and lower your risk factors for oral cancer in general. It is one of the worst late stage cancers to recover from. You may be alive after the treatments but radiation will destroy your quality of life and you will likely be dependent on doctors for basic tasks for a long time, if not the rest of your existence. I don't want to think about what my life will be like if my cancer ever returns.
Wow that's brutal. I always thought of these cancers in terms of mortality, but for every lethal case there have to be dozens of hundreds of people that are non-lethally damaged by the disease.
Congratulations on surviving!
Whenever you read some antivax/antimedicine nonsense online, watch the words… you’ll always hear about fatality.
Keyboard warriors don’t need to think about pain, suffering, and misery.
An immediate family member of mine lives with the same diminished quality of life as you. It is very significant. I wish you the best.
"In the US, almost anyone under 45 can get vaccinated."
Can you expand on this ?
Why can't people over the age of 45 be vaccinated ?
Is that restriction "on label" ?
The CDC does not "recommend" vaccinations over 45, mostly due to previous exposure. I suspect one can find doctors willing to do the vaccination for those over 45, though one may need to convince them.
Whether this is useful depends. HPV 16 and 18 are the "high risk" strains most associated with cancer. Depending on your sexual history, getting vaccinated at 45+ may be useful. Unfortunately, there's no reliable test for HPV 16 and 18 for those who have already had it.
https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
The FDA approval is up to age 45, any use after 45 is off-label. Off-label prescribing is perfectly legal, but it might be difficult to find a medical provider willing to do it. You might have the best luck going to a place that specializes in sexual health (like Planned Parenthood).
Wow, thanks for your story. I'm terrified of getting this too, and I've been wondering what it's like.
[dead]
> 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.
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/
Does that mean you can get certain HPVs via forms of non-sexual contact, such as handshakes, massages, etc.?
Yes, all warts are caused by HPV no matter where they appear
I really hope this happens, I'm a little cynical after hoping that we would come together and eradicate COVID 19.
COVID-19 is also transmissible to a lot of animals [1]. The Wikipedia link says "Most animal species that can get the virus have not been proven to be able to spread it back to humans", though I don't know if that's still the current consensus:
https://en.wikipedia.org/wiki/List_of_animals_that_can_get_S...
I thought we could have cut the entire thing short by vaccinating everyone who wanted it, and letting them quarantine, while at the same time encouraging everyone who didn't want to be vaccinated to socialize as much as possible (while watching hospital capacities carefully.)
There was this strange determination at the time, from every media and government outlet, not to accept that having had covid was as (or more) effective than taking the vaccine. And also not to accept that mass lockdowns were destructive. My grandfather was a victim of the lockdowns (as one of the many with vascular dementia who were kept going by being stimulated by family.) After 93 years of raising a family, he got to die alone, confused and isolated.
edit: it's all of the authoritative disinformation during covid that's threatening cervical cancer vaccination. It brought the thoroughly discredited anti-vaxxers of yore back into the (numerical) mainstream, and respected as heroes (JFK, Jr. for one example.) Wakefield's paper is just as stupid as it ever was, but now you will never convince the majority of Americans that vaccines don't cause autism. The Lancet is trash.
> I thought we could have cut the entire thing short by vaccinating everyone who wanted it, and letting them quarantine, while at the same time encouraging everyone who didn't want to be vaccinated to socialize as much as possible (while watching hospital capacities carefully.)
We sort of did do that because of how much policies varied from state to state and even from county to county or city to city within a state. For nearly any aspect of of pandemic response it is possible to find demographically similar counties that differed on that particular are and compare outcomes.
That would be pretty hard to do since the mRNA "vaccine" neither prevented infection or stopped the spread.
The current mRNA vaccines are moderately effective at preventing Covid infections, about on par with current flu vaccines.
Not all vaccines are equally effective, but none of them are 100% effective at preventing infections. The only thing vaccines do is prepare the immune system for an infection. Since SARS-CoV-2 mutations happen a lot faster than (for example) measles, Covid vaccines are a lot less effective - by the time you're infected, the infection is dissimilar enough to what the immune system was prepared for that the preparation is no longer optimal.
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.
And yet there are still people that think it was supposed to in the first place. Thinking that makes it a failure, at least you don't think it's full of mind control tracking nanobots though. :D
Or maybe you are, since you used scare quotes. It's probably too late to share any facts with you at this point...
It did for the first variants, but then Omicron happened.
I see you're calling a vaccine a "vaccine". Noted.
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.
Studies showed it decreased infection and transmission against the original strain of Covid.[0]
It lost effectiveness against delta and then became nearly ineffective against Omicron (although still helping with reduction of hospitalizations and deaths).
Non-mRNA vaccine is available now (Novavax) and the effectiveness, or lack thereof, seems similar.
[0] https://med.stanford.edu/news/all-news/2021/07/vaccination-a...
It was also more dangerous to healthy young men than just getting COVID, due to myocarditis.
Absolutely not true.
Looks like we have a science denier: https://www.drvinayprasad.com/p/uk-now-reports-myocarditis-s...
"It is now clear for men <40, dose 2 and dose 3 of Pfizer have more myocarditis than sars-cov-2 infection, and this is true for dose 1 and dose 2 of Moderna."
You need to analyze the total risk of both options to state that getting vaccinated is more dangerous, not just the risk of myocarditis following each.
I need to state the risk of COVID in a healthy male under 40? That's self evident.
If you want to say you are doing science, then yes, you need to define what you mean by "healthy" and make the case that the harm from vaccination was greater in your group than the harm from infection.
If you want to say your subjective group is self evidently better off with some option, then don't say you are making a scientific argument.
Unfortunately I don't have the budget to fund a large RCT. It is also worrying that the companies and health authorities with the budgets haven't done so either.
Unless there is some unknown, long term effect from COVID that is yet to manifest itself, it is self-evident that the comment that "It was also more dangerous to healthy young men than just getting COVID, due to myocarditis." is "Absolutely not true" is incorrect.
You don't need an RCT. You need a study that compares COVID's many consequences and sequlae to the vaccine's myocarditis. Not COVID's myocarditis rate to the vaccine's myocarditis rate.
I can't find age-breakdown data of which specific complication causes the most death in COVID patients, but for the population broadly, it is multiple organ failure, then pneumonia and related pulmonary problems. Not myocarditis.
So if you're excluding the primary causes of death of COVID then sure, the tradeoff gets a lot less clear.
>> You don't need an RCT. You need a study that compares COVID's many consequences and sequlae
Effectively zero for healthy men under 40.
I do think common sense needs to play a part in your risk assessment.
But the rate of myocarditis, even using the upper end numbers for the highest risk group, is also “effectively zero”! That pre-print shows myocarditis rate of 0.01% for men under 40.
The IFR for men between 35-39 is five and half times higher than that.
I wouldn’t mind common sense, but in lieu of that, some basic numeracy would be helpful.
>>The IFR for men between 35-39 is five and half times higher than that.
For healthy men?
Not sure but CV risk is the primary comorbidity that matters for young people wrt COVID, which is also the main contributing factor to myocarditis risk. So no reason to believe there’s a huge difference here.
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.
> 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.
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.
>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.
>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.
> 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.
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.
>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.
Aha thank you! I really appreciate your feedback here. It's a bit more expensive here, just over 200 per injection but that sounds about right then. I will see about getting the 1 or 2 then!
You're welcome!
I forgot to link the sources the 9-valent vaccine is the current Gardasil:
https://www.gov.uk/government/publications/single-dose-of-hp...
Take a vacation to somewhere in Africa, see the Mara and get the vaccine there. It does cost about $40 per dose…
I made the mistake of arguing with a somebody on facebook about Gardasil once. In the end I asked her flat out would she rather her daughter got cervical cancer, or had the vaccine. She said she chose cancer.
Some people you just can't reach. I stopped arguing at that point.
Do you think part of their resistance to the vaccine is that HPV is a sexually transmitted disease? The parent probably wants to believe that their daughter can avoid STIs ... because magically thinking.
If it is a pure STI it can be avoided by celibacy. This is not a protocol most humans are comfortable with though. Unfortunately most disease are just mainly spread through sexual contact and have additional vectors so vaccination might still be preferable
>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.
>> 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!
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.
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...
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?
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.
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)
> 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.
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.
Last I checked it wasn’t available for men.
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...
> 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.htm...
I’m a 38 year old male in the USA and I’ve had two out of three shots of gardasil 9, with my third (final) in a few months. There are multiple strains, so even if you have one, the vaccine will protect against the others.
You have to bring it up to the doctor yourself though.
In the US Gardasil 9 is FDA approved for men and women up to age 45.
https://www.fda.gov/news-events/press-announcements/fda-appr...
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.
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.
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.
That would come as a surprise to me, as a male. What did they give me??
Im male and had it offered to me by my primary care in like 2009
Last I checked was in the US, 2008.
I was going to be traveling overseas, and was worried it would be required by a foreign country. I wanted all vaccines handled by my American GP, so the records would be in one place. I was very insistent: "Give me every vaccine for every country."
He said if I wanted the vaccine that bad, I'd have to get it overseas.
It was on the checklist at Walgreens when I got my flu shot and COVID booster. Maybe you don't even need a prescription now?
It wasn't approved by the FDA for those over 27 until October 2018. Now that it is, I think technically you need a prescription but requesting it through Walgreens/CVS/etc. means they handle that for you. (COVID/flu are similar - if I look at the records for CVS they show a "prescribing doctor" I've never seen.)
Interesting, at the Walgreens portal I don't see any prescribing doctor listed for any of the vaccinations I've gotten there.
In looking at the little pharmacy receipt they give you, there's certainly a prescription number, and a note that says "DR. AUTH REQUIRED" and at the top of the printout there's a field for "DOCTOR" but no value (like there is for "PATIENT"). I guess I have a question for next year, if I can remember!
I did find out that my state has a law that allows administration of flu vaccine by pharmacists without a prescription. That doesn't account for COVID not having one listed, but maybe that's still part of the emergency use authorization?
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
Over here is the leading cause of cervical cancers world wide - 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/ke...
A vaccine for HPV became available in 2006 — 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…
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.
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.'
How are the authors able to discern between vaccine related events, and non-vaccine related events? There is no oracle one can consult to determine this. That’s the entire point of having a second group which was not treated - to have a reference that one can compare against to determine if outcomes were correlated with the treatment. Even then, one cannot say with certainty if the events were caused by the treatment, or simply correlated; to say that all 231 distinct serious outcomes were not caused by the vaccine seems a very extreme statement to make, and can almost be disregarded prima facie; if the researchers were infallibly able to determine what adverse events were caused by the treatment, then why would they need another group to compare to?
Similarly, while there may be ethical concerns with using a placebo, statistics and biology do not care about ethical concerns. There are real results which come from medical treatments, and ignoring them does not make them go away; it just makes us ignorant of them.
You can just read the text, you know. It's fully and freely available online.
> None of the deaths were considered by the study investigators to be vaccine-related. The five deaths in the 9vHPV vaccine group were the result of suicide (15 days after vaccination dose 1), acute lymphocytic leukemia (diagnosed 27 days after vaccination dose 3), traffic accident (226 days after vaccination dose 3), hypovolemic shock and septic shock (531 days after vaccination dose 3), and sudden death (678 days after vaccination dose 3). The five deaths in the qHPV vaccine group were the result of accidental death (airplane accident 7 days after vaccination dose 3), spinal cord injury (141 days after vaccination dose 3), gastric adenocarcinoma (diagnosed 403 days after vaccination dose 3), cervical spinal cord injury (811 days after vaccination dose 3), and cerebral hemorrhage (1114 days after vaccination dose 3).
Sudden death and cerebral hemorrhage seem hard to declare as unrelated to the medication they took.
Cerebral hemorrhage over 3 years after a vaccination could actually have another cause not listed here, eg. high blood pressure or poor diet.
Or getting hit in the head or falling down.
Sudden death almost two years later, and Cerebral hemorrhage almost three years after vaccination does seem unrelated to the “medicine they took”.
Maybe but if they were related to the vaccine we would expect them to occur more than once in the study group, right?
Yup! That’s exactly why they initially list every bad outcome before trying to rule it in/out.
For example, you might be tempted to dismiss deaths due to traffic accidents as being obviously unrelated to a drug. However, if there were a lot of them, it would be prudent to check for potential effects on reaction times or judgement.
My grandmother died of a cerebral hemorrhage. It wasn't because of the cholesterol medication she took. It was because she was on blood thinners, was old, and tripped and hit her head on the dresser while preparing for church.
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.
Calling cervical cancer a death sentence is a bit extreme. Regular pap smears and early treatment made it eminently survivable.
It’s a big deal. “Survivable” means intrusive treatment that is painful, not always effective and has side effects on things like fertility.
Or you can eliminate it by vaccination and avoid the suffering and risk.
I can see how you'd end up with that interpretation but I was actually talking about Hodgkins, so in that case the placebo arm would in fact be basically a death sentence. You've got an aggressive cancer, and you've decided (or your treatment arm has decided) to just let it take its course.
You can detect melanoma with the eyes. But when you don't get there early enough it was game over. Now it's a coin flip.
> the use of a placebo was not considered to be acceptable for ethical reasons
The same bullshit reason they used to not do a controlled trial for COVID-19 vaccines. That's pseudo science.
I can't prove the efficacy and the safety so let me find a reason to remove any form of control to make more money and avoid class action lawsuits. The heath agencies have been completed hijacked.
>a placebo was not considered to be acceptable for ethical reasons
This reason can also be used to cover up the side effects of the vaccine/drug. Complete BS.
[flagged]
That's not true.
It's also not untrue, either, we don't know who will be taking that seat.
I think it remains to be seen.
[flagged]
[flagged]
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.
This suggestion was specific to HPV vaccination. I did appreciate his explaining risks and benefits.
You know what it means.
[flagged]
Would you please stop taking HN threads into hellish flamewar? It's not ok here, and your account unfortunately has a long history of doing a lot of it. I really don't want to ban you, but if you keep doing this, we're going to end up having to.
https://news.ycombinator.com/newsguidelines.html
[dead]
> 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?
The previous comment is very likely talking about RFK Jr. Trump promised him "a major health role" in his administration, and Kennedy already announced on Twitter that he plans to push Trump to make aggressive changes. Based on his views, it's not difficult to predict what they might mean for vaccines.
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?
[dead]
[flagged]
You're the one trying to retcon reality.
Trump undermined initial vaccination efforts, defunded health agencies and downplayed the severity of the pandemic[0..2] and then took credit for all of it. He mocked masks and refused to wear a mask or get vaccinated[3..5], then he got vaccinated. And just days ago he said he would consider defunding schools that required vaccines[6].
No one is going to buy this narrative that Democrats were the anti-vaxxers all along and Trump and the Republicans were always pro-vaccine. All of this is recent history. It wasn't that long ago. We were all there. We remember how it was.
[0]https://www.nbcnews.com/think/opinion/covid-vaccine-distribu...
[1]https://www.science.org/content/article/inside-story-how-tru...
[2]https://www.statnews.com/2021/01/31/trump-officials-lobbied-...
[3]https://abcnews.go.com/Politics/trump-downplaying-virus-mock...
[4]https://www.wsj.com/articles/trump-says-he-is-unlikely-to-ge...
[5]https://www.cnn.com/2020/05/06/politics/donald-trump-mask-ar...
[6]https://www.pbs.org/newshour/show/trump-vows-to-defund-schoo...
>>No one is going to buy this narrative that Democrats were the anti-vaxxers all along and Trump and the Republicans were always pro-vaccine. All of this is recent history. It wasn't that long ago. We were all there. We remember how it was.
No-one is saying that. It's just as false as it is to say the Republicans (and Trump) were never pro-vaccine. They were, but once a) the lack of severity of COVID was better understood, and b) the lack of effectiveness and the side effects of the vaccine became known, they became more sceptical.
And masks still don't work, and are a waste of time. The science tells us that.
And then his crowd booed him and he stopped doing that.
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.
[flagged]
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.
[flagged]
"A CDC study examining HPV prevalence among sexually active females aged 14 to 24 demonstrated no net change in overall HPV infection rates following the introduction of the vaccine."
Not all HPV strains cause cancer, so it's not surprising that a vaccine that targets cancer-causing strains would decrease the prevalence of those strains, and, as a side effect, increase the prevalence of other strains. This is not a bug, this is the whole point.
https://publichealthscotland.scot/news/2024/january/no-cervi...
"An exciting new study from Public Health Scotland (PHS), in collaboration with the Universities of Strathclyde and Edinburgh, shows that no cervical cancer cases have been detected in fully vaccinated women following the human papillomavirus (HPV) immunisation at age 12-13 since the programme started in Scotland in 2008. "
Don't draw equivalence between peer-reviewed scientific data and some random blogs.
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/Surgisphere#COVID-19_misconduc...
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.
> 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.
It's wild that we've collectively passed that over. Heads should have rolled for that, all the way to the top of whoever had knowledge of that campaign.
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.
[flagged]
You're not the first to think this, but there isn't evidence for it - in fact there is evidence of less risky sex + less teen sex.
If we are just coming up with theories before looking at evidence you would imagine STDs benefitting from more risky sexual behaviour as it would be an advantage to them spreading.
[flagged]
People had sex and will have sex no matter if std vaccines exist or not.
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
>The topic it overlaps with doesn’t matter
It does to voters. Reducing the workload for healthcare providers is great if you believe in science, but half of voters in the US think they can cure COVID with a horse dewormer because they read it on the internet somewhere.
[flagged]
as HPV isn’t solely an STD, promiscuity isn’t required for exposure and is a red herring to being inoculated against it
I’m guessing your reply was about quantifying “strain on the healthcare system”, frequency of positive STD diagnosis and treatment is not as stressful as frequency of cancer diagnosis and treatment
HPV inoculation mitigates several cancers from manifesting and subsequently advancing, no matter how promiscuous people choose to be
on an individual basis, it is a low effort thing to take an HPV vaccine, no different than the regime for inoculating against chicken pox. its wild to think that if chickenpox was linked to cancers where genitalia happens to be and go, that developed nations around the world would have had issues rolling it out, like, get over it? People can consider changing their relationship with the government if they think state involvement is the same as its endorsement of contributing activities
"as HPV isn’t solely an STD, promiscuity isn’t required for exposure and is a red herring to being inoculated against it"
"HPV inoculation mitigates several cancers from manifesting and subsequently advancing, no matter how promiscuous people choose to be"
Right, there's different strains of HPV, often called types, and since the article focuses on their effect on cervical cancers, we are focused on the ones that are transmitted sexually, as those are the ones that cause cervical cancer.
"on an individual basis, it is a low effort thing to take an HPV vaccine, no different than the regime for inoculating against chicken pox. its wild to think that if chickenpox was linked to cancers where genitalia happens to be and go, that developed nations around the world would have had issues rolling it out, like, get over it? People can consider changing their relationship with the government if they think state involvement is the same as its endorsement of contributing activities"
I'm not familiar with how HPV relates to the state. But I would like to make clear that the locus of the cancer and the transmission route of the pathogen are NOT coincidences. Pathogens enter the body either through abrasions, and less commonly through mucous membrane absorption. The damage is caused not necessarily by the resources the pathogen parasites, but by the collateral damage the pathogen causes to enter the body. At any rate the damage is localized to the site the infection occured.
So yes, to the extent that HPV causes cervical cancer, it's an std. To the extent that it's not an std it doesn't cause cervical cancer.
There's other types of cancer that cause oropharyngeal cancer and are related to oral sex by the way. Same mechanism, so PSA if you love your partner don't be rough with them, you can literally hurt them in irreversible lasting ways.
https://xkcd.com/605/
edit: bonus https://xkcd.com/592/
Haha. In this case I comically extrapolated to denote a mathematical equation without doing the algebra that makes brain hurty at 1 am
You're assuming that STDs are the only thing keeping everyone from having 'infinite worldwide orgies'. That's certainly not the case. I think that's a very minor factor considering a condom takes most of that worry away already and most people never participate in an orgy in their life.
I do but I'm pretty kinky (and poly) :P but most people have pretty monogamous sex lives. It's societal standards that stop people from doing this, or they simply have no interest.
It's not like most married or dating couples are like "Hey will we do a movie or an orgy tonight? Let's do the movie because I'm worried about STDs". Could you really imagine that? Most people abhor the idea of having sex with lots of random people :)
In a society that didn't have all this ingrained religious programming that sex is somehow bad it might be true but this is not our reality.
Oh yeah, it was just hyperbole. I really do think that natural human promiscuity áttern involves more a facade of monogamy and "cheating" than simultaneous sex (I do think it's an event, and it has been claimed to be related to the mushroom shape of the glans).
Cheating promsicuity is probably the case for most primates, and certainly the case for many mammals as shown by their preference to mate during the dark.
It relates to paternity certainty and mate jealousy/protection, which is again, present in most species.
Ah yes the old "we shouldn't fix anything because people will do it more and it'll be a wash" argument. Complete nonsense. Your argument is, essentially, saying that we shouldn't make airplanes safer because if we did more people would fly and the deaths would remain the same. Does that pass the sniff test to you? Of course not. It only seems to make sense to you because of the little sprinkling of irrational puritanism you're including with your argument.
First of all calm down. Read what is there, not what you imagine to be there, or what you would like to be there so you can enter your rage trance.
I never said we shouldn't be making the vaccines or curing diseases or making airplines safer, just suggested that the death rate could remain constant.
Wouldn’t this mean that promiscuity was increasing?
Do you have an evidence that it is?
"Wouldn’t this mean that promiscuity was increasing?"
Maybe it would mean that? I see the logic, we have more vaccines and cures now so to reach the same risk there would need to be more sex, according to the theory.
But it doesn't mean it is increasing now or that it generally increases over time.
As the risk of stds fluctuate, so would promiscuity, albeit with a time displacement and inversely of course.
So that's what the hypothesis would predict. A steep decrease in promiscuity following a pandemic, and then a gradual growth as a cure for it or vaccine is found.
Regarding the present time. I think we would be in a promiscuous phase, yes, the std risks are quite low.
Evidence? How about dropping marriage and increasing divorce rates? Divorces even peak in the aids pandemic. The effect of cures for gonorrhea ,clam etc.. I don't know exact dates, but generally it does coincide that we've been curing them for the past century and marriage is becoming less prevalent.
I don’t think that marriage indicates a lack of promiscuity.
It's literally a vow to monogamy.
Maybe you can argue that married people are as promiscuous as single people, but at that point the onus is back on you.
To be clear, I asked if you had any evidence of the increased promiscuity you claim exists.
Any onus is on you.
I offered marriage data, you rejected that, what is your threshold of evidence, do you want me to install cctvs and record people fucking? You tell me what type of evidence would satisfy you?
> You tell me what type of evidence would satisfy you?
Maybe some data or a study. You offered opinion on marriages collapsing. That’s not evidence of promiscuity.
Ah, to live in a world where people say what they mean and mean what they say
There's the "I did my own research" guy, with bonus sex shaming.
Long term, yes, everybody dies.
I mean, you remember aids pandemic ? I don't think people (especially straight people) today realise just how devastating that was.
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.
Speak for yourself I guess