[HN Gopher] HPV vaccination: How the world can eliminate cervica...
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       HPV vaccination: How the world can eliminate cervical cancer
        
       Author : ZeroGravitas
       Score  : 279 points
       Date   : 2024-11-04 19:49 UTC (5 days ago)
        
 (HTM) web link (ourworldindata.org)
 (TXT) w3m dump (ourworldindata.org)
        
       | Qem wrote:
       | > The virus is also responsible for a large share of other
       | cancers, including anal cancer, penile cancer, vulval cancer,
       | vaginal cancer, and some head and neck cancers.
       | 
       | It would greatly reduce other types of cancer too. Men also
       | benefit from it. Unfortunately the way campaigns market it causes
       | many people to think it benefits ladies only.
        
         | yieldcrv wrote:
         | I took one look at the initial FDA approvals and paid out of
         | pocket for this vaccine.
         | 
         | A cursory understanding of the virus, insurance, and the age
         | bounding of getting vaccinated would lead anyone to the same
         | conclusion. Unless they are allergic to the word "vaccine".
         | 
         | Basically, the vaccines dont work with prior exposure, and
         | there is no test to know if men have been exposed. So thats why
         | there is no focus on men, and why initially men were only
         | approved for use if they were under 26 years old, based purely
         | on probabilities they havent been exposed yet. This is a
         | problem for insurance companies.
         | 
         | Also at one point in time, it wasnt linked to cancers affecting
         | men, and men were seen only as carriers. Now it seems any area
         | of flesh exposed to HPV strains are at risk of cancer there.
         | 
         | The age of male coverage has been expanded to like mid-40s by
         | now.
         | 
         | The abstinence crowd worried about anything that makes people
         | feel safer engaging in sex will get you killed.
        
           | carlmr wrote:
           | >Basically, the vaccines dont work with prior exposure, and
           | there is no test to know if men have been exposed. So thats
           | why there is no focus on men, and why initially men were only
           | approved for use if they were under 26 years old, based
           | purely on probabilities they havent been exposed yet.
           | 
           | The vaccine (Gardasil) protects against 9 strains. Even if
           | you've been exposed to 1 strain, it protects against the
           | other 8 strains.
           | 
           | >Also at one point in time, it wasnt linked to cancers
           | affecting men, and men were seen only as carriers. Now it
           | seems any area of flesh exposed to HPV strains are at risk of
           | cancer there.
           | 
           | Even if it didn't do anything in men, it's stupid not to
           | vaccinate as many people as possible to get herd immunity. We
           | understand this for a hundred years now with other vaccines,
           | why not this one?
           | 
           | Apart from that it's not a bad guess to think that if it
           | causes one cancer it will be causing other types of cancer as
           | well. Absence of evidence is not evidence of absence.
           | 
           | >The age of male coverage has been expanded to like mid-40s
           | by now.
           | 
           | Sadly in Germany it's still only for younger men. And older
           | men weren't offered the vaccine at all when they were
           | younger, so they never got the offer. I paid out of pocket
           | for it, but it's still stupid that we're still putting a part
           | of the population at unnecessary risk for cancer, and also
           | decreasing herd immunity at the same time.
           | 
           | Lack of HPV vaccination is just a symptom of lack of
           | understanding of science and statistics in politics.
        
             | potato3732842 wrote:
             | >Lack of HPV vaccination is just a symptom of lack of
             | understanding of science and statistics in politics.
             | 
             | At some point it stops being about science or understanding
             | and starts being wholly about politics. There's a lot more
             | "well these demographics or institutions f-ing hate me so
             | I'm sure as shit not taking their word for anything" going
             | around than there was a decade ago.
        
               | JumpCrisscross wrote:
               | > _There 's a lot more "well these demographics or
               | institutions f-ing hate me so I'm sure as shit not taking
               | their word for anything"_
               | 
               | This would be fine. It goes further: not only rejecting
               | the institutions, but concluding adversely based on their
               | advocating for something.
        
             | wkat4242 wrote:
             | Just wondering how much did you pay for it? Here in Spain I
             | also can't get it in my 40s and it costs 800 euro, which is
             | a lot on a Spanish wage. And the doctors say there isn't
             | much point because I've probably been exposed already
             | (considering number of partners that's likely). And then
             | the effectiveness is supposed to be massively reduced.
             | Still, if it were 200EUR I'd do it. There's only one place
             | here where I can get it so I wonder if it's cheaper
             | elsewhere.
        
               | carlmr wrote:
               | >Just wondering how much did you pay for it?
               | 
               | 180EUR per injection. The normal schedule is 3
               | injections. (first, 1 month, 6 month). However I checked
               | and NHS (UK) did a study on it that showed a single
               | injection provides the same protection as 3, so they
               | changed their injection schedule to single injection for
               | people under 25, and 2 injections (first + 6-24 months)
               | for over 25s due to the expectation that older immune
               | systems take longer to adapt.
               | 
               | The German (StIKo) recommendation is still 3, but I
               | prefer listening to the NHS here because they have been
               | more scientific about this in the past and seem to be
               | actively studying this stuff.
               | 
               | I asked my doctor and they said I can pick the schedule I
               | want, since it's not insured anyway. So I picked the two
               | injection schedule. So that makes 360EUR for me. If the
               | NHS study holds you could probably pick a single
               | injection and already have most or all of the protection.
               | I picked two because I figured it's still recommended for
               | my age group that way.
               | 
               | >And the doctors say there isn't much point because I've
               | probably been exposed already (considering number of
               | partners that's likely).
               | 
               | My doctor said the same, but the NHS says it's still
               | useful from their studies. Especially since Gardasil
               | protects against 9 variants. It's unlikely you've been
               | exposed to all 9 variants.
               | 
               | I am not a doctor, so I can only tell you what I've found
               | helpful in making my decision.
        
               | wkat4242 wrote:
               | Aha thank you! I really appreciate your feedback here.
               | It's a bit more expensive here, just over 200 per
               | injection but that sounds about right then. I will see
               | about getting the 1 or 2 then!
        
               | carlmr wrote:
               | You're welcome!
               | 
               | I forgot to link the sources the 9-valent vaccine is the
               | current Gardasil:
               | 
               | https://www.gov.uk/government/publications/single-dose-
               | of-hp...
        
           | theGnuMe wrote:
           | >Basically, the vaccines dont work with prior exposure
           | 
           | The FDA recommends it for males under 45 now. It does prevent
           | infection from new exposures. In time I bet that we will find
           | it reduces cancer incidence even in those infected before
           | vaccination. Those studies will take years to complete and it
           | is too early to tell.
           | 
           | When the vaccine was first available, it was rationed, and
           | the highest priority was for young girls before they become
           | sexually active since they have the highest benefit.
        
           | crossroadsguy wrote:
           | I had wart on my heel once - kinda annoyingly stubborn which
           | finally removed/subdued by laser removal (nitrogen therapy
           | did jacks). That's HPV, right? And guess once inside you, it
           | stays inside you, right?
        
             | bluGill wrote:
             | There are over 100 hpv strlins. Warts are one yes, butnot
             | the strain in question (though there are reports the
             | vaccine helps for warts too I have not seen science verify
             | that)
        
             | tialaramex wrote:
             | HPV is a family of viruses. There are _dozens_ and the
             | vaccine targets, I think, _nine_. So, that probably was
             | HPV, but it probably was _not_ one of the members of the
             | family which the vaccine targets, the vaccine is focused on
             | the sexually transmitted variants, since these are
             | associated with Cervical cancer in particular, and several
             | other nasty cancers, plus the genital warts.
        
           | Nifty3929 wrote:
           | >> Basically, the vaccines dont work with prior exposure
           | 
           | This is a beef I have with a lot of medical thinking: that if
           | it doesn't work it would be bad to do it. But that's not true
           | at all - many things are good to do, if there is some chance
           | it will help, even if most of the time it does nothing. You
           | do have to weigh other negatives like cost, pain, hassle, or
           | unknown side effects.
           | 
           | But in general - if it might make me better and won't make me
           | worse - then sign me up!
        
             | pbhjpbhj wrote:
             | Every vaccine (happy to get counter evidence) has negative
             | side-effects, every injection is a risk. When you're
             | injection multiple millions of your population on the off-
             | chance it might help then you're going to get some very
             | sick, or dead people.
             | 
             | At 200EUR a time (plus administration costs, plus lost work
             | hours of those you're injecting), for millions of people
             | that's also a lot of wasted funds that could be put into
             | medicines that are known to be effective for the people
             | they're treating.
             | 
             | Why, for medicines that are highly available, that a doctor
             | considers to be low risk, a sane adult can't just elect to
             | pay for and take a medicine, that I am not sure of.
        
         | pyuser583 wrote:
         | Last I checked it wasn't available for men.
        
           | bertylicious wrote:
           | What do you mean not available? It's the same vaccine for men
           | and women AFAIK. Or do you mean it's usually not paid for by
           | health insurance? I (male) don't remember if I had to pay for
           | the vaccine myself when I got vaccinated, which to me
           | indicates that it wasn't that expensive.
        
             | SoftTalker wrote:
             | I'm not a doctor nor particularly fond of them, but as I
             | understand it older men who have been sexually active are
             | likely already exposed, so doctors won't prescribe the
             | vaccine nor will insurance cover the cost. I don't know if
             | it's something you can just walk in to a clinic and ask for
             | and pay cash.
             | 
             | The big push lately has been to get kids vaccinated before
             | they are teens, which mine (all males) were.
             | 
             | I have not had this vaccine, but at my age and being
             | married any new sexual contacts are pretty unlikely so not
             | sure there's any benefit to me either way.
        
           | trescenzi wrote:
           | I'm getting my course of it now. I'm a ~30 year old man in
           | the US. Maybe other countries haven't expanded access?
           | 
           | My doctor recommended it to me and it was covered by
           | insurance. They said while it cannot protect you from
           | previous exposure it's pretty wide so it's unlikely I have
           | yet to encounter every HPV variation it protects against.
        
           | itishappy wrote:
           | You should check again!
           | 
           | > The CDC suggests catch-up HPV vaccinations for all people
           | through age 26 who aren't fully vaccinated.
           | 
           | > The FDA approved the use of Gardasil 9 for males and
           | females ages 9 to 45.
           | 
           | https://www.mayoclinic.org/diseases-conditions/hpv-
           | infection...
           | 
           | > HPV vaccine is recommended for routine vaccination at age
           | 11 or 12 years. (Vaccination can be started at age 9.)
           | 
           | > ACIP also recommends vaccination for everyone through age
           | 26 years if not adequately vaccinated when younger. HPV
           | vaccination is given as a series of either two or three
           | doses, depending on age at initial vaccination.
           | 
           | https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm.
           | ..
        
           | Modified3019 wrote:
           | I'm a 38 year old male in the USA and I've had two out of
           | three shots of gardasil 9, with my third (final) in a few
           | months. There are multiple strains, so even if you have one,
           | the vaccine will protect against the others.
           | 
           | You have to bring it up to the doctor yourself though.
        
           | DontchaKnowit wrote:
           | Im male and had it offered to me by my primary care in like
           | 2009
        
             | pyuser583 wrote:
             | Last I checked was in the US, 2008.
             | 
             | I was going to be traveling overseas, and was worried it
             | would be required by a foreign country. I wanted all
             | vaccines handled by my American GP, so the records would be
             | in one place. I was very insistent: "Give me every vaccine
             | for every country."
             | 
             | He said if I wanted the vaccine that bad, I'd have to get
             | it overseas.
        
               | opello wrote:
               | It was on the checklist at Walgreens when I got my flu
               | shot and COVID booster. Maybe you don't even need a
               | prescription now?
        
           | astura wrote:
           | In the US Gardasil 9 is FDA approved for men and women up to
           | age 45.
           | 
           | https://www.fda.gov/news-events/press-announcements/fda-
           | appr...
        
         | TZubiri wrote:
         | Well since the probabilities of infection is magnified by
         | lesions, and those occur more often in the receptive partner,
         | it will disproportionately affect women and gay men. As is the
         | case for stds in general.
         | 
         | The extent to which these vaccines would be helpful to mean is
         | usually to avoid hurting women. Which is not minor at all, I
         | would definitely get one for that reason alone. But I wouldn't
         | be concerned for personal risks.
        
         | Ponet1945 wrote:
         | > Unfortunately the way campaigns market it causes many people
         | to think it benefits ladies only.
         | 
         | That's a pretty diplomatic way to say that they pretty much
         | don't care about men being affected. In my region the vaccine
         | is free for women but men have to pay despite >40% of cancers
         | caused being in men and nobody even informs you of that.
        
       | stuaxo wrote:
       | I really hope this happens, I'm a little cynical after hoping
       | that we would come together and eradicate COVID 19.
        
         | EricE wrote:
         | That would be pretty hard to do since the mRNA "vaccine"
         | neither prevented infection or stopped the spread.
        
           | Krssst wrote:
           | It did for the first variants, but then Omicron happened.
           | 
           | I see you're calling a vaccine a "vaccine". Noted.
        
             | WillPostForFood wrote:
             | MRNA vaccine is highly effective at reducing symptoms and
             | saving lives of those at high risk (e.g., over 65), but it
             | was never effective at preventing infection or stopping
             | transmission. People who were saying that were somewhere
             | between being over optimistic, and spreading disinformation
             | to try to increase uptake.
        
               | javagram wrote:
               | Studies showed it decreased infection and transmission
               | against the original strain of Covid.[0]
               | 
               | It lost effectiveness against delta and then became
               | nearly ineffective against Omicron (although still
               | helping with reduction of hospitalizations and deaths).
               | 
               | Non-mRNA vaccine is available now (Novavax) and the
               | effectiveness, or lack thereof, seems similar.
               | 
               | [0] https://med.stanford.edu/news/all-
               | news/2021/07/vaccination-a...
        
           | seattle_spring wrote:
           | I assume they're talking about attempts to eradicate it in
           | the first few weeks when it was thought to only be present in
           | a few people.
        
           | InsideOutSanta wrote:
           | The current mRNA vaccines are moderately effective at
           | preventing Covid infections, about on par with current flu
           | vaccines.
           | 
           | Not all vaccines are equally effective, but none of them are
           | 100% effective at preventing infections. The only thing
           | vaccines do is prepare the immune system for an infection.
           | Since SARS-CoV-2 mutations happen a lot faster than (for
           | example) measles, Covid vaccines are a lot less effective -
           | by the time you're infected, the infection is dissimilar
           | enough to what the immune system was prepared for that the
           | preparation is no longer optimal.
        
           | ChrisClark wrote:
           | And yet there are still people that think it was supposed to
           | in the first place. Thinking that makes it a failure, at
           | least you don't think it's full of mind control tracking
           | nanobots though. :D
           | 
           | Or maybe you are, since you used scare quotes. It's probably
           | too late to share any facts with you at this point...
        
         | Rendello wrote:
         | COVID-19 is also transmissible to a lot of animals [1]. The
         | Wikipedia link says "Most animal species that can get the virus
         | have not been proven to be able to spread it back to humans",
         | though I don't know if that's still the current consensus:
         | 
         | https://en.wikipedia.org/wiki/List_of_animals_that_can_get_S...
        
         | pessimizer wrote:
         | I thought we could have cut the entire thing short by
         | vaccinating everyone who wanted it, and letting them
         | quarantine, while at the same time encouraging everyone who
         | didn't want to be vaccinated to socialize as much as possible
         | (while watching hospital capacities carefully.)
         | 
         | There was this strange determination at the time, from every
         | media and government outlet, not to accept that having had
         | covid was as (or more) effective than taking the vaccine. And
         | also not to accept that mass lockdowns were destructive. My
         | grandfather was a victim of the lockdowns (as one of the many
         | with vascular dementia who were kept going by being stimulated
         | by family.) After 93 years of raising a family, he got to die
         | alone, confused and isolated.
         | 
         | edit: it's all of the authoritative disinformation during covid
         | that's threatening cervical cancer vaccination. It brought the
         | thoroughly discredited anti-vaxxers of yore back into the
         | (numerical) mainstream, and respected as heroes (JFK, Jr. for
         | one example.) Wakefield's paper is just as stupid as it ever
         | was, but now you will never convince the majority of Americans
         | that vaccines don't cause autism. The Lancet is trash.
        
           | tzs wrote:
           | > I thought we could have cut the entire thing short by
           | vaccinating everyone who wanted it, and letting them
           | quarantine, while at the same time encouraging everyone who
           | didn't want to be vaccinated to socialize as much as possible
           | (while watching hospital capacities carefully.)
           | 
           | We sort of did do that because of how much policies varied
           | from state to state and even from county to county or city to
           | city within a state. For nearly any aspect of of pandemic
           | response it is possible to find demographically similar
           | counties that differed on that particular are and compare
           | outcomes.
        
       | daggersandscars wrote:
       | I was diagnosed and successfully treated for HPV+ oropharyngeal
       | cancer in 2023. My treatment results were almost perfect, from a
       | clinical perspective. I had transoral robotic surgery to remove
       | the tumors in my mouth / throat, neck dissection to remove
       | cancerous and non-cancerous lymph nodes, and radiation to treat
       | the area after cancer was found to have escaped the lymph nodes.
       | 
       | If I were 10-ish years younger, I wouldn't have gotten cancer. I
       | was likely exposed to HPV in my early to mid 20s, where it hid in
       | my tonsils for decades.
       | 
       | In the US, almost anyone under 45 can get vaccinated. Please do.
       | As another comment points out, they protect against multiple
       | strains. It's unlikely you've been exposed to all of them.
       | 
       | While HPV+ head and neck cancers are more easily and more
       | successfully treated than HPV- ones, I do not recommend getting
       | cancer.
       | 
       | From the outside, I look like a normal person of late middle age.
       | The two incision scars I have look like neck folds -- literally
       | no one, including medical personnel outside of the cancer world,
       | notices them.
       | 
       | From the inside, tho:
       | 
       | * Can no longer taste sugar, salt, chocolate, and a host of
       | other, smaller things. Most other things have less taste and
       | pretty much nothing has a flavor after a few bites. For some,
       | this eventually stops -- I'm unlucky. (Radiation destruction of
       | taste buds)
       | 
       | * Significantly decreased saliva to the throat. Cannot eat
       | without some liquid. The saliva that forms is thicker and
       | sometimes causes problems swallowing. Some get this to the mouth
       | and to a larger extreme -- I'm lucky. (Radiation)
       | 
       | * Dental trauma, including teeth extraction / root canal / deep
       | fillings, may cause spontaneous bone tissue death in the jaw.
       | (Radiation)
       | 
       | * Permanent sensation of partial numbness centered around my left
       | ear and cheek. Touching that area produces a pins and needles
       | sensation. (Neck dissection)
       | 
       | * No feeling in a stripe about 1.5" (4cm) wide where the neck
       | dissection scars are. (Neck dissection)
       | 
       | * Changes in speech quality. These are not clinically significant
       | but changed my voice from one people enjoyed listening to (asked
       | to do voice over work, complemented, etc) to just another voice.
       | (Surgery)
       | 
       | * Tinnitus increased significantly and hearing has worsened. I
       | was not given chemo, the normal cause of hearing loss. (Unsure
       | cause)
       | 
       | There's more, but those are some of the highlights. Get
       | vaccinated, get your kids vaccinated, etc.
       | 
       | HPV- head and neck cancers in the US are dropping as people quit
       | smoking. HPV+ are on the rise for now, but will drop as the
       | generations with vaccinations get older.
       | 
       | I'm traveling today, but will look at this later today if anyone
       | has a question to ask.
        
         | nick_ wrote:
         | An immediate family member of mine lives with the same
         | diminished quality of life as you. It is very significant. I
         | wish you the best.
        
         | TZubiri wrote:
         | Wow that's brutal. I always thought of these cancers in terms
         | of mortality, but for every lethal case there have to be dozens
         | of hundreds of people that are non-lethally damaged by the
         | disease.
         | 
         | Congratulations on surviving!
        
         | seth323 wrote:
         | I am now 31, was diagnosed stage 4b oral cancer in 2022 when I
         | was 28 - underwent the same general surgery as parent comment
         | to remove positive margins left after the initial biopsy of my
         | tongue and almost all lymph nodes in the left side of my neck.
         | I also underwent 6 weeks of radiation. I was not HPV positive
         | and don't smoke or drink so doctors are still clueless as to
         | why I developed cancer.
         | 
         | Can confirm radiation is brutal and almost indescribable.
         | Everything tasted bitter and sulfurous for 6 months, even
         | water. I had a feeding tube placed after not eating for 3 weeks
         | and losing 25% of my body weight (roughly 35 pounds). I was
         | days away from death. I would wake up every night with blood
         | pouring out of my nose and was not able to open my jaw for
         | almost a week. 2 years later, after many iterations of
         | lymphedema, physical and speech therapy I am still in
         | significant pain every day and cannot even swallow my own spit
         | unless I am on narcotics around the clock. That in itself is a
         | nightmare because finding a provider that will prescribe a
         | steady supply of narcotics instead of pushing expensive
         | procedures so they can get rich is difficult. I am routinely
         | drug tested so I can get medications that prevent me from
         | starving to death. It is humiliating.
         | 
         | I am lucky in that my speech is virtually the same as before
         | treatment which is rare, and my taste has returned to normal. I
         | would die of starvation without narcotics and I don't know if I
         | will ever gain the energy and stamina to have children, and yet
         | I still consider myself extremely well off compared to other
         | survivors.
         | 
         | Please get vaccinated for HPV and lower your risk factors for
         | oral cancer in general. It is one of the worst late stage
         | cancers to recover from. You may be alive after the treatments
         | but radiation will destroy your quality of life and you will
         | likely be dependent on doctors for basic tasks for a long time,
         | if not the rest of your existence. I don't want to think about
         | what my life will be like if my cancer ever returns.
        
         | rsync wrote:
         | "In the US, almost anyone under 45 can get vaccinated."
         | 
         | Can you expand on this ?
         | 
         | Why can't people over the age of 45 be vaccinated ?
         | 
         | Is that restriction "on label" ?
        
           | daggersandscars wrote:
           | The CDC does not "recommend" vaccinations over 45, mostly due
           | to previous exposure. I suspect one can find doctors willing
           | to do the vaccination for those over 45, though one may need
           | to convince them.
           | 
           | Whether this is useful depends. HPV 16 and 18 are the "high
           | risk" strains most associated with cancer. Depending on your
           | sexual history, getting vaccinated at 45+ may be useful.
           | Unfortunately, there's no reliable test for HPV 16 and 18 for
           | those who have already had it.
           | 
           | https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm.
           | ..
        
         | Avalaxy wrote:
         | Wow, thanks for your story. I'm terrified of getting this too,
         | and I've been wondering what it's like.
        
       | w10-1 wrote:
       | The HPV vaccine has been a universal win for this generation.
       | Screening (pap smear) is also highly effective, but requires
       | constant effort.
       | 
       | The remaining gaps in screening and vaccine uptake reflect
       | broader lack of health-care capabilities that won't be solved
       | with pushing the HPV vaccine alone. Changing from injectable to
       | oral could help, but isn't on the table, and local populations
       | and governments are likely to become increasingly resistant to
       | outsiders waving their science authorities, particularly on
       | family matters.
       | 
       | Both authors are Phd's working in outreach - i.e., they seem to
       | have no experience with deploying HPV campaigns.
        
       | prepend wrote:
       | I think it's funny how in the US the vaccine schedule says not to
       | get the HPV vaccine if you're over 45. That means that insurance
       | won't cover it and I even struggle finding a doctor who will
       | administer it because it goes against the guidelines.
       | 
       | The rationale is that if you're 45, you probably already have
       | HPV. But that assumes that you've been sexually active all that
       | time. It doesn't take into account people who were monogamous
       | until their 50s and then started having sex with new partners.
        
         | opello wrote:
         | Exactly. It'd be nice if primary care physicians approached the
         | request with an open mind and had the real conversation about
         | any risk/reward. I don't know if there's any risk to taking the
         | 9-valent version if you might have been exposed to one that it
         | covers. But why isn't it valuable to have protection from the
         | other 8?
         | 
         | My bias is climbing the hill of convincing on this front 5
         | years ago and being on the receiving end of a pretty dismissive
         | attitude. But I got my way and think it was the right choice.
        
         | FirmwareBurner wrote:
         | _> schedule says not to get the HPV vaccine if you're over 45.
         | That means that insurance won't cover it_
         | 
         | If it makes you feel any better I live in an EU country with
         | one of the best healthcare systems, or so we keep hearing, and
         | here the public health insurance only covers it for those under
         | 30. What a joke.
         | 
         | And Europeans keep saying how much worse the American system
         | is.
        
           | formerly_proven wrote:
           | Here it actually depends on which pseudo-private-public
           | insurer you have. Most have age limits for coverage, the most
           | common one being 25 or 26. The lowest seems to be 19 (what a
           | joke, it's in the catalog for <=18), many don't cover it at
           | all. Total cost (no discounts, since not covered) seems to be
           | about 700-800 EUR.
           | 
           | > And Europeans keep saying how much worse the American
           | system is.
           | 
           | There's a reason the comparison is always the average/median
           | situation in the EU vs. the worst possible situation you
           | could be in the US.
        
           | jeroenhd wrote:
           | I don't know about the quality of our local healthcare
           | system, but I'm a little annoyed that I didn't qualify for
           | the free HPV vaccination but people two years younger than me
           | did. The government invited anyone born in an 8 year period
           | and about 20% responded. I wish they'd given me the option to
           | take part in the program even if I wasn't actively invited,
           | it's not like there's a shortage because of high demand; even
           | among kids the vaccination rates are only at 50% to 60%
           | thanks to the rise of antivax parents and covid
           | misinformation.
           | 
           | I'm not going to start a fight with the local healthcare call
           | center to let me pay the 200-300 euros for a vaccination they
           | think I shouldn't be getting according to every piece of
           | information they publish about it. I know the government is
           | trying to cut costs on healthcare and all, but the resistance
           | the idea that someone without a cervix may benefit from a HPV
           | vaccination annoys me to no end.
           | 
           | Out of all possible healthcare cost cutting measures,
           | charging hundreds for vaccines against diseases that are
           | widely present within the borders of the country must be the
           | stupidest.
           | 
           | That said, I'd much rather take the annoying European
           | healthcare system over the American one. I can get every
           | vaccine out of pocket twice a year and still be cheaper off
           | than with your average American health insurance.
        
             | Tijdreiziger wrote:
             | Your profile indicates you're Dutch, so you can just ask
             | your huisarts or local GGD for the vaccine, no fighting
             | necessary. I did this myself a few years ago.
             | 
             | You'll have to pay for it yourself, though.
             | 
             | Info: https://www.rivm.nl/hpv-humaan-
             | papillomavirus/vaccinatie-hpv...
        
         | selimnairb wrote:
         | I got it when I was around 40. Before getting the three doses,
         | I would get 3-4 nasty viral sore throats per year (white
         | blistery lesions, very painful). Now I get zero. I was probably
         | on my way to getting throat cancer like Michael Douglas.
         | Hopefully I have avoided or at least forestalled that.
        
           | ivewonyoung wrote:
           | Thought it doesn't help against the strains that you're
           | already infected with? Hence the min and max ages in the
           | guidance.
        
             | throwitawayfam wrote:
             | There is some evidence that it can help against self
             | inoculation and immune response to an existing infection
             | 
             | https://www.frontiersin.org/journals/immunology/articles/10
             | ....
             | 
             | https://www.sciencedirect.com/science/article/abs/pii/S0090
             | 8...
        
             | abracadaniel wrote:
             | From what I've seen, it's been shown to be effective
             | against existing infections, as well as preventing it from
             | progressing to cancer.
        
               | Avalaxy wrote:
               | I can't find anything about this, do you have any papers?
        
         | InsideOutSanta wrote:
         | I also got the vaccine at 44 (years later than it is
         | recommended where I live in Europe), because:
         | 
         | - It targets multiple HPV strains, and even though I've been
         | sexually active, I'm probably unlikely to have all of them, so
         | there is some future protection
         | 
         | - It helps prevent reinfection
         | 
         | - There is evidence that it helps reduce the risk of
         | progression to a cancerous state, which is also something that
         | can happen for males
         | 
         | I didn't even bother to talk to a doctor, I just called a
         | women's clinic, made an appointment, and paid for it myself.
         | They were surprised, but super happy and supportive.
         | 
         | All three injections cost me the equivalent of 160 US$.
        
           | tecleandor wrote:
           | What country is that? I'm 42, male/ Spain, and I also have to
           | pay for them out of pocket, but it's around 190EUR EACH of
           | the three doses.
        
           | Avalaxy wrote:
           | > There is evidence that it helps reduce the risk of
           | progression to a cancerous state
           | 
           | I have not been able to find this. Do you happen to have a
           | link to a paper?
        
         | Retric wrote:
         | It's not just that older people are more likely to have HPV but
         | also there's significantly less time for it to progress to
         | cancer at that age.
         | 
         | 45 may be young enough to be worth it if the treatment was
         | free, but at ~1,000$ the net benefit is more questionable.
        
       | stared wrote:
       | I am surprised that this study does not mention which vaccines
       | are being used - as they vary by the number of HPV types they
       | protect against.
       | 
       | "Currently there are six licensed HPV vaccines: three bivalent
       | (protect against two types of HPV), two quadrivalent (against
       | four), and one nonavalent vaccine (against nine)" -
       | https://en.wikipedia.org/wiki/HPV_vaccine
        
       | richrichie wrote:
       | My physician told me that for ages above 40 benefits don't
       | compensate potential side effects and advised against it. This
       | was pre-covid times, before vaccines became unquestionable cult
       | drugs.
        
         | oezi wrote:
         | When the health authorities say that they don't recommend it
         | because benefits do not outweigh risks they usually mean that
         | the benefits aren't at least 2 magnitudes (100 times) bigger
         | than the risks. Vaccination usually is highly beneficial, but
         | as one ages the benefit does diminish. Agencies don't want to
         | be stuck with vaccines which have large side effects.
        
       | rawgabbit wrote:
       | I remember when Gardasil was first introduced and the related
       | controversy. I believe there were questions about its safety
       | because at first it was targeted at 12 year old females. At one
       | point the Japanese Ministry of Health suspended the vaccine and
       | then later resumed it.
       | 
       | For me the explanation of how this vaccine works still confuses
       | me. For example while older people are advised to get Shringix to
       | mitigate the consequences of a reactivated chickenpox virus.
       | Older are advised not to get Gardasil because once you get HPV,
       | the vaccine is ineffective?
       | 
       | https://mainichi.jp/english/articles/20211115/p2a/00m/0op/00...
        
         | Teever wrote:
         | As I understand it from talking with a healthcare worker it
         | isn't so much that it's less effective if you already have the
         | infection (though it is) it's more just a triage decision.
         | 
         | People in various health care systems around the world have
         | just done a cost benefit analysis and decided that it isn't
         | worth paying for the vaccine for older people, that we'll just
         | let them get cancer and go through treatment/die.
        
       | 123yawaworht456 wrote:
       | babe! it's 4 PM
        
       | Avalaxy wrote:
       | I really wish we had therapeutic vaccines against HPV. As a man,
       | I always got told "it's not for men", followed by "it is also for
       | men, but only if you never had sex", followed by "it's also for
       | men who had sex, but only to a limited age".
       | 
       | As a male who meets all the criteria to be in a high risk group
       | for HPV throat cancer, and who is dealing with a persistent HPV
       | infection (as proved by warts that won't go away), I'm really sad
       | that I may one day at a young age get cancer in my throat, and
       | there is nothing I can do about it to prevent it. I wish we would
       | put the same amount of energy into inventing vaccines that
       | suppress the virus, or help the body to get rid of them.
        
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