The HPV vaccine is as important for boys as it is for girls | Hacker News Reader

The HPV vaccine is as important for boys as it is for girls

statnews.com

222 pointsvo2maxer116 comments

> HPV gives 34,800 Americans cancer every year, according to the Centers for Disease Control and Prevention. Of those, 20,700 are women and 14,100 are men.

> the burden of HPV positive oropharynx cancer in men in the United States now exceeds the burden of cervical cancer diagnosed each year

41% of all cancer victims of HPV are men and there is almost no public awareness.

This is often the case in society's reaction to problems of men and women, and the result is that there's 4 years (5%) life expectancy gap between the sexes.

And it's completely ignored while salary gap (where the discrepancy is the other way) is a hot topic for decades already.

It's ironic, that the response for male problems is "whatever, you're an adult, deal with it", and for female problems it's "we need to help you".

After reading this article and a quick search, I was pleased to find that the NHS in the UK has recently decided to extend Gardasil vaccination to boys too -

https://www.nhs.uk/conditions/vaccinations/hpv-human-papillo...

When a friend died of oropharynx cancer a while back, I explored the possibility of HPV vaccination only to be rejected because of age (now 78).

Also, if you or your partner are having receptive anal sex, ask your doctor about getting an anal pap smear. 90% of anal cancers are caused by HPV. They are slow growing and treatable. Screening is quick and easy.

http://www.colonrectal.org/services.cfm/sid:7580/Abnormal_An...

Does it do anything for you if you're already infected but not cancerous? or is it merely prevention from infection?

I want to know this too.

There are many strains of HPV, the vaccine prevents several of the worst but not all strains. Even if you are already infected with one strain it makes sense to get the vaccine to not become infected with the others.

Gardasil is described as a prophylactic vaccine, rather than therapeutic, so no- it sounds like you would have to be vaccinated prior to infection in order for it to be effective. However, it sounds like there are therapeutic vaccines in development [0, 1].

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586871/ [1] https://www.ncbi.nlm.nih.gov/pubmed/30955915

"In those already infected, the vaccines are not effective." - https://en.wikipedia.org/wiki/HPV_vaccine#cite_note-WHO2017-...

I've often wished I retained where I read it, but I read that in human trials in China, that in some test subjects, all warts on their body cleared. Also the researcher who developed the vaccine was my step-son's grandmother's next door neighbour.

That's not at all what the actual linked document says. From pg. 17/257:

"There is conflicting evidence on whether HPV vaccines are efficacious in preventing vaccine type HPV associated anogenital pre-cancer in women who had evidence of prior HPV exposure to the same vaccine type."

This section cites Miltz et al. (2014; PLoS ONE) and Lehtinen et al. (2013; Nature Reviews Clinical Oncology).

My impression is that efficacy against the same strain hasn't been demonstrated, but it's very clear that people infected with one strain (say, 6) can be subsequently infected with other strains. In that case, there's a partial benefit of the vaccine, since it'll help with the other 1/3/8 strains that the vaccine targets (plus maybe a few more, as there are also off-target effects).

Another aspect to this that is not often discussed is that HPV-16 and HPV-18 increase the risk of penile cancer, no oral sex required.

Looking at my HMO's website it seems like the vaccine is not recommended for males over 26. The CDC also backs this up. Does this mean those of us over 26 are screwed? Is there anything we can do to check for cancers to catch an infection early?

It is approved but not recommended, which means insurance doesn't have to cover it to satisfy the ACA.

I'm 35 and one dose in (about due for the second dose) - what this has meant for me is that it's no trouble to get my doctor to give me the vaccine (but the county's vaccination lab refused) but insurance didn't cover the vaccine.

For me it's worth the $600 or so it'll end up costing, just for the peace of mind that I'm doing what I can to minimize the risk.

FDA guidance has recently (within the last year) extended this out to age 45.

If you are going to have intimate contact with more than a few people (perhaps even just a few) the doctors I have talked to recommend getting the vaccine.

Does it mention why? Is it because the adverse reaction rate for (e.g.) Gardasil is higher than the probability of catching one of the HPV strains it targets after 26?

"HPV vaccination is also recommended for everyone through age 26 years, if not vaccinated already. Vaccination is not recommended for everyone older than age 26 years." https://www.cdc.gov/hpv/parents/vaccine.html

Does anyone know why? Is it because most sexually active people would already have HPV at that point?

They seem to imply so:

> However, some adults age 27 through 45 years who are not already vaccinated may decide to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit, as more people have already been exposed to HPV.

So is screening. Men can be carriers of HPV.

I'm a 33 y/o male and just found out last week that the eligibility range has been expanded, so I opted to get the vaccine. It's a three dose course over a few months. Everybody should do it!

I saw this comment on Reddit:

>HPV in men causes a significant number of anal and mouth cancer, it is not symptomless. And of course, vaccinated men can't pass it on to unvaccinated women.

[HPV vaccine is systematically given](https://www.health.gov.au/news/protect-your-kids-against-hpv...) to all 12 year olds, boys and girls, for free through school vaccination programs.

...in Australia

And a bunch of other countries with routine vaccination programs. These programmes make extra sense in a country with universal healthcare because the country is paying for cancer treatment if its people get cancer, so preventing cancer actually saves the whole country money.

And the Netherlands. I got it when I was 18 as the girls were getting it, the government decided it would be cheaper and more effective to do boys at the same time. HPV effects have plummeted, but this is hard to prove. What shocks me is that a lot of comments show a understanding of the average Facebook-mom. (misinterpreting workings of herd immunity, whilst the article doesn't even mention that, it clearly is about direct effects.) This is HN!

Can you get the vaccine as an adult? For some reason I always thought if you didn't get it young it was too late to get it.

They keep increasing the age, i think it's 26 now. That's only to get insurance to pay, you can get it off label at any age

It's 45 now.

https://www.cdc.gov/vaccines/acip/recs/grade/HPV-adults-etr....

Getting this vaccine especially for your kids is a no-brainer. HPV is everywhere and it is not benign.

I paid for this vaccine out of pocket while I 25 and the treatments lasted till after I was 26.

I would not be salty if insurers covered men and future people didnt have to pay for it.

The reason that insurers dont cover it is because there isnt a test to see if men have been exposed, the vaccine doesnt work if men have been exposed already, and after a certain age you can assume that men have been exposed and function as carriers. The cancers men get from hpv are either due to cunnilingus or smoking, and there is no way to tell

Because we need to get over the idea that boys and men are expendable, and only women and children deserve protection

That's the exact opposite of the point of the article. Men and boys don't get the vaccine because they and their parents perceive it as a female-only problem (cervical cancer induced by HPV). The article is trying to get apathetic men and boys to realize that not only are they acting as carriers of HPV that can kill their wives and partners, but they themselves can die from HPV induced cancers.

When I wrote my comment, the headline was something along the lines of "Why we should vaccinate boys against HPV too". The headline has now been changed, and my comment seems really odd.

Sorry, changed headlines here have caught me, too. I understand.

The meaning of the title hasn't changed much though. Is it too much to expect people to read the article before making inflammatory MRA style comments? Looks like a common problem in this thread.

It shouldn't be, but it's often good practice to quote whatever you're responding to.

People sometimes get hinky with the edit button, or mods change the title, sometimes even the swapping out an entirely different url...

The headline for the STAT article was “New evidence shows why the HPV vaccine is as important for boys as girls” and I shortened it to its current form in HN. I hope this hasn’t caused any confusion.

On the other hand (edit: an outdated article, see vo2maxer's comment below) https://www.cbsnews.com/news/gardasil-researcher-speaks-out/

"The risks of serious adverse events including death reported after Gardasil use in (the JAMA article by CDC's Dr. Barbara Slade) were 3.4/100,000 doses distributed. The rate of serious adverse events on par with the death rate of cervical cancer. Gardasil has been associated with at least as many serious adverse events as there are deaths from cervical cancer developing each year."

You mean adverse events like a rash? Or headache?

The comment explicitly states "serious adverse events", which is well-defined: https://en.wikipedia.org/wiki/Serious_adverse_event

We have another 10 years of evidence since this was posted in 2009 [1]. That article quotes Diane Harper quite bit, and has also been discussed since [2].

[1] https://infectagentscancer.biomedcentral.com/articles/10.118...

[2] https://scienceblogs.com/insolence/2013/08/16/yet-another-an...

Thanks! Those are good arguments I was looking for (downvote accepted).

Thank you, also. These are good discussions to have, particularly that we’ll make the decision to vaccinate on behalf of others, our children. Many parents are fearful or confused before the large amount of information pro and against (unfounded) vaccines in general. Add the association of HPV and sexual transmission, and it becomes more difficult to go ahead and vaccinate. I’ve read the evidence carefully and have no doubt that despite the (low) risk of adverse events, children of both sexes should have the HPV vaccine. As I said in another comment, I think the recommended age will continue to expand given the new favorable evidence in ongoing studies.

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