- HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. Unless you plan to remain completely celibate, you are likely to contract a strain.
- Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive. While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/
- HPV16 is responsible for a large number of throat cancers (around 50% in smokers and 80% in non-smokers!). This affects both men and women. Vaccinating men is important for their own safety and to reduce transmission to their partners.
"HPV is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex"
This focuses on sex, but any virus that can be found on skin, also has a chance to be transmitted without sex just as well. Admittedly the chance here for HPV infection is much higher with regard to sex, but not non-zero otherwise. The HeLa cells also contain a HPV virus in the genome, though this was probably transmitted via sex:
"The cells are characterized to contain human papillomavirus 18 (HPV-18)"
HPV-18. I think HPV-18 may in general be more prevalent than HPV-16.
> also has a chance to be transmitted without sex just as well. Admittedly the chance here for HPV infection is much higher with regard to sex, but not non-zero otherwise
I successfully treated a persistent hand / feet / knee warts infection with 3 shots of Gardasil-9. The common warts are supposed to clear on their own within 2 years, but it was not the case for me. They all cleared out about a 1 year after the first shot, never to return. Including a deep plantar one that was completely immune to cryotherapy
>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives.
This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common.
But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gardasil-9, which I took as a male at age 35) protects against nine specific strains.
Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body).
People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case!
Parent is overstating the case. Neither infection nor vaccination provides sterilizing immunity [1], but the general reasons to prefer vaccination are (in order of descending quality of evidence & reasoning):
1) you probably haven't had all N strains yet.
2a) you likely haven't been infected with the ones that cause cancer, because they're relatively rare.
2b) ...that is especially true if you're young and not sexually active.
2) being infected with one strain does not provide sterilizing cross-immunity against the other strains.
3) even if you've been infected with a strain, some of the vaccines have been shown to prevent reinfection and reactivation better than natural infection alone.
4) in general, the vaccination-mediated immunity might last longer or be "stronger" than the natural version, since the vaccines are pretty immunogenic, and the viruses are not.
But for point 4, it's well-known that vaccine efficacy is lower for people who have already seroconverted (cf [1]), so there's clearly some amount of practical immunity provided by infection.
[1] The vaccines are roughly 90% effective for the major cancer-causing strains, but it's not a simple answer, and varies a lot by how you frame the question. See table 2 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
Also be sure to see table 4 if you're a man. The data for biological men and women are surprisingly different!
A question for your doctor and your partner (and of course, you can read the data in the link I posted above and use that to influence your conversation and decision!)
I'm not being avoidant here -- medical decisions are always subjective and multi-factor, and I can't begin to tell you what you should do. (But I also sincerely believe that propagandists try to reduce nuanced data to talking points, which is equally wrong.)
Please note the caveat about gender that I just added. The data for biological men and women are very different. Also, I haven't discussed risks at all, which is the other side of the ledger -- these vaccines are pretty darned safe, but everything comes with risk, and only you can decide what level of risk is appropriate for your life.
I usually am pro vaccine. But the HPV vaccine discussion seems politicized to me. As someone who is monogamous and over fifty, I had trouble following the risk vs reward discussion. The CDC says it is only recommended for young adults so I interpret that for my case the answer is negative.
All vaccination is now heavily politicized in the US. HPV vaccination was an obvious focal point initially because of why we'd do it when we do.
The initial data says you should vaccinate somewhere around 12-14 year old girls because most of them will be HPV naive but if you wait longer they won't be any more. But too many US parents cannot imagine their little girl ever having sex and if they never have sex they almost certainly won't contract HPV so, why are we vaccinating them? Are you trying to make my daughter a slut?
If you've been a teenage American this should strike you as very silly, and doubly so if you understand biology. Teenage girls are not, in fact, celibate by default, so some of them will get horny. And if you understand biology the viral infections aren't caused by the same mechanism as pregnancy "sexual activity" is a shorthand, you can easily get infected while steering clear of anything that would get somebody knocked up. A peck on grandma's cheek is unlikely to work, but if you're sucking face for most of a Stranger Things episode that's definitely enough that you might contract HPV.
> recommended for young adults so I interpret that for my case the answer is negative.
You need to be careful making assumptions.
Previously that recommendation was due to limited vaccine production and trying to prioritize young women.
There were CDC recommendations during covid that were not about what was best for you individually.
As always with health, the right answer is to seek professional advice. But also to take personal responsibility for your own choices (that depend on your specific circumstances).
Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents.
> Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents.
Did I read this correctly? You are going to decide for your children based on their plans to be monogamous?
And you’re also going to decide for your parents? I can only assume you’re in the unfortunate situation where your parents are no longer capable of making decisions?
I don't want to assume, so I'll ask if you're willing to share - are you making the implicit assumption that your kids are and/or will be monogamous, and is that assumption a key factor in your decision on their vaccinations?
The CDC recommendation to get it at 11 or 12 does not make sense to me. I know they aren’t having sex - and I know that some kids do. We will discuss, together, the pros/cons as they get older to see if it makes sense. As they get older, they’ll make these decisions themselves. Until then, I’m weighing the pros/cons and in our case, it doesn’t seem they are at risk in the near future.
The early recommendation age just falls out of the data that shows the vaccine is substantially more effective if you haven't been infected yet, together with the fact that it's a multi-dose vaccine where the second dose comes months later, and realistically for many that's going to mean a year or more before completing the series.
I think there's truth to the idea that the specific 11-12 range is somewhat arbitrary: as much as anything it's that because there was a preexisting "slot" in the vaccine schedule at 11-12. The American Academy of Pediatrics differs from the CDC's panel on this... but on the earlier side: they would start the recommendation at age 9. I think to a significant degree the thinking there is that if you go earlier the messaging and reaction is more "your child will probably eventually have sex and this is an effective time to give the vaccine" and less "your child will be having sex like, tomorrow."
I am a parent who vaccinated my daughter at 9 for HPV, and my son will be vaccinated as soon as he’s old enough, without delay or hesitation. It is my opinion you are doing a disservice to your children with a suboptimal mental model, potentially driven by emotion instead of data.
Your children will have sexual contact with another human eventually as they grow into adults, and there is very low risk with an HPV vaccine. There is, in my opinion, no reason not to vaccinate as soon as possible (considering the material reduction in future cancer risk, and that there is no cure once infected, only prevention via vaccination). You might have feelings, as many have strong feelings, but they won’t matter once your kids are 18 and you no longer control them. Google the stats on parental estrangement.
Try to do better, you are a guardian of your children, not an owner, and your values will potentially not be their values. I don’t care with who or when my children have sexual experiences with once they are old enough to consent, what matters is they are respected, as well as protected from harm and poor health outcomes from these experiences they will certainly have eventually during their lifetimes. If you don’t think your kids are going to have sex when they’re older, or think you can control it, you are lying to yourself. So, protect them from what you can, which in this case is HPV.
Let me start by saying I am mostly in agreement with what you've written. But I do not understand why there is the urgency to vaccinate them when they are 9 (as you did).
Because the United States is rapidly devolving, including around vaccine recommendations and what availability and access might look like because of that, and my child and I were already at the pediatrician that day. Administering the vaccine and me asking the pediatrician “can we do it today?” cost me nothing beyond the time. If I need to find them their second dose elsewhere six months after the first (unlikely, but possible), I am prepared for that, but once they have that second dose, they have the persistent health benefit with very little effort required (regardless of what the future looks like). I’ve just lowered their future cancer risk, with no more than an hour or two of time.
I work in risk management, and have for almost a decade, so that’s how my brain is wired to evaluate and manage risk. I understand others may decision and action differently. Low cost, low risk, high reward choice? That’s a damn good deal, I’ll take that deal.
Pretty sure this line never convinced anyone of anything. We all want to do "better" but have different definitions of what that constitutes.
> If you don’t think your kids are going to have sex when they’re older, or think you can control it, you are lying to yourself.
I don't think anyone thinks this. Some people do hope and expect their children not to have sex outside of a monogamous marriage. If you give your kid a vaccine that is primarily meant for people who do not do this, you are letting your kid know that you don't really have faith in them.
That sends a strong message that some people do not want to send. As GP said, you're free to raise your kids different, and if you don't place value on reserving sex for marriage, it would make sense that you would do differently.
"Sending a message" is generally a cover term for evil.
And there is no issue of having faith in them--you are trying to make a decision you have no right to make. You're a parent, not a slavemaster.
The real world data is that the "good" girls are more likely to get pregnant, more likely to get STDs. And more likely to end up in bad marriages.
And lets add another data point. I used to have a bunch of coworkers from a very conservative background. An unmarried person would not be able to buy a condom in town type conservative. Over the course of many years I became aware of many marriages--and every single marriage was either arranged or due to pregnancy. Every single one. Remember, one of the definitions of insanity is keeping trying the same thing and expecting a different outcome.
Neither does a parent, based on all available evidence, and multiple jurisdictions make vaccination compulsory without exception. Parents aren’t special, and they are failing in this regard by believing they should have a right to say no, simply for being a parent. Anyone, broadly speaking, can have children. That does not make them good or qualified parents unfortunately. It just makes them temporary guardians (until their children are adults) with an opinion.
~54% of Americans read below a sixth grade reading level, for example. We would trust your average American’s judgement on vaccination need or schedule, especially for their children, why?
> based on all available evidence, and multiple jurisdictions make vaccination compulsory without exception
Can you share which jurisdictions mandate the HPV vaccine and have no exceptions? I am aware of only a few jurisdictions where it is required, and all such jurisdictions have exceptions.
They also only require it for kids in schools, so any kid who is homeschooled is not subject to the mandate in the first place.
More importantly, the vast, vast majority of jurisdictions have no mandate whatsoever, so any parent can also choose to move to one of those, in addition to the homeschool option.
Ah ok I'd be curious to know what those are, though I would find them to be less persuasive/relevant from a policy perspective. There are countries that have no freedom of speech, outlaw non-govt schools, etc., and I don't want to be taking cues from such countries.
Regardless, I would imagine that very few jurisdictions, and a relatively small percentage of the world, lives somewhere that mandates these vaccines and has no opt-outs.
No, you have an obligation to do the best job you reasonably can with raising children. We generally do not permit parents to do things which pose an undue risk to their children, and most of the exceptions to this involve religion being given a weight it shouldn't get.
Trying to make sex more dangerous to me falls squarely in the realm of child abuse.
For a 9, 10, or 11 year old? I'm definitely not encouraging them to have sex.
I surely hope we go after actual child abusers than parents who delay or opt-out of this OPTIONAL vaccination for their kids.
The problem here is the do-it-later crowd is going to wait too long. Same thing as we see with sex-ed, knowledge is treated as encouraging when reality says it's exactly the opposite. Honest sex ed leads to later sex and fewer problems.
Well, hope and faith are not effective strategies. Good luck to those who operate from this perspective, they will face disappointment, which is theirs to own. Monogamous marriage is a shrinking minority of potential outcomes [1] [2] [3] [4] [5] [6], and ~40% of first marriages end in divorce [7] (rates are higher for second and third marriages).
The kids of these people get a chance to do better when they become adults, and that's all we can hope for: that they make better choices than their parents. Better luck next generation I suppose.
[1] How has marriage in the US changed over time? - https://usafacts.org/articles/state-relationships-marriages-... - February 11th, 2025 ("In 2024, US adults were less likely to be married than at almost any point since the Census Bureau began tracking marital status in 1940. The percentage of households with a married couple peaked 75 years ago: in 1949, it was 78.8%. That percentage has been below 50.0% since 2010, when the rate was 49.7%. In other words, less than half of American households have included a married couple for over a decade.")
[2] Charted: How American Households Have Changed Over Time (1960-2023) - https://www.visualcapitalist.com/how-american-households-hav... - November 6th, 2024 ("More Americans today are delaying or forgoing marriage altogether, with just 20% of women and 23% of men aged 25 being married—the lowest on record. Projections indicate that by 2050, one-third of Americans aged 45 may remain unmarried.")
[3] Morgan Stanley: Rise of the SHEconomy - https://www.morganstanley.com/ideas/womens-impact-on-the-eco... - September 23rd, 2019 ("Based on Census Bureau historical data and Morgan Stanley forecasts, 45% of prime working age women (ages 25-44) will be single by 2030—the largest share in history—up from 41% in 2018.")
> Well, hope and faith are not effective strategies. Good luck to those who operate from this perspective, they will face disappointment, which is theirs to own.
Hm, worked great for many people I know. I can imagine it would depend on a number of factors.
But looking at your links, they don't seem especially relevant to the question of whether more people are having sex before marriage than before. They don't even mention the word "sex" in fact. And of course, the relevant question isn't whether people in general are having sex before marriage less, it's whether people raised in families where abstention is valued are upholding that value in their lives.
But congrats on sharing lots of links, which makes it look like evidence is on your side!
As to whether "hope and faith are not effective strategies", it probably makes sense to listen to the experience of people who rely on such hope and faith in their lives, and who have many friends/family who do. People who express outward disdain for such things are probably not the best source of reliable info on the matter.
I understand that religiosity (faith and hope) is negatively correlated to intelligence, so I also understand faith driven mental models are an uphill climb to better health outcomes at scale. "It is what it is." As I mentioned, perhaps we'll have better luck next generation, when systems have improved in this regard.
(edit: facts and data are not unkind, they just are, and I feel like I have been very polite in my delivery of all facts and data presented; if you are unhappy about the facts and data presented, that is an internal issue to reconcile)
That's a pretty longwinded ad hominem you've got right there.
Forgive me for not digging into your links again...fool me once, shame on you; fool me twice, shame on me.
You're entitled to your opinion, but when you go around spouting about faith not being a good strategy and then cite a bunch of unrelated articles, you've shown that you are yourself not very intelligent (or kind).
"Faith" is fundamentally belief without knowledge. Thus you by definition have no reason to rely on it. (Although the word also gets used in situations where there is a track record to rely on but no specific evidence in the particular case.)
And you're using the wrong yardstick. What you should be looking at is the number of adverse events. STDs. Unintended pregnancies.
Everyone hopes for and has faith in their kids with regard to some actions. It could be going to class, staying out of gangs, not drinking/doing drugs. We don't know for a fact our kids will do what we hope, but we act in a way that shows we have faith in them, so as to avoid undermining their confidence.
I don't need to use the yardstick you propose. There are many confounders in aggregate data, and there are not public polls that capture the demographics and beliefs of my family. It would be a fool's errand to pretend that publicly available data is somehow more important than my own understanding of my kids.
It's funny how you think I shouldn't be able to make decisions for my children, but you seem to think that you know better than me what is right for them.
The available data indicates that you're wrong. You *think* you know, you don't.
Would it be acceptable to not belt your kids because you have faith in your driving skills? (And never mind that the one time in my life where a seat belt mattered was when I was essentially PITted by someone who didn't look left. I walked away with nothing but a pulled muscle and because I was belted my foot correctly found the brake pedal while I was spinning around and totally disorientated.)
Or how about the woman from ~30 years back that said that DUI doesn't really matter if your faith is strong enough as god will protect you.
Not belting your kids when you put them in the car is unsafe and is illegal. However, not getting your 9 year old a vaccine for STDs is not unsafe if that kid is not sexually active, and therefore not at risk for contracting the STD. As the kid gets older, the calculus changes because they are more independent. But pretty much any responsible parent has a very accurate sense of whether their 9 year old is having sex.
And the parents who have a sexually active 9 year old that they do not realize is sexually active are probably not taking them in for their regular doctor appts and vaccines.
It's not that they'll be active at 9. Rather, that you don't know when they'll be active and the ones who see this as encouraging sex will delay too long. Thus it's better to do it early.
I'll never understand how differences of opinion can make people so extreme. Child abuse is a serious issue and you have gone through some mental gymnastics to conflate child abuse with my decision to not vaccinate my 9, 10 or 11 year old child for HPV.
You get to make your own health choices here, but as someone who got the vaccine in my 30s, I am glad as I didn’t know about my future divorce when I got vaccinated.
Consider that it's possible that the person's partner may have exposed them to their then-unknown extra partners, creating one of the conditions for the divorce.
There are other STDs that you'd still be at risk of getting/giving in the case of infidelity, so getting this one vaccine doesn't actually make things all good. I imagine for some people, the thought of possibly bringing home a disease would actually be a sufficient deterrent to prevent infidelity. Not just because they wouldn't want to infect their partner, but because they know it could lead to them getting caught.
I'll elaborate: if you are worried about being unfaithful, or your spouse being unfaithful, then protecting yourself against one STD might seem like a good idea. And if the risk of unfaithfulness is very high, then it is better to mitigate one STD rather than none.
But the fact remains that you are still at risk of many other STDs, so you can still bring home (or have brought home) plenty of other diseases.
The last point, which I knew some people here would dislike, is that the possibility of HPV transmission could, on the margin, discourage some people from being unfaithful. This is because it would be a telltale sign of infidelity, and would cause the spouse to investigate.
Granted, this is only the case where the spouse knew he/she did not have HPV before (mostly people who remained celibate before marriage). If you had many partners before marriage, this advice probably doesn't resonate, but for people who did it makes perfect sense. It acknowledges the risk of infidelity and creates additional accountability by not shielding one's self from a likely telltale sign.
Think about your future health while your mind is clear. After the trauma of divorce is not the time.
Also, I think these questions are in bad faith.
It is actually hard to get people to change any behavior. The public health benefits should be a primary concern. Avoid vaccination if there is a downside to you personally, but that isn’t what I’m hearing from your comments.
Ha, we had this conversation with our doctor and they said not to worry about the vaccine if you are married and monogamous. It would likely have zero benefit to us at that point in time.
Now maybe that changes if you get divorced and get a new sexual partner.
It's never a guarantee in practice, the CDC says "More than 98% of recipients develop an antibody response to HPV types included in the respective vaccines 1 month after completing a full vaccination series"
> This statistic seems to be used by some people to avoid the vaccine
The FDA itself restricted access to the vaccine on the basis of age. Given that virions aren't even involved in the production process, its safety should have been deemed good enough for the entire population early on.
I think the main reason it isn't recommended for all ages is that it wears off. If you get it before 50, when your immune system starts declining, you might end up getting shingles when you're 60 or 70.
Insurance companies used to only pay for the vaccine at 60. They've reduced it to 50 now because people (like me) were getting it in their 50's. I got it in my left eye and because my immune system is kinda shit, I still have it, though it doesn't give me too much grief now. But it did trash my cornea in that eye, so it's messed my vision up pretty good. And since there's still an active infection (after 8 years), I can't get a cornea transplant.
My PCP actually recommended holding off until later in the 50s for this reason. There's not currently a booster so his suggestion was to play the odds & delay a bit in order to get longer protection in my elderly years.
Beg for forgiveness, don't ask permission. I got Shingrix when I was under the age of 40, and at no cost to myself even, simply by scheduling a Shingrix vaccine at CVS. It wasn't until I went back for the booster shot months later that the nurse was like "Wait, aren't you too young for this?", but they nevertheless gave me the second dose to complete the vaccine course. You can just so things.
I was unable to get a first dose just by asking the pharmacy -- they were happy to enforce the arbitrary 50 year age rule. But my PCP was happy to just prescribe it off-label. Do it; shingles is terrible and there's no reason to suffer it under 50.
Your average HN reader can absolutely afford paying a few hundred bucks to avoid getting a potentially life-changing disease, and should. I know multiple young adults who got messed up by shingles.
That’s not how drug approvals work. You don’t make assumptions about safety, you make decisions based on data.
The original trials were for a specific population - no prior HPV infection, young women. Hence the approval was for that population.
Additional trials have been run expanding the population, but the decision was based on data not “yeah, I’ll bet this is safe/works for this other group”
>>>>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives.
>> This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common.
As people cite these statistics, it would be useful to distinguish exposure to HPV causing foot warts, etc from the much more dangerous variants. I rarely see any statistics do this sort of segmentation.
> I rarely see any statistics do this sort of segmentation.
There are multiple publications. THe easiest way to find is Gemini 3 Pro or ChatGPT Thinking + find for publications (go to link, not just rely on summary).
They differ by population and methodology. For example, here is "Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia", 2023,
https://pmc.ncbi.nlm.nih.gov/articles/PMC10255022/
Yes. It would still protect you from the other strains and reduce risks of reinfection by the strains you already have, which is the main issue preventing your immune system from clearing the infection up by itself
Yeah, I only read the abstract and looked at the plots, but this is what I hate about public health papers:
They say the prevalence of virus is down. They don't say that the cancer rate is down (granted too early to tell), nor do they talk about any adverse events or all cause mortality differences (again, probably too early to tell)
The only thing they can conclude is that the treatment given to stop the virus, stops the virus. But they don't mention any tradeoffs.
Not trying to be an anti-vaxxer conspiracy theorist, but good science needs to talk about the whole picture.
Research papers are not literature reviews. This paper reports on the results of this study. And that study only investigated what it investigated.
In the case of public health, there are a bunch of organizations that keep on top of the research and maintain a more comprehensive view of their perception of the current consensus.
For day to day guidance, individuals should be referring to either those sources, or healthcare professionals.
If people are looking at individual studies like this to make decisions, something has gone very wrong.
You can’t talk about the whole picture unless you have all the parts. There’s no reason all of those parts have to come from the same study.
The first thing on your list of complaints is something that by your own admission cannot yet be determined. If you’re not trying to be an anti-vaxxer, you’re doing a bad job of it.
For those men wondering whether they should get vaccinated:
- HPV causes genital warts, HPV is permanent, doctors won't test you for HPV unless you demand it, and the tests aren't reliable, which is why they literally won't diagnose you unless you already have genital warts.
- Once you are confirmed HPV positive (again, you won't be confirmed without getting genital warts), you need to inform your partners, as it causes cancer in both men and women (but mostly women).
You are giving some honestly really bad and dangerous info.
The HPV strains that cause cancer and the ones that cause genital warts are different. The strains that cause cancer do not cause warts.
So you can very much have HPV without genital warts.
And conversely, while having genital warts tells you you are infected with the low risk strains, it does not guarantee you that it is the only strain you are carrying.
Thus you cannot rely on the presence of genital warts to know if you are or are not infected with the high risk strains, they are completely uncorellated.
The cancer-causing strains cause no symptoms and can only be detected by getting tested for them.
You're putting words and assumptions in my mouth that I never said in my comment. My comment includes different facts about different strains, in one comment, which some people might misinterpret. Your reply is re-stating the facts in more detail, so that's fine, I am happy for anyone to clarify information. However, the assigning of bad faith and action to me just because you don't like the way I presented the facts, is pretty rude. If you want to get really specific, we should probably clarify to the readers these statements you made:
> The cancer-causing strains cause no symptoms and can only be detected by getting tested for them
Cancer-causing strains can still cause the following symptoms: persistent sore throat, lumps, pain when swallowing, earaches (one-sided), swollen lymph nodes in the neck (painless lump), painful/difficult urination or bowel movements, unusual lumps or sores, or unexplained weight loss, in addition to others I have not listed here. However, early cancers often do not present symptoms.
> and can only be detected by getting tested for them
There is no test that covers all strains. You would need to get penile brushing, urethral brushing, semen samples, and anal pap smear. So "getting tested" is not the only solution, and getting regular scans for cancer is the best detection method. Therefore there is more involved than you have indicated, making your own comment as ;really bad and dangerous' as mine.
Perhaps we should trust people to do their own research and ask their doctor, rather than only listen to randos on the internet?
False. Not all do. And more importantly, the ones that cause cancer do not!
> Once you are confirmed HPV positive (again, you won't be confirmed without getting genital warts)
Again false. You can be tested without genital warts and be positive to a strand of HPV that simply does not cause wart. You might have had (or heard about) a bad experience with a health professional that refused to test without warts, but the presence or absence of warts has absolutely nothing to do with the strands that matter.
> you need to inform your partners, as it causes cancer in both men and women (but mostly women).
False again. Since you were specifically talking about the strands of HPV causing warts, then it does not cause cancer. You can still inform them if you care about no propagating warts, but the fact that you have wart-strand HPV does not make you more at risk of getting/causing cancer than someone with no symptoms whatsoever.
Your comment clearly says that someone with cancer-causing HPV will have warts, thus someone reading this might feel confident they are not carrying a cancer-causing strand since they do not have warts, which is dangerous because again, it is 100% false. It might also needlessly worry someone that recently noticed genital warts on themselves into thinking they might have gotten/propagated a dangerous disease, while the wart causing strand are in fact harmless and are just unpleasant aesthetically.
So tl;dr, you should get vaccinated if you can, and if you want to be sure you do not have a cancer causing strand, you need to get tested for it, that's the only way. Warts or no warts is completly unrelated.
> Perhaps we should trust people to do their own research and ask their doctor, rather than only listen to randos on the internet?
You missed three very important caveats that complicate the story you’re trying to tell:
1) not every strain of HPV causes cancer (iirc, the bad ones are rare).
2) many people (in fact, most people) who are active in the world have been infected with at least one strain of HPV.
3) it’s common to have asymptomatic HPV infections. you probably have one now.
one more:
4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman).
Overall, it’s a situation where you’re asking that sexual partners “disclose”
something that the partner probably already has, if they bothered to be tested for it to begin with. Moreover, nobody does these tests (in men, at least), because there’s no point to doing them, other than creating anxiety.
I will leave the nuances of bioethics to other people, but it’s not as clear a situation as you’re making it out to be.
One final thing: these infections aren’t “permanent”. They generally clear naturally in a few years.
> 4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman).
This guidance is changing. Vaccinating men protects women. Also just because you were infected with one strain, that doesn't mean you can't contract another, possibly oncogenic one. Get vaccinated, it protects against the most common cancer-causing strains. I did, why would I want to unknowingly give someone cancer?
>> 4) the vaccines likely have little effect on anything unless you were vaccinated as a child (and are a biological woman).
> This guidance is changing. Vaccinating men protects women.
Yeah, it was fucking like pulling teeth getting my HPV vaccine as an adult male. "It's for teenage girls" comments from multiple health care professionals.
I only took the first fucking dose in the regime, and none of my health care providers now offer low cost or covered options. I had to spend Covid money when I had it. I still need the rest of the regime.
It’s “like pulling teeth” because the guidance isn’t changing (at least not because of evidence).
There seems to be a very motivated contingency who want to spin a story that male vaccination for HPV has benefits for women. The problems with this story are:
1) Efficacy of the current vaccines for women are incredibly high. Vaccinating young women, alone, is basically enough. Whatever benefits you're imagining must therefore be marginal.
2) Efficacy of current vaccines for men are (surprisingly) low [1], so it’s hard to claim secondary benefits for other people without substantial additional evidence.
It’s perfectly OK to acknowledge that the HPV vaccine is an overall good, should be on the schedule for young women, and yet does not need to be administered to men. Giving it to men (particularly older men) is not supported by data at this time, which is why your doctors don’t make it easy for you to get it.
See table 4. In a naive population of men, the efficacy against DNA detection of HPV runs around 50%, and in men who may or may not have the virus, the number is lower. Efficacy against persistent infection is similar. Compare to tables 1-3 for women, where efficacy nears 100% in some populations.
It's a relatively new vaccine, this commonly happens for a few reasons:
1. They start with a cautious roll out to the highest lifetime risk population (teenage girls in this case)
2. They may be limited by vaccine stocks as it does take time to build up product. There's an entire world to vaccinate, billions of doses needed
3. They need time to prove that it will be useful to give to other populations - in this case, adults
There's no conspiracy here, you had to push to get it because you were going against the existing recommendations, which were reasonable. Not because of your gender.
Those recommendations have likely changed recently because when I went in for shots last month (male, 40s) they immediately recommended that me and my partner both get it.
The situation is pretty clear when you're a woman who got cancer from her boyfriend who knew he had HPV and didn't tell her, or didn't get vaccinated because he didn't feel like it. I think most people would want to avoid that situation. The genital warts thing is just embarrassing but another good-enough reason to get vaccinated early.
On Permanence: 10-20% of HPV infections either don't go away, or go dormant and recur throughout your lifetime. These strains are the ones likely to cause cancer. Low-risk ones cause genital warts that continue causing warts throughout your lifetime. High-risk ones may cause cancer.
The vaccine is available up until 45 years old. Worst case it does nothing, best case it prevents genital warts and cancer.
> The situation is pretty clear when you're a woman who got cancer from her boyfriend who knew he had HPV and didn't tell her
You can make up “just so” stories to justify anything.
The point is, the story you’re telling isn’t likely to occur if the woman is vaccinated.
The vaccine is incredibly effective in young women, and only borderline effective if administered in older men and women who have never been infected. Long-term efficacy in young men is less certain than for young women.
> Low-risk ones cause genital warts that continue causing warts throughout your lifetime.
Again, no. Most infections clear on their own. You are correct that rarely some infections are persistent or dormant, and that these sometimes lead to cancer. But these are the minority.
I, a male, got vaccinated with the Gardasil 9 vaccine shortly before turning 40. Convincing my doctor to prescribe it wasn't terribly difficult, I told them a few things about my sexual history and explained some of my sexual plans, and that was that.
That is terribly difficult. Why the hell do I have to make an appointment weeks in advance, then take time out of my day just to get permission from some asshole who asks about my sexual history? Why can't I just walk up to the counter, say "I'll take one HPV vaccine please" and pay the money? If you want me to get vaccinated make it easy.
You can make an appointment at eg Walgreens (and probably also CVS) and pay out of pocket for the Gardasil-9 HPV vaccination without any consultation with or referral from a GP (General Practitioner) or a Specialist.
> When you have your first shot is the main factor that determines whether you will need 2 doses or 3 doses
> Without insurance, the average price of 1 dose of Gardasil is $368.82. But you could pay as little as $169.50 with a GoodRx coupon at certain pharmacies
A prescription is only required for insurance reimbursement fwiu
Insurance, if it covers it, will cover it at CVS, no doctor needed.
Many insurances do. I asked if the pharmacist could check last time I was at CVS, and it did. I'm turning 46 before I can sneak in the 3rd dose, but 2 doses seems to be all that's needed for most of the benefit.
Because we over-rely on insurance for routine medical care, when really insurance should just be reserved for the catastrophic and everything else out of pocket (and/or directly subsidized).
I agree with that, and I don't have a problem with insurance companies demanding a doctor's approval before paying. What I have a problem with is that I can't even pay my own way without a doctor.
My GP just offered it during my physical along with the flu and COVID booster. I declined the COVID booster since I had just gotten a mild case a couple months back. Got two shots in the left arm, was sore for a day and that was that.
This is why you have to go to the grey market for medical stuff in the USA anymore. Every rich celebrety, and women with body dysmorphia knows how easy it is to get GLP-1s right now. Good and thank goodness for it.
Deregulating medical systems regarding patient choice and access to drugs is good, but you'll eventually get some bootlicker claiming that "we can't do that because SOMEONE WITH A VIRUS MIGHT USE AN ANTIBIOTIC INCORRECTLY" while ignoring the mass consumption of antibiotics by farm animals as a vector for super bugs.
Antibiotics are actually an exception to my general opinion that all medications should be available without prescription. Unlike most drugs, their use has major externalities which means there is a role for larger societal regulation of their use.
Also, are farms actually the major vector for antibiotic resistance in the human population? I was under the impression that the majority of antibiotic resistant infections occur in places like hospitals rather than among farm workers, which would seem to indicate farm animals are not the main problem (I 100% support banning the practice anyway).
I'd ask the opposite: are hospitals the places where the immunities develop or are they merely the places where the presence of antibiotic resistant bacteria is most deadly and therefore investigated?
The dangerous thing about antibiotic immunity is that it can transfer also between bacteria species.
I did the same at 34. There's a dermatology/STI clinic in Budapest where I live that gives the shot at cost (about 130 euros) because they think people should get it.
How much did it cost? I've considered it but it seems the only option for me is to pay for it out of pocket (~$1000 for the full course), which seems kind of not worth it at this point.
Your own doctor is as likely to be a quack/have quack-like beliefs as you are. Unironically this is true! Better learn to start reading Pubmed!
Doctors/medical associations don't agree with each other on much, even at the very highest levels. For example, the USA and EU have totally different recommendations related to digital rectal exams for aging men. One believes that finding cancer in old men is important, the other claims it's bad because most of those cancers are benign and sticking a finger up an old mans butt often causes its own complications.
Doctors don't have the time or capacity to know their patients well enough to make personalized recommendations in most cases. If you show up with symptoms of X they can recommend Y and will probably ask you whether you have Z which can impact the treatment. But virtually no doctor is going to ring you up proactively and say "hey, I noticed you haven't had a HPV vaccine yet, and I think it might make sense for you because I know this and that about your risk profile".
Doctors are not all knowing, infallible oracles. They are human beings you can have a conversation with about your health. If you think something makes sense for you, you can run it past them. No one is suggesting randomly asking doctors to prescribe random shit.
Because doctors are human and fallible operating in suboptimal systems. Don't want to provide me with a low risk, potentially high reward, low cost intervention? I'll shop until I find a doctor who will, or source it myself. Suboptimal systems and practitioners of various quality require advocating for one's self. I had to twist Planned Parenthood's arm to get Gardasil before it was approved for older adults, even though I was paying cash out of pocket, but had no problem with a trusted PCP providing me Metformin, GLP-1 prescriptions, etc simply by arguing my case and meeting sufficient criteria it would not come back to bite them.
The bigger issue is that someone who is 40 has likely already been exposed. I know women who had to ask to get it in their late 20's, and only succeeded after convincing the doctor they had been celibate up to that point. Apparently such a thing is relatively rare.
In either case this neither means that they are now immune against that specific strain, nor that they can't or won't get infected by another. Therefore that reasoning is flawed.
Yeah that’s the way I take it - “you’re probably not going to convince many people to sleep with you.”
Kind of hurts my pride, but seeing as I'm older than 40, and my wife and I are pretty freaking boring, the vaccine is better spent on someone with more opportunities ahead of them.
I really hate these vaccine specific awareness campaigns. Not only do they hurt my vanity, but I know too many people who are anti-vaxers, or into weird fake medicines.
I just go with what my doctor says. If social media says something different, social media is wrong.
But really, don’t get your vaccine schedule from Hacker News.
The activists on these threads should probably be pushing folks to get their kids vaccinated.
Best of luck, the reason it took so long for males to be approved for Gardasil use and they slowly keep pushing it up by age is two fold:
1) if you've ever been exposed to HPV already, then the vaccine is useless
2) there is no test to determine if a male has been exposed, although there is one for females
so they just push the ages up by probability, over time. As the probability of a man being with an older and therefore unvaccinated woman decreases - since with women is the most probable - the age can rise
> 1) if you've ever been exposed to HPV already, then the vaccine is useless
This is patently incorrect. The vaccine protects against 9 variants. Having been exposed to all 9 before vaccination sounds like really bad luck.
> 2) there is no test to determine if a male has been exposed, although there is one for females
The female HPV tests, as I understand, only test for the presence of HPV in the cervix. It can be present in many other areas. No one is testing women for the presence of HPV on their hands or in their throats.
Most places now offer HPV vaccines to young boys as well. People over 40 more or less missed the boat, but they can still get vaccinated. How useful it is depends entirely on their personal circumstances and risk profiles.
> 2) there is no test to determine if a male has been exposed, although there is one for females
It is incorrect. I had it tested multiple times. It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology.
> It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology.
No. The general reason that people don't do the test for men is that DNA testing is extremely sensitive, and produces a lot of false positives for a virus that is widespread.
It's also not actionable. You can't treat an asymptomatic infection, and a positive leads to the same outcome they would give anyway: use physical barriers and abstinence.
(Edit: hilariously, your first link says exactly what I just wrote, at the very top of the page. Did you read it?)
The claim I refuted is that there are no test for men (there are). Not sure why you want to get needlessly argumentative here, repeating things I already linked (sic!).
Sure, test from penis has lower specificity and sensitivity that for cervix, but it is not binary "works or not" (as side note, just measuring from urethra is rarely enough [1]). Life is probability, and it is a huge fallacy to believe that things work 100% or 0%, nothing in between (rarely the case in medicine).
Results are actionable on many ways. Most important, screening for female partners, informed risk for partners or your on safety for ones partners (condoms BTW reduce infection rates, but do not fully protect, as HPV can be on other parts of skin).
[1]
> The overall prevalence of HPV was 65.4%. HPV detection was highest at the penile shaft (49.9% for the full cohort and 47.9% for the subcohort of men with complete sampling), followed by the glans penis/coronal sulcus (35.8% and 32.8%) and scrotum (34.2% and 32.8%). Detection was lowest in urethra (10.1% and 10.2%) and semen (5.3% and 4.8%) samples. Exclusion of urethra, semen, and either perianal, scrotal, or anal samples resulted in a <5% reduction in prevalence.
I quoted you, and responded specifically to the quote. The reason doctors don’t offer the test is not because of some straw man arguments (“a horrible mindset…”) involving their diminished judgment of importance of the virus in men, as you assert.
You keep saying things in these sub threads that are factually incorrect in some important way that hides nuance, or otherwise seems calculated to provoke outrage. This was another example, which I why I replied here.
so far the comments are adding more vectors to understanding the situation, but nothing that fundamentally changes the user experience
I think the most insightful thing is that there are 9 HPV variants some of which someone wouldn't have exposure to so its worthwhile to get the vaccine anyway
but other than that, the situation is the same. for men's age the utility of the vaccine is based on probability alone, as its a waste of resources to even attempt checking for prior/current exposure
this is what I don't understand, why is it useless? there're multiple variants, vaccination could create reaction to a different part of the virus, etc.
I’m confused why it won’t clear an existing infection while still working on future infections.
Here is what I know (which may be limited, I’m not a biologist) and also what I’m assuming:
1) The body apparently doesn’t eliminate the virus on its own when it picks up the virus unvaccinated. I’m assuming that this is because it isn’t registered by the immune system as being harmful, for whatever reason.
2) The attenuated virus in the vaccine would not produce an immune response without the adjuvant, because even viruses that are registered as harmful are not reliably registered as harmful when attenuated. This is where the adjuvant packaged with the attenuated virus comes in - it is registered by the body as harmful, and in its confusion the immune system also adds the virus to the registry.
So, naively, if the immune system previously didn’t register the natural infection as harmful, and if it does register the virus in the vaccine as harmful, why doesn’t the registry entry for the vaccine also get applied to the natural infection, the same way as it does for a person who wasn’t previously infected?
Is there some kind of specificity hierarchy, along with a “not harmful” registry alongside the “harmful” registry, such that the natural infection continues to get its previous classification of “not harmful” because the “not harmful” registry entry is more specific than the “harmful” registry entry? That’s the only explanation I can (naively) think of.
And if that’s the case, could we first wipe out the registry by infecting the person with measles, and then give them the HPV vaccine? Just kidding about this part!
Yes, I understand that. Would you mind reading my comment above? The thing I’m confused about is why it won’t protect you against one you already have.
Like for viruses that have a vaccine, normally you wouldn’t vaccinate someone who had the virus already because the vaccine would be redundant - they already have natural immunity.
But in the case of HPV, apparently they don’t have effective natural immunity, the immunity naturally acquired is worse than the vaccine one. So why can’t the vaccine one take effect after the absent (or at least ineffective one) natural one isn’t (or is slightly) in place? That’s what I don’t understand. It seems like the natural immunity prevents the vaccine induced immunity from developing, but the natural immunity in this case doesn’t seem to work, while the vaccine induced immunity does work. Why…?
> - Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive.
However, the vaccination is expensive (~1k) and it is difficult to find doctors who will do non-recommended vaccinations for self-payers.
This is ultimately an American site so you can assume 80%+ of comments come from a US background (I'm not American, I've just been here longer than I should have).
Are there insurance plans that won't cover it? I know that a lot of plans love not paying for things but vaccines seem to be the one thing that they all at least seem fairly good at (at least in my experience).
I am currently getting the HPV series and I only had to pay my copay for the first appointment have nothing for the second one (I am assuming it will be the same for the third)
Yeah, one downside to giving this vaccine to your kids is you're basically telling them you expect they won't do this, even if they plan to (and you planned to, and in fact did). But pediatricians talk about how you really have to do it young, before they're going to be sexually active, and how it's hard to get later (not entirely true, as demonstrated by the comments here).
Is there any issue for adult males vaccinating ? I seem to remember some mention of risk by my doctor when I asked about it, but I might be misremembering.
No vaccine is without risk, but the vaccine approach is based on that risk being so low (but not zero) in comparison to the risk of not vaccinating that it is vastly the better choice.
Ok that was a bad question, let me rephrase: isn't there something particularly bad about this one for males that are already adults that makes it not recommended by doctors by default?
The benefits may be statistically lower, since you may have been infected by some of the variants already, older males may have fewer sexual partners in the future, and cancer takes a while to develop.
In the USA, it is recommended by default for adults up to 26 and kinda for 27-45.
Any infection risks sensitizing the immune system against some aspect of the human body. More likely with more severe infections, but not even a pseudo-infection is completely immune from it as it's a property of the immune system, not of the vaccine. The risk is very low, not zero.
(And dengue fever has the nasty property of making subsequent infections worse--and the vaccine does the same thing. Thus you get the really weird risk balance of only vaccinating those who have already had it. Also, Covid is prone to causing myocarditis--and the vaccine carries a small risk of doing the same thing. AFIAK no vaccine caused case is serious, though.)
> While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/
The study you've quoted here is not definitive evidence of the claim you're making, and that claim is...let's just say that it's controversial. Conventional wisdom is that you're unlikely to benefit from HPV vaccination unless you have not already seroconverted for at least one of the 9 strains (6, 11, 16, 18, 31, 33, 45, 52, 58) in the current vaccine.
There's not much hard evidence to suggest that vaccination for HPV has strong ability to protect you from a strain after you've already been infected with that strain [1], as the best available data shows a substantial decline in efficacy for women over age 26 and for women of any age who had prior documented infection [2]. This study is small, unrandomized, and the measured primary outcome (anti-HPV IgG) doesn't really tell you anything about relative effectiveness at clearing an infection. The only real evidence they advance for this claim is:
> Persistent HPV infection after vaccination was significantly less frequent in the nine-valent vaccinated group (23.5%) compared to the control group (88.9%; p < 0.001).
...but again, this is a small, unrandomized trial. We don't know how these 60 people differ from the typical HPV-positive case. You can't rely on this kind of observational data to claim causality.
Vaccination is great, but let's not exaggerate or spread inaccurate claims in a fit of pro-vaccine exuberance. The HPV vaccine has age range recommendations [3] for a reason.
[1] For the somewhat obvious reason that your immune system has already seen the virus.
It's also worth calling out table 4, which shows the (IMO bad) efficacy data for biological men, which is why I only talk about women, above, and why anyone who recommends vaccination without mentioning this factor is not being entirely forthright. Few people are rushing to give older men the HPV vaccine because it's not really supported by data!
[3] I believe the current guideline is under age 45 in the USA.
I understand why it wouldn't be recommended in policy but individually, provided you are rich enough to waste a hundred bucks, worse case is it's useless, best case you are 1-5% likely to spread a bad strain dangerous to yourself or to your partners, right ?
It's your body, and you can do whatever you want (assuming someone will consent to give it to you), but the worst case is that you have a bad reaction. It's rare, but not impossible, and things like GBS do happen -- though it must be emphasized that these vaccines are extremely safe by any reliable form of measurement [1].
But that's the general response to any question of this form. Medical treatments carry risk, however small. There is no free lunch.
> best case you are 1-5% likely to spread a bad strain dangerous to yourself or to your partners, right ?
I don't know where you're getting this number. I don't think anyone knows the actual answer to this question.
The age 45 bit isn't actually a guideline. Rather, finding naive but at risk individuals over 45 is quite difficult. They did not test it on anyone over 45, thus the FDA approval cuts off at 45.
1) Surrogate endpoint only — HPV PCR positivity is not a clinical outcome; no CIN2/3, no cancer, no mortality measured
2) Correlation ≠ causation — HPV-cancer link is epidemiological association; Koch's postulates not fulfilled in traditional sense; detecting DNA doesn't prove pathogenic activity
3) PCR detection ≠ disease — Transient HPV infections are common and clear spontaneously; most HPV-positive women never develop lesions or cancer
4) Type replacement signal ignored — 66% higher incidence of non-vaccine HR types in vaccinated group is dismissed rather than investigated as potential clinical concern
5) No long-term clinical follow-up — Cervical cancer takes 15-30 years to develop; this 7-year study cannot assess actual cancer prevention
6) Confounding in vaxxed vs unvaxxed comparison — Unvaccinated group is small (n=859), likely differs in health behaviors, screening adherence, socioeconomic factors
7) Circular reasoning — Vaccine "works" because it reduces detection of the types it targets; says nothing about whether those types were actually causing disease in this population
8) Assumes HPV16/18 reduction = cancer reduction — Untested assumption; clinical benefit must be demonstrated, not inferred from PCR
9) High baseline HR-HPV in vaccinated group unexplained — 32% prevalence of other HR types suggests substantial ongoing oncogenic exposure despite vaccination
10) Genome validity unestablished — HPV reference genomes are in-silico constructs assembled computationally; never validated by sequencing purified, isolated viral particles; PCR/sequencing performed on mixed clinical samples where true origin of amplified fragments is indeterminate
Venereal diseases have been a significant cause of human mortality for ages. The first outbreak of Syphilis in Europe killed ~7% of the population. The only thing that broke up that state of affairs was the advent of antibiotics.
And if it turns out you weren’t a perfect judge of character and your partner cheats on you, then fuck you, right? I guess you deserved to die from cancer because you couldn’t read your fiancé’s mind. Or maybe it’s your fault for not being a good enough spouse.
I’m so confused. “…don't blame me for your partner being a slut.” This implies that I would otherwise have some reason to hold you responsible for this, like your advice not to get vaccinated would prevent it, but since I’m acting against your advice the outcome is no longer your fault.
Chastity is 100% effective at preventing STDs exactly like living in a plastic bubble is 100% effective at preventing the flu (incidentally, it's also 100% effective at preventing humanity from existing within 80 years...). The fact that people throughout history, even in the most repressive times when "adulterers" were stoned or forced to marry rapists, have had much higher rates of STDs than we do today, shows that reality, rather than an abstract ideal case, is what matters in terms of public health.
Put another way: a "slut" practicing safe sex today will have fewer chances to contract an STD than a regular married woman in Victorian times.
> stupid man without any arguments
Seriously? Your argument is "damn those slut whores" and you're pretending to have an intellectual high ground...? Have a good weekend.
Almost zero? So you have seen throat cancer cases? And you don’t think it would have been good for those people not to have had throat cancer? Did they seem to enjoy the experience or something?
Uh, monogamy of both partners is also an option, not just celibacy. Not common in these times, I know, but you don't have to completely abstain from sex to be safe.
In the 1960s, more than 900 people were diagnosed with cervical cancer each year, corresponding to more than 40 cases per 100,000 Danes.
Today, that number is below 10 per 100,000 nationwide – and among women aged 20 to 29, only 3 out of 100,000 are affected. This is below the WHO’s threshold for elimination of the disease.
Just a quick point as an American living in Denmark, one of the reasons government programs like this work so well is everything is delivered digitally. We have "e-boks" https://en.digst.dk/systems/digital-post/about-the-national-... official government facilitated inboxes so when they need to notify you of vaccinations or whatever else, it arrives to your inbox. And basically 100% of residents use these systems.
This HPV vaccine was part of the children vaccination program (børnevaccinationsprogram) which kindly asks the parents to vaccinate their children.
While we have some anivaxxers here in DK, most people (90%, I believe) are sane and follow the recommendations.
The vaccinations start while the children are small and continue while they grow up .. the last one is when they are 12.5 years old.
The notifications are delivered in eboks or by mail if you don't want to use eboks. Everything from the state is delivered like this. There is nothing special about how the information is delivered. The SMS/e-mail notifications are just about hwo sent you something and not about what it is. At least for me.
I don't see how the use of eboks makes this work better. It would work just as well without eboks. People listen to doctors and the MAGA like shitheads we do have don't have a lot of influence.
This is why I posted it from the perspective as an American. We don't have anything remotely comparable. Vaccinations are delivered by private doctors and public schools often require vaccinations or exemptions but the system works entirely differently. If you homeschooled your kids and if your doctor didn't mention it, you'd never even know that vaccinations were available.
I fail to see how e-boks makes this work. Younger people check their e-boks less frequently than average, so sending a physical letter to their address would work just as well if not better.
e-boks sends a text message to the phone, so I see it much faster than a paper mail.
e-boks is like gmail (and others) in that it keeps your old mail. So you can easily find old stuff, a great improvement on paper mail.
I don't even check my physical mailbox once a week.
Denmark is one of the very most digital countries. Physical mail is very much on the way out. We no longer has mailboxes to send mail, you have to go to a shop to send letters, which now cost at last $6 per letter due to the low amount of mail sent.
It is only a matter of less than 10 years before letters will be fully gone.
Okay, well Ireland has similar vaccination rates, broader childhood vaccination coverage, and no central medical records at all, so while e-boks may assist administration, it's certainly not necessary.
Which is bad, we definitely should have them. Referral data appears to be managed through Healthlink, which may just be a privatised not always used medical record system.
I'm a proponent of EHRs but not necessarily of centralised medical records, which have not been shown to improve outcomes and which do impose serious privacy risks on patients.
HealthLink is a messaging system and stores no EHRs at all. eHealth is the National EHR programme aiming to roll out EHRs by 2030 nationwide.
It will be a no-opt-out centralised EHR and combined social care record.
In high-trust societies these things work, yes. Not all societies are high-trust. Often, they once were high-trust but are no longer thanks to sociopathic, non-empathetic actors.
I do think people put too much stock in how many things RCV would fix in the US, but I am a big fan of it and it would certainly be a big first step improving representation in this country. Unfortunately, multiple states (all Republican dominated) have already outlawed RCV as an option. So in order to do it you would have to overturn the existing ban as well. It’s ridiculous.
Trump rode to the White House pitching that the government is broken/corrupt and as an outsider he would fix it. A significant part of his appeal is that he was a big middle finger to the establishment and current system writ large. This is well studied, documented, and easy to see in our daily lives. How many campaign ads begin with “the system is broken” or “Washington is out of touch”? Nobody ever lost voters for saying the government isn’t doing enough for them and isn’t trustworthy.
You can look at any Gallup or Pew poll or whatever sources you prefer and you will likely see that Americans have been steadily losing trust in their government. It has been in steady decline since the post-war era with some notable brief increases, but they don’t last.
>citation needed
I disagree as it is incredibly easy information to track down. But here you go anyway:
Obviously social trust in the US has declined and Trump benefited from that. But this is not evidence that the primary cause is sociopathic, non-empathetic actors. Theoretically it could also be things such as increased diversity, loss of shared identity, people acting in good faith but failing to adapt to social media.
Go and look around in former high-trust societies where this trust has broken down or is breaking down - my points of reference are the Netherlands, Sweden, Germany and to a lesser extent the UK - and you'll get your citations. What you'll probably find is that in 'marginalised areas' people have trust in governmental institutions - those which provide social welfare, healthcare, schools and such - while they have little trust in 'other (groups of) people'. In other words they trust the state but distrust their neighbours, especially those from different ethnic groups. If you look in more well-to-do areas you'll find the opposite: people mostly trust their neighbours but they have lost trust in the higher echelons of the state which in their eyes has been instrumental in the dissolution of their former high-trust society. They'll still mostly trust their local police and fire brigade but they see academia and the social workers and soft-on-crime judicial institutions it produces as part of the problem. Any articles produced by academia which claim to provide proof of the opposite are seen in the light of the severe political bias in those institutions - sociology as a discipline has lost nearly all trust due to this - so citing those only feeds the fire.
Sweden is not a society were trust has broken down. Neither is Germany. Maybe the Netherlands can be argued to have a breaking down of trust. Go look at actual data, and don't rely on racist internet memes to form your arguments.
In neighboring Denmark, where they do gather and publish crime stats by the country of perp's origin, it turns out that some people (like Somalis) have up to 10 times more criminal convictions than the country baseline.
One would have to be crazy in order to extend exactly the same trust towards a random Danish Dane vs. a random Somali Dane.
Not every negative statement about non-white people is rooted in racism, and the ugly, fanatical attitude "everyone who has a negative observation about any sort of immigrants must be racist, stupid and evil" is what upended the political spectrum and brought the far right to power in many places.
I know you said or is breaking down. I'm telling you that its only for Netherlands you can argue a drop in trust. I'm sorry that you take the racist label as an insult. But the Sweden has fallen talking point is a racist lie, so don't perpetuate it if you don't want to be called out on it. Again I invite you to look at data on trust, and stop making stuff up.
Why do you think AfD is close to becoming the biggest party in Germany, why is (or was?) Wilders big in the Netherlands, why is Sverigedemokraterna close to becoming the biggest party in Sweden? Do you think suddenly 25% of the population of these countries has turned rabidly racist?
That 'racism' word has lost its meaning due to severe overuse, find another argument. As to finding 'data', that is easy enough if you ask people around you. I live in Sweden and I hear this every day, everywhere, both in the countryside where I live as well as in the more urbanised areas on the west coast where I work and where my daughter goes to school.
If you want to get a bit closer to the actual truth than your knee-jerk 'racism' accusation you should look into the clash of cultures - not races - which lies at the bottom of these problems. Go and speak to people from low-trust societies as well as those from high-trust societies and ask them where they put their trust, how they think about their neighbours - not just the ones in the house next door but also those in other areas.
It has fallen due to many reasons, some of which are related to migration, many others with no or only tangential relations to it. You already mentioned the 'housing crisis' which is partly related to migration - where asylum seekers with residence permits ('statushouders' [1] in Dutch) get preferential treatment and now stand for 8% of the total, 20% of the housing for 'first time renters' and 78% of the 'first time renters with children' [2]. This is only part of the problem though and not the largest one, that being the fact that there are simply too few housing units (apartments, houses, etc.) available. This in turn is partly due to the fact that it is hard to get permission to build something due to the heavy regulatory burdens and especially the rules around nitrogen emissions ('stikstofregels' [3], nitrogen oxide emissions by diesel engines used in construction put strict limits on what can be built when and where).
Then there are problems like the childcare benefits scandal ('toeslagenaffaire') - again partly related to migration by way of Bulgarian migrant fraud [4] - where the tax department made erroneous claims about benefit fraud without every really acknowledging they were wrong. I have some experience with the Dutch tax authorities making clear mistakes without accepting responsibility, instead they come up with mysterious restitutions which somehow exactly match the erroneously claimed taxes due.
The restrictive and SARS2 unpleasantness hit trust in public institutions hard which caused the universities of Rotterdam and Leiden to publish a report calling the Netherlands a new low-trust society ('de laag-vertrouwensamenleving', [6]). This trend has not reversed, especially among those with 'higher educational levels' [7] who used to have a higher trust in governmental institutions but now slid down to resemble the trust levels seen among those with 'lower educational levels' - this could simply be related to the fact that the left-wing parties favoured by those with 'higher education' did not participate in the government at that time.
I grew up in the Netherlands and lived there until about 25 years ago. I have seen this slide in trust with my own eyes, from the country where I could open the front door by pulling the string which dangled through the letter slot when I cycled home from school at 6 years old to the Fort-Knox-with-cameras now required, from the police officer on his bike greeting the people on his beat to "romeo's" (undercover arrest teams) being accused of inciting riots [8], from nearly the entire village coming out to welcome Sinterklaas (St. Nicholas who brings presents to children at the 5th of December) to those events being cancelled due to the fear of violence and protests, etcetera.
If there were a string in the mail slot in the house where I grew up it would not end well, unfortunately. Even the mail slot itself is suspect since these have been used by burglars to open unlocked doors (metal wire through the slot, easy), by vandals to throw in fireworks (one house burned down that way), by creeps to pee through it (another house in the same area), by other vandals to put a garden hose in to flood the hallway just for kicks, etc.
This was in Amstelveen, to the south of Amsterdam. Where do you live?
I don’t get it. Everyone online gives advice like “Ask your doctor to get the vaccine even if you’re male” but the pharmacies here in SF refused to give it to me. They said that it’s not indicated for a 35+ yo male.
So I get the theory of this thing. But has anyone actually tried this? Finally I got OneMedical to prescribe it for me for some $1.2k at which point I decided I’ll just get it abroad during some planned travel.
I decided years ago I’d do this because I was going to have girls and I wanted to minimize my daughters’ risk of cancer.
Over a decade ago I tried getting the HPV vaccine in my early 20s, but the doctor told me it wasn't recommended for men and that insurance won't cover it. I was young and didn't have the money to pay out of pocket.
I went to Planned Parenthood and got the vaccine last year. At some point they changed the recommendation to men under 45 now and I got all 3 shots free.
Honestly, though I'm glad to have finally got the vaccine it's been a pretty frustrating experience.
The FDA has approved it for men up to age 45. I myself got it in my late thirties at a pharmacy. For one of the shots, the pharmacist hassled me a little, asking if I was high risk, but acquiesced when I told them I was. For the other two, they just gave me the shot. It was also covered by my insurance.
> I decided years ago I’d do this because I was going to have girls and I wanted to minimize my daughters’ risk of cancer.
I don't understand: how would your daughters be more/less likely to get cancer based on whether you were vaccinated? There's obviously the (hopefully extremely) roundabout way in which there is a direct path of sexual partners leading from you to your future daughters, but is there something else I'm missing?
And if you don't have it by age 35 (and married, per your comment below), how likely are you to even get it at this point? Are you thinking you could hypothetically pass it to them by kissing your babies on the mouth, after contracting it in the future?
The vaccine is likely to do very little damage to me, but cervical cancer is a big bad. I think I'm just accounting for some risk that we discover a non-sexual mode of transmission.
Seems unlikely that there's a way for fathers to accidentally give HPV to their daughters and we haven't figured it out yet.
I would think that kissing a baby on the lips would be the best chance, and if that were the case it'd be super obvious because there'd be a bunch of toddlers with HPV, which would cause alarm.
Carrier screening revealed a shared genetic risk so my wife and I decided to do IVF and PGT qualified our female embryos as unaffected (coincidentally, it’s autosomal recessive).
My reading of the following is that the cost of each additional quality adjusted life year would be over $100,000, rather than that each vaccination prompts $100k in economic value
> Including preadolescent boys in a routine vaccination programme for preadolescent girls resulted in higher costs and benefits and generally had cost effectiveness ratios that exceeded $100 000 per QALY across a range of HPV related outcomes, scenarios for cervical cancer screening, and assumptions of vaccine efficacy and duration
Lots of viruses are really oncogenic. The real success here is the ability of Denmark to track effectiveness. It sounds crazy but most countries do not have electronic health record capability to measure the effect of many interventions at population scale. Once good EHRs are rolled out, we will be able to double down on effective interventions, like this one, and vice versa.
A lot of viruses insert themselves into your DNA, they may mess up the 3D structure, or during DNA repair result in misrepair / duplications, or simply insert somewhere and break something important. All of these are ways that can contribute to kickstarting or accelerating cancerous growth.
Sadly, no matter how good the data is, some societies will value opinions of uninformed celebrities above facts and reason, leading to a resurgence of preventable diseases.
Idk the Danish approach of opennnes seems to be working for them. They acknowledge it isn't fully effective. They acknowledge that there may be a small risk of side effects. And they tell people it's worth it and to go take it.
"Since HPV vaccination was implemented in the Danish childhood vaccination programme in 2009, we have received 2,320 reports of suspected adverse reactions from HPV vaccines up to and including 2016. 1,023 of the reported adverse reactions have been categorised as serious. In the same period, 1,724,916 vaccine doses were sold. The reports related to HPV vaccination that we have classified as serious include reports of the condition Postural Orthostatic Tachycardi Syndrome (POTS), fainting, neurological symptoms and a number of diffuse symptoms, such as long-term headache, fatigue and stomach ache."
"The risk of cervical changes at an early stage was reduced by 73% among women born in 1993 and 1994, who had been vaccinated with the HPV vaccine compared with those who had not been vaccinated."
"The Danish Health Authority recommends that all girls are vaccinated against HPV at the age of 12. The Danish Health Authori-
ty still estimates that the benefits of vaccination by far outweigh any possible adverse reactions from the vaccine."
Its not like it wasn't without issues. You had the documentary from a state funded tv station that uncritically let people claim all kind of issues after getting the vaccine. It drastically lowered the uptake of the vaccine.
> They acknowledge it isn't fully effective. They acknowledge that there may be a small risk of side effects. And they tell people it's worth it and to go take it.
Those are basic bits of knowledge that apply to most vaccinations.
The problem is that the quacks diminish the positive effects, exaggerate the negatives and engage in a campaign of fear mongering that costs some people (and in some cases lots of people, see COVID) their lives. They are not only clueless, they are malicious.
From Gwyneth Paltrow, JFK Jr, all the way to Donald Trump and a whole raft of others the damage is immense. I have a close family member who now is fully convinced of the healing power of crystals and there isn't a thing you can do to reason with people that have fallen into a trap like that.
I think those who advocate for censorship are gullible and have fallen for the bush-league trap of believing that the state is on your side and exists to benefit you.
As bad as many celebrities/politicians are (I'm waiting/fantasizing for "cheeto in chief" to sit in the same jail cell as "bubba"), the real quacks are organized groups like Chiropractors, "Naturopaths", Multi-level-marketers, etc.
My medical insurance will pay for several literally fake/quack treatments because of this crap. If you want to wage war against Quackery I better see you going after "big Chiropractor" first.
Telling lies should never be criminalized, because there is no single trustworthy arbiter of truth.
This has nothing to do with vaccines. There is a very good reason that misinformation is, and should remain legal. This simply allows the person or group who gets to define what is or is not misinformation to arbitrarily imprison anyone doing publishing they don’t like.
You really need to think through the implications and consequences of censorship laws before advocating for them.
> You really need to think through the implications and consequences of censorship laws before advocating for them.
Maybe I did?
It is possible that we just disagree on this. Clearly misinformation about medical stuff is so damaging that many places have found it necessary to have laws on the books. I'm just elevating this from a misdemeanor to an actual crime based on the outcomes.
What if 25 years ago I spoke out against opiods as highly addictive and dangerous. Remember, this was in contradiction to the scientific consensus at the time that modern opioids were not that addictive. A reasonable person could have said at the time that my claims were false and posed a danger to people who were in pain and needed this medication. In hindsight it's obvious that the scientific consensus was catastrophically wrong, but it people like you were in charge, people could be jailed for their dissent.
If you did you'd have been in very good company because the world over the scientific consensus was that opioids were addictive.
That scientific consensus you are alluding to is not what you claim it was.
Finally, we're talking about celebrities without any qualification whatsoever spreading utter nonsense causing real harm, you can look at that in isolation and compare it to you making that statement out of an abundance of caution regarding something where there is no downside. The two simply are not equivalent. Free speech absolutists always pull the same trick, aiming to refuse an obvious wrong in order to defend their bastion while forgetting that there isn't a black-or-white at all, you can have some reasonable limits on what people can and can not do and in the age of 'influencers' with global reach the danger is much more prevalent than it used to be.
Free speech is a great good, but it is not the greatest good.
Scientific consensus is often NOT the defining measure of what a state (and thus a prosecutor) considers truth, and thus what they consider misinformation.
The dangers of medical misinformation, regardless of scale, do not negate the fact that criminalizing _what the state calls_ misinformation allows the state to arbitrarily imprison people publishing things, because it demands that the state be the arbiter of truth, something that does not have an objective legal
method of determination. If it somehow did, promoting religion would of course be illegal as it is clear misinformation.
Also, consider for a moment the insane amount of harm the delusion that is religious belief has wrought. Should we be outlawing that, too? The suggestion that prayer is an effective treatment for ailments is a claim they have been making for millennia. Shall we somehow square your anti-misinformation law with religious freedom?
People should always be free to be wrong, because we often don’t know what is right until many decades or centuries or millennia later.
Yeah, we should have a Ministry of Truth that declares things "quackery" or "misinformation" and then jails people for saying it. I can't see how this could possibly go wrong.
Quackery in what sense? It is my understanding that to be a quack in a legal sense one must first be a licensed doctor, and malpractice is covered by freedom of speech. But you referred to celebrities practicing "quackery" which I assume means that they were saying the same nonsense that could get a doctor's license pulled, and that is absolutely covered by freedom of speech.
Also, you have already admitted there is a Ministry of Truth equivalent, as such a thing is necessary to prosecute people for telling lies.
Celebrities in general are quite dubous. See a certain actor suddenly promoting Palantir spysniffing on mankind. I decided that guy won't get a dime from me for the rest of my life - when actors suddenly become lobbyists for Evil, they need to not get any money from regular people really.
This is just normal not supporting things you disagree with. It's not a rule of thumb you can quickly use to discount an opinion. Ignoring actors is a pretty handy rule of thumb. Their main skill is repeating someone else's words and emoting. There is no reason to consider them smart, knowledgeable, informed, or competent.
The numbers are quite solid. People who don't want to accept the numbers, need to come up with an explanation why the data can not be trusted. With regard to oncogenic HPV, I think the data is very convincing. To me it was a lot more convincing than the SARS covid datapoints (e. g. the media constantly shifted; I noticed this with regard to Sweden, which had a bad early data due to barely any protection of the elderly, but lateron it still had better data than e. g. Austria which went into lockdown - so Austria had worse data points than Sweden overall. Japan or Taiwan had excellent data points, so the respective governments were much better than either Sweden or Austria. The most incompetent politicans acted in Austria during that time, replacing facts with promo and propaganda. The data points, though, were always solid. I remember I compared this about weekly and it was interesting to me when Austria suddenly surpassed Sweden negatively; the media here in Austria critisized Sweden early on, but once Sweden outperformed Austria in a better, more positive manner, suddenly the media no longer reported that. Private media simply can not be trusted.)
Covid data didn't keep shifting except in the early time before we understood it.
Your comparison of Sweden vs Austria has a problem: Covid did more damage in warmer climates. Thus this proves nothing about policy. Look to others more similar--Sweden didn't fare well.
Anecdote time (and some info from real life EMTs and Oncologist). I just recently “won” the cancer lottery related to this.
Never had the HPV vaccine. Honestly thought it was only for young girls (didn’t spare topic a thought, zero time investigating).
80-90% of adults gets some form of HPV during lifetime. Often several strains. Each have different risks of cancer. Even if you’re married - if you or your partner experience a severely stressful period- it might reactivate.
Most people’s immune systems clears HPV, and makes it dormant. (Mine likely doesn’t see HPV as a threat.
Long term (10y+?) exposure to active HPV cause cancer.
If you can, at least do your very best to avoid the cancer nightmare. Take the vaccine. Worst case it protects you from being a vector.
It’s an imperfect insurance from 3-4 months in/out of hospitals, scans, blood work, from chronic dry mouth,all food tasting very bad, issues with energy, possible bone death (that you suddenly have to monitor every day for the test. Oh, and any alcohol or smoking after having had this increases risk of recurrence by 30-50%
A comment with an article citing published medical literature on risks associated with this type of vaccine was flagged and hidden. Why? I don't know the author nor am I a medical doctor to understand the topic at depth, so it's a genuine question. Was it misleading? If so, how? That's what the comment was asking, actually, if there were counter-points to the text, which was favorable to live vaccines (e.g. shingles) but critical of those developed with other methods. Is there no merit to that? I genuinely don't know, and since it seems impossible to discuss the topic, it's hard to say.
I sometimes vouch for incorrectly flagged posts. You got me curious, so I took a look. What I found was a blog from an anonymous conspiracist vaccine opponent claiming to be a doctor. He's a decent writer but in my estimation a loon.
So I'm fine with it being flagged and decline to vouch for it.
For the HPV section specifically, there were at least two major omissions.
First, in his table showing autoimmune adverse effects, he has chosen to crop out the next column in the table containing the control conditions - which show very similar rates of adverse effects to the vaccine condition.
Secondly, when discussing negative efficacy in the case of existing persistent infection, he only quotes the data from one of three studies that the linked report covers. The linked report indeed covers the negative efficacy in study 013 as an area of concern. However, study 015 (which had roughly twice the number of total participants as study 013) showed no real evidence of negative efficacy. When all 3 studies are pooled together, the point estimate still says negative efficacy, (at ~-12%), however the error bars are quite wide.
Why this is tragic, is because these two omissions do actually point to failures in public communication about the vaccine. For example, the control condition in the Merck trials were a mix of saline injections (this is the traditional placebo), as well as injections with just the adjuvant (AAHS). This is less standard, and raises legitimate questions about why Merck used an adjuvant as the control, instead of just saline. There a cynical/conspiratorial angle to this question, which I think would be directionally correct.
The second omission is because I think there is a reasonable question of "are there extra risks associated with getting the HPV vaccine while having an active persistence infection", even when taking into account the different and larger study populations within the original trial data. Once again, I think the idea that both companies and public health agencies don't want to deal with a vaccine that requires testing before hand is true. I also believe that on a population level, even if there was a modest increase in risk in that specific subgroup, it makes sense to implement broad vaccination campaigns.
That said, I think the unwillingness of public health agencies to engage with this tricky area of communication and education creates these types of opening for anti-vaccine messaging. If you want a sense of "conspiracy" - here's a random review study - https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
Notice that when reporting results, the groupings for HPV status at enrollment time are "naive" and "irrespective" - the "test positive" grouping isn't broken out.
In this house we believe
Love is love
Black Lives Matter
Science is real
Feminism is for everyone
No human is illegal
Kindness is everything
Signaling your alignment to the public-facing opinions of your social betters is the modern ersatz religion for atheists. The television is the temple, the pundits the priests. Apostates and heretics are not welcome here. Now, my child, you would not want your words to inadvertently cause the faithful to stray. Would you? Just think of what the late night comedians would say if they could hear you cast doubt on their sponsor Pfizer? Perhaps you would rather join our hate session on the pagans in flyover country?
First hand experience here, 6 years ago I had tonsil cancer from HPV16. It SUUUCKED. Doing well now though thank god. I’ve had a hard time getting decent info even from my oncology team in the years since as to whether I should even consider getting the vaccine now. I am 45, married and my wife of 5 years (yes we went through all of that while engaged) has gotten her series of shots 3 years ago.
I have heard from my Drs that as obviously I have already had at least the one strain, there isn’t really a point in getting the shots now. Is there any newer info regarding this semi specific situation that anyone is aware of?
The data is IMO quite convincing. Harald zur Hausen pointed this out decades ago already; this is another data point that adds to the theory which back then he proposed was fairly new (not that viruses cause cancer, that is much older knowledge, but specifically the role of some HPV strains; Harald died about 2 years ago).
HPV vaccination leads to massive reduction in nasopharyngeal, penile and rectal cancer in men.
The focus of messaging around HPV vaccination on ovarian cancer, female fertility and the age limitations for recommendations / free vaccination in some places are nothing short of a massive public health failure and almost scandal.
Just truthfully tell the boys their dicks might fall off and see how all of them quicklky flock to the vaccine.
> Just truthfully tell the boys their dicks might fall off and see how all of them quicklky flock to the vaccine.
Every male above the age of 26 is locked out of the vaccine unless you pay out of pocket, which will be €300-€500 (or even higher).
It's led to this really weird situation, where HPV vaccination for men is now recommended up to 40s but only covered up to 26yr old, and that recommendation upgrade happened relatively recently. Which means there's a whole generation of men who are told they should get the vaccine, who would have had covered access to the vaccine in the past, but are now expected to go out of pocket.
Yep, I paid for mine. male/43/Spain. Almost €400. Two shots of the nonavalent vaccine, ~€190 each.
For younger people it's three shots (second after two months, third after 6 months of the first one), now for older (over 30s or 40s, I can't remember exactly) it's recommended to get two shots (second after six months).
I'm in the US and have wanted to get it but perpetually have been older than the recommended cutoff. They have raised the age over and over again but I've always been older than it. I'm not sure why they don't just get rid of the age limit recommendations altogether.
Promiscuity is not a healthy lifestyle and we need to stop presenting it as one. The AIDS crisis of the 1980s should have been enough of a warning. If people don't sleep around then HPV's spread will be much reduced and they will be much less likely to catch other STIs.
This adds nothing. It has been repeatedly shown that stupid abstinence-driven approaches to public health do not work. It’s equivalent to saying “maybe the obesity crisis would be solved if we all just ate less”.
Moral crusades have zero place in public health and are actively harmful.
And countless couples followed this path in life and are not happy at all, and countless individuals can't for a variety of reasons follow this path. But public health advice should also be available to them.
Psychology is a whole other matter, but if you're talking about sleeping around like Bonnie Blue then it is a form of Russian roulette and is likely to result in physical health trouble. Especially if people are having unprotected sex.
I am not talking about 'sleeping around' at all. Just by the look at the divorce rates around the world it is very clear that 'marry young and then never change partners' is an advice divorced from reality.
If there's somebody out there advocating for "unprotected sex with large numbers of people", you should go post at them, because I don't see that here.
The biggest barrier to disease transmission reduction, at least here in the US, is uncritical abstinence promoters like yourself. It works, at best, for a small fraction of the population, and leaves the rest woefully unprepared for the biological realities. The best solution to STDs is education. Which, yes, should emphasize that not having sex is an option, but cannot stop there.
Strawman--nobody's suggesting unprotected sex with many people.
Simple data point, though: my wife is from China, grew up in a culture where divorce is basically unheard of. At first she was horrified at what she saw here--but over time she's come to see the marriages of her culture weren't any more successful. It just they turned into unhappy people staying together for reasons of face. Just about everyone she was close enough to to know about their marriage was no longer having sex.
Not as sad as catching something which will damage you physically, sterilise them or even kill them.
People don't want to hear this obviously. But it is a fact STI transmission has skyrocketed since the so called sexual revolution of the late sixties. Within fifteen years, we has an AIDS epidemic.
But it is a fact STI transmission has skyrocketed since the so called sexual revolution of the late sixties
It’s the opposite of a fact. Gonorrhoea rates as an example rose significantly in the 1960s, but are now lower than in the 1940s and 1950s. This is thanks to good public health measures.
Yeah that’s a moral crusade. It’s a public health issue; you deal with it through public health measures like education, vaccination, and treatment. You don’t make it go away by wagging your finger at it.
The AIDS crisis happened because it was unknown and very stealthy--nobody knew there was a risk to be guarded against. And it certainly didn't help that because of the association with gays the government response was slow-rolled. Same thing we saw with Covid--the US response was slow-rolled because at first it looked like it was selecting for blue areas.
Without the gays it might have gone a long time as a blood vector without being identified. When it was a "gay" disease it was busy killing old people who got transfusions but were never identified as having AIDS.
You could probably have gotten away with it a decade ago but that is a very poor plan in the far more critical of public health world of today.
Statistically nobody even knows a guy who knows a guy who's dick fell off. Serious HPV problems for men are not even common enough to be viable urban legend. You have less to back up your DARE messaging than DARE did. It's just not gonna work. The nanosecond someone who took your bait shows up to be interviewed by some Youtube talking head about side effects the already severely damaged (compared to, IDK a decade ago) credibility of the medical establishment will go up in flames.
You need to tell the truth the whole truth and nothing but the truth and let people make their own decisions. People don't "trust the experts" anymore at the scale you need for stuff like vaccination campaigns so you have to operate based on that reality.
Apparently HPV is responsible for some ~70% of throat cancers and ~30% of penile cancers in men. Seems pretty significant to me.
If nobody knows a guy who knows a guy who had penile cancer, that's probably because people are very bad about talking about genital health. I'm sure some of the men in my life have issues with erectile dysfunction, enlarged prostates, hemmorrhoids, etc. But no one is talking about those issues.
Think of it as shared responsibility. The tobacco and the virus are both reasons why you got cancer and died, prizes for all.
So maybe 70% of throat cancer victims have HPV, and like 70% smoked - and if those were independent facts you'd expect that about 49% both smoked and had HPV, but it's actually more than half 'cos it turns out that if you have HPV then smoking is even worse. So that's nice.
And how many men get throat and penile cancers vs other cancers and health issues? There's a reason old men crack jokes about prostate health, erectile dysfunction and incontinence rather than their dicks falling off and are way more worried about colon cancer than rectal cancer.
I didn't say it wasn't a significant source of cancer. I said that nobody knows a guy who knows a guy who's dick fell off or some other extreme outcome. Without enough of that to back up your messaging it just won't work. You need to be honest with people, not try and scare them like you're trying to keep school kids from smoking weed in 1990.
The public messaging you're trying to engage in could perhaps have skated by in a less critical time but in the current environment it will be counterproductive.
I don't want my kid or my grandkid to get measles or some other "of immediate consequence" disease because they go to school with a bunch of unvaccinated kids because you people sullied the reputation of public health via "just push the truth a little, it'll make them take the vaccine" type endeavors.
> Among the 859 unvaccinated women, HPV16/18 prevalence was 6%, 5%, and 6%
and
> However, about one-third of women still had HPV infection with non-vaccine high-risk HPV types, and new infections with these types were more frequent in vaccinated than in unvaccinated women.
so… real summary is “hpv vaccination correlates with lower infection for vaccine specific HPV strain, but does not impact / potentially worsens overall high-risk HPV infections”
so what exactly is solved here, supposedly?
not to mention, the study does not compare helth outcomes, which is the only meaningful measure.
I believe HPV16/18 were considered the highest risk (in terms of causing cancer), even amongst all the other high risk HPV strains. In the intro, they state that prior to the start of the vaccination campaign 74% of cervical cancer cases in Denmark were HPV16/18, and the other 26% from the non-vaccine HR HPV strains. Following through to the referenced paper, in their study they found 20.5% of overall patients had HR HPV, with 5.4% and 2.4% with HPV16 and/or 18. However, for cancer cases, they found that 40% of cases had HPV16, and 33% had HPV18 (note that multiple simultaneous strains are possible).
There's a lot in the paper to summarize, but I think it makes a reasonable argument that HPV16/18 are especially high risk, and that "simple" replacement of the 5% HPV16/18 with another 5% of any of the other HR HPV strains would be beneficial. The linked paper suggests up to 74% (depending on your assumptions) reduction in cancer with "simple replacement".
> Infection with HPV types covered by the vaccine (HPV16/18) has been almost eliminated. Before vaccination, the prevalence of HPV16/18 was between 15–17%, which has decreased in vaccinated women to < 1% by 2021. However, about one-third of women still had HPV infection with non-vaccine high-risk HPV types, and new infections with these types were more frequent in vaccinated than in unvaccinated women.
I wonder if we'll those non-vaccine strains will eventually become the most prevalent.
In my EU country Gardasil 9 is the most common HPV vaccine nowadays. This protects against 9 most common strains. I would assume the same is true in other countries. We have gone from HPV 16/18 -> +6/11 -> +31/33/45/52/58 protection with 2/4/9-valent vaccines.
Absolutely completely off the topic at hand here, but it seems like the bot and troll level goes up a lot on topics like this. A lot of people use HN data for training data, stats analysis, etc. Anyone out there figure out some good tools for trying to detect the bots in a thread like this? There are probably some good tells with throw-away accounts, account age, etc etc. In a world where misinformation is algorithmically generated and comments are a prime way that happens getting tools that can detect it is important. Hmm if there are good tools I wonder if they could be built into a plugin somehow.
Another angle of why vaccinating men is important is because gay men (or more precisely those who participate in oral-penile or penile-anal sex) are at risk for these cancers, but if we only vaccinate women then we do not protect this group of men.
Also on my soapbox it's an absolute absurdity that we still do not have any HPV test for men.
The only thing I've never understood about the HPV vaccination is that for some reason after a certain age as an adult in the United States, no primary care provider appears to recommend you get it in addition to your regular vaccination schedule.
Is the idea that you're married and have a single partner and the risk factor has dropped below a certain percentage of the population where there's little reason to recommend getting it if the likelihood is that you've already acquired HPV in your lifetime thus far?
Every other vaccination appears to be straightforward, besides HPV, and I don't know why. I've also never heard a clear answer from a physician.
Is it just that our vaccination schedules are out of date in the United States? This seems to be the most likely culprit to me.
I don't really have time to read it all, but the basic idea is as you said - the cost-benefit ratio is off. Basically expanding from something like the current case, to vaccinating up to 45 year old will avert an extra 21k cases of cancer (compared to the base case of 1.4 million) - so about an extra 1.5% cases averted, while the direct vaccination costs are estimated to increase from 44 billion to 57 billion (+29%).
The current guidance says "do not recommend" plus "consult your doctor". You should read that as "blanket vaccination as public policy is cost inefficient in that age range" not "you as a 45 year old should not get the vaccine categorically".
The weird thing is all these people commenting who seem opposed to vaccination so that people are afraid to have sex.
I mean if you support lifelong monogamy or similar sure, you do you, but I don’t think more dead people is a good thing to advocate to promote your lifestyle choice.
I used to know a lot more people like that and I swear half of them left the church and had a hoe phase despite earlier professed beliefs.
You sound like my fellow citizens who have decided to use their theocratic power to push this view across my city and school. It impacts my children and their future mates. Sure, there’s an ideal world in which every person finds their ideal partner on the first time, falls madly in love and remains forever faithful. I don’t live in a Disney fantasy world, and would prefer public health policies are based on pragmatic principles.
> Despite this being clearly shown within the HPV vaccine trials, since testing before vaccination would reduce vaccine sales, it was never recommended within the prescribing guidelines (some groups even said to not test before receiving the vaccine).
Citation needed. In Germany, the HPV vaccine is recommended only to below 14 year olds, so as to reduce precisely that risk.
This is one of the many reasons I think medicine is full of people who are good at memorizing but are outright stupid when it comes to problem solving and logic.
I wanted an HPV vaccine when i was younger. As a male, I was told "no", even though it causes the most common throat cancer in men, and was linked to prostate cancer. Stupid.
- HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives. Unless you plan to remain completely celibate, you are likely to contract a strain.
- Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive. While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/
- HPV16 is responsible for a large number of throat cancers (around 50% in smokers and 80% in non-smokers!). This affects both men and women. Vaccinating men is important for their own safety and to reduce transmission to their partners.
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