If you're living in the US: please consider getting the vaccine, ragardless of your age. It was covered by my (rather shitty) health insurance. It consists of just 2 (EDIT: 3 for adults!) doses. It is recommended for both Males and Females.
Your PCP may give a vaccine off-label though, which is how I got my Shingrix, though I had to pay out of pocket.
Simplest route would be to call your primary doctor and ask if they can give it to you at your next annual checkup.
Maybe I could have understood if I had said she was my wife. But it is still stupid to assume that there will be no other sexual partners ever again in her life.
With the prevalence of HPV, it's likely that we have one or more strains already, but who knows. Maybe the strain of a future partner is what will trigger cancer.
If anyone here can enlighten me about the pharmacist's attitude, I would be grateful.
I got vaccinated way before I met her, and even as a male I didn't get any comments from the pharmacists that gave me the shots.
> "“Hepatitis B vaccine was made for prostitutes and for promiscuous gay men,” Kennedy said in an interview on his Children’s Health Defense show in 2022."
https://www.washingtonpost.com/health/2025/06/25/rfk-jr-vacc...
The WaPo article doesn't bother to refute RFK's lies, but here's /r/medicine responding to them (in the context that's topical this week—RFK ordering the removal of the Hepatitis B vaccine from the children's schedule):
> "Let's be even more clear about this. If you contract Hep B in the first year of life, more than 90% develop the chronic form, and the need for liver transplant is much higher.... Worldwide, the second most common route for children under 5 to catch HBV is from other children, and that's not by doing IV drugs or having sex. (First most common is vertical, through mother.)"
https://old.reddit.com/r/medicine/comments/1niml9d/kennedys_...
It’s almost as though he has had a brain injury.
People read the recommendation guideline, and brainlessly follow it without care of why it's in place. If you haven't had a reason to be exposed by 30, 30 is as good of a time to get the shot as 9.
One of the few times I can say the majority of medical practitioners don't know what they are talking about when they spit dogma instead of life-saving sense.
So please don’t get it regardless of age. Its not really considered effective for women who have been sexually active for some time.
Which is why its only recommended for girls, not women.
https://www.ssi.dk/vaccinationer/boernevaccination/vaccinati....
Tldr; Dont rush to get a vaccine that is probably not effective for you. Make an appointment with your doctor and discuss it with her first.
I dont see any reason not to take if you get it for free and you are planning to be sexually active with multiple different partners.
My doctors have generally refused vaccinating me for years (Male/43yo), but finally a new (female) doctor told me it's a good idea. I'm not in a risk group, so I have to pay for the vaccine: Gardasil 9, 3 doses, 3 months away of each other, ~€200 each, although studies say that 2 doses might be enough.
In reality, you can pay to a private doctor so they write you a prescription, but I feel more validated if my doctor says it's OK :)
From top of my layperson head: bruised insertion sites, tainted needles, tainted vaccine supply, customer capacity crowding for the pharmacy, squeezing supply capacity for actual target demographics, etc etc etc.
Things have tradeoffs, even if they are subtle. Relentless follow-through on marginal protocols should generally be treated with suspicion.
Stranger danger advocates brush off the criticism that most abductions occur among family with the "if there's a small chance it would make a difference" argument, but this ignores the real harms of teaching children to fear everyone by default.
if e.g. they are in trouble, then you don't want them to be afraid of strangers and not ask for help from the 99% of the people who would be happy to help them.
Vaccines are subject to stringent safety standards since they’re administered to healthy people. The age limit may suggest that at the time of the recommendation, in the relevant jurisdiction, the manufacturer had not studied its safety and efficacy in >40 year olds.
(I also don’t think it’s an age limit as much as the upper end of a recommendation.)
And how can you say the vaccine definitely works for populations it hasn't been tested on?
If you have a limited supply the greater bang per buck would be to start with the young people who almost certainly haven't caught it yet and then work your way up.
Sure you are more likely to have it the older you are but even then you are unlikely to have all the strains. The vaccine covers like 9 or 10 different strains so it can protect you from the other strains even if you already have one of them.
It's generally only when you get into the 60s and up that the justification for not recommending the vaccine changes. Once you get into those later years the immune response changes a bit and you get new concerns.
An example being herpes zoster (chickenpox) where after a certain age you are recommended to get the shingles vaccine instead of the chickenpox vaccine since the way the disease presents and how the body reacts to it changes with age (technically shingles can happen at any age but generally herpes zoster presents as shingles instead of chickenpox the older you get).
If the underlying virus is the same, what is different between the vaccines? How it presents shouldn't matter as much?
The shingles vaccine is a larger/more aggressive dose than the chickenpox vaccine.
And nowadays chickenpox vaccine uses live attenuated viruses (i.e. modified to be non-infectious but still look the same) whereas the shingles vaccine uses recombinant proteins. This allows the shingles vaccine to deliver the higher viral load that they want for inoculating against shingles without putting a bunch of live viruses into the body.
It's also worth noting that the recombinant vaccine is more effective for shingles compared to the equivalent viral load live vaccine by a significant margin. It's something like 90% reduction in incidence vs 50%.
----------
> How it presents shouldn't matter as much?
It's not an all or nothing thing but it's a matter of percentages.
And the big reason why they present differently is that chickenpox kind of attacks every part of the body since it's new. It of course does best at infecting the skin and nerves but it mildly affects every part of the body. But then it goes dormant in the nerves because that's where it's most "compatible" and the body is the worst at fighting it.
So then with shingles your body still has the immunity but the reactivated virus is able to out-compete your immunity in the nerves and it wakes up in whatever specific nerve and spreads along that nerve. This is why shingles generally presents in a band on the body. It's spreading along a specific nerve "line" rather than spreading throughout the whole body, blood, and all.
And so the because the infection can't spread broadly throughout your body it ends up concentrated in that location and presumably the higher viral load combined with focusing on the specific proteins rather than the whole virus increases the body's sensitivity to these flair ups, catching them before they can reach momentum. And then that focused immune training sits on top of the body's existing immunity for the initial "whole body" presentation of the virus.
https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
There used to be fears of "death panels" controlling access to medical care when Clinton tried to propose universal health care.
The CDC and FDA are about safety, not cost management. And they get significant complaints about how much they regulate pharma and are impediments to pharma for that!
Now the conspiracy theorists of the other side seem to be having their day in the public mind.
thinking that they are conspiracy theories? that's a conspiracy theorist.
let me guess, you work in this area too.
Even with CDC its recommendations, it's not the final word.
The reasoning you're highlighting here is highly conspiratorial
That was, for example, why boys were originally not part of the recommendation for the HPV vaccine. It would double to cost, while doing very little to prevent cervical cancer via indirect protection. Once the evidence accumulated that it was associated with other cancers, that stopped being true.
Similar logic applied to older women and men.
In any case, somebody thinking that evaluating safety and efficacy aside from cost considerations means that there's collusion with pharmaceutical companies would be a conspiracy theory.
you are one of the generals in this scenario, thinking that evaluating safety and efficacy aside from cost considerations couldn't possibly lead to higher costs because you yourself and everybody in your industry are so darn smart, clever and by god ethical.
what did you do before this? work on creating the covid 19 virus, or just calling people who questioned it "conspiracy theorists"? what's that, you were in caves tracking down the zoonotic transfer, which you'll find any day now, scientific consensus and all, peter daszak assured you you'll find it and he's beyond reproach!
and I resent you saying that I'm a conspiracy theorist because I have not said any of this is happening, I am pointing out the vector where it could happen (go back, look, where did I say any of this was happening?)
it's simply, methinks the lady doth protest too much
The real question is why are people who are capable of identifying the problem when it's generals sitting on the board of Lockheed or a telecom industry insider heading the FCC suddenly unable to do so when it's someone who's made their career engineering stormwater solutions taking a position at the EPA or the pharma industry funding research that the CDC will base its policy on.
The CDC, the DOD, etc, etc, these are all symptoms of the problem and a distracting sideshow.
As usual, the real evil is in the minds of the people who peddle double standards and the fact that we have architected society such that this behavior is mainstream and those who engage in it are not marginalized.
It's a level of evidence that's generated (usually) prior to ACIP, and it is presented to them, while there is not necessarily a bright line threshold.
Brilliant.
I think government costs for a retiree are about NZD27000 a year.
A government should be subsidising a good deadly recreation for say NZD10000 a year. Assume expected life remaining is 10 years, assume recreation has a 10% chance of clean death, assume low chance of expensive ongoing chronic outcomes.
Suggestions: Car racing, climbing, fentanyl habit, boat racing, ocean sports, Russian roulette, foreign legion soldiering, free climbing, wingsuiting.
Maybe a better way would be to allow people to gamble with their lives to win a few tens of thousands (need to balance costs against expected savings). Pay out to winners, but saves the government their expected lifetime of expenses for the losers. Let the old and unhappy roll-the-dice and the winners get to live it up a little . . .
There are two factors here:
1) Vaccine-derived immunity is a function of the individual's immune response, which in general, weakens significantly with age. It is not unrealistic for a vaccine to simply fail to elicit any response in someone old enough.
2) It is very, very difficult to recruit folks without HPV that are over 40 for a clinical trial. Most people of that age, who were never immunized, most likely have had it. This significantly convolutes the signal.
3) This is all especially confounded once something becomes "standard of care". Every year there are fewer and fewer people age 40+ with HPV.
For these reasons, the vaccine is currently officially ??? in people over 40. Most doctors will prescribe it anyways if you ask. It may or may not infer immunity. It almost certainly will not harm you.
this was pre- antivaxxer anxiety, and just run of the mill 'is the government condoning sex' anxiety, and it was controversial for that reason alone
the issue was that if you've been exposed already then the vaccine doesn't work. they had a test for women that can prove they've been exposed or not, and most adults have. they don't have a test for men that can prove they've been exposed or not, and most adults have. At the time, they had also only considered males to be carriers, with no cancers themselves.
so for the US government to recommend a limited stock and get insurers on board, it was all based on probabilities of exposure and utility.
I was younger at the time, naturally, I paid $600 out of pocket to get it across 3 doses because I figured it was worse than that, or I could get some 'male ally' brownie points from women. I wasn't wealthy then but figured this experience couldn't be taken from me even if I went bankrupt.
Since then, they've further linked it to throat cancers in males, because of our mouth's contact with genitals, and insurers are told to cover it across all genders and up to mid 40s. that's not really much of a difference now though, since the checkpoint is basically the same group of people, 13 years later.
They're still assuming older people are not worth bothering with, due to likely exposure.
There is an amusing side of this if you are male and not vaccinated yet, since nobody can tell if you've been exposed still: keep your sexual relationships with younger women. lol. in case you needed an excuse - higher probability they're vaccinated.
Another thing to keep in mind was that the initial trials were only using cervical cancer endpoints - the association between HOV infection and cervical cancer is really strong. At that time, vaccinating boys provided only indirect protection (you couldn't infect a female partner), rather than direct protection (you won't be infected) in the context of cervical cancer.
Women prior to sexual debut were the biggest "bang for the buck" and the obvious first recommendation target.
Researchers both at universities and in private industry then started working on other populations based on alternative endpoints.
It was a stupid decision to leave out the boys. I mean hindsight is 20/20, but if heterosexual women were getting cervical cancer from HPV, and HPV is spread by sexual activity, then vaccinating the boys along with the girls would have been the logical thing to do in order to stop the spread.
I assume this wasn't done because they didn't do any studies on boys at first, because they were looking for cervical abnormalities to gauge vaccine effectiveness, and maybe it would have been hard to recruit a bunch of boys for a vaccine study that would probably not benefit them.
With that same hindsight we now know that HPV vaccination also prevents some oral cancers, and that leaving out the boys was a very stupid decision indeed.
These days most places do seem to also vaccinate boys. I got an HPV vaccine at some point in my 30s, and I pretty much had to wrestle my doctor into submission in order to get a prescription.
So this is more about the inflexibility of our recommendation process and how insurers are tied to the regulatory agencies.
The logic makes sense but its about who is paying for administering to the carriers. Or what was initially seen as just carriers.
And over 45s that engage in casual sex have almost certainly been exposed. Those who don't have prior exposure probably have few or one partner in a marriage or marriage-like situation and thus are not likely to be exposed. Yes, they could be cheated on or the like but exposure is not expected so effectiveness can not be measured.
https://support.goodrx.com/hc/en-us/articles/360000707483-Ho...
I know you are very well intentioned, but American's actually have very good doctors.
I’ve had a few GPs in the past 20 years. They’re consistent.
I admit it’s weird. And ideologically I feel like a bit of a laggard.
But I’ve had both the conversation with my doctor, and the conversation with online “smart people who know better than my doctor” many times.
I ideally you could test for parasites, but time and resources don't allow for that in many countries. So if it's generally safe to just give ivermectin along with steroids when treating COVID - in countries where parasites are common.
Maybe I'm wrong about this. Maybe I'm making it up. Don't listen to what I say. Listen to your doctor.
> Ivermectin is an antiparasitic drug. After its discovery in 1975, its first uses were in veterinary medicine to prevent and treat heartworm and acariasis. Approved for human use in 1987, it is used to treat infestations including head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis and lymphatic filariasis. It works through many mechanisms to kill the targeted parasites, and can be taken by mouth, or applied to the skin for external infestations.] It belongs to the avermectin family of medications.
Doctors aren't setting the rules on who gets what vaccine and when. RFK Jr is. Health insurance companies are.
Please do not turn mainstream medical advice into a fringe position.
Family members have died from cervical cancer so I get it. I also made sure my younger children received this vaccine.
There a ton of vaccines I could seek out. Why HPV specifically?
Assuming you are not commenting in bad faith, my reasons are in my original comment: "I do not want to expose women to a potentially deadly virus (plus I’d also like to avoid having penile cancer and mouth/throat cancer myself)."
Ideologically it feels weird, but when the doctor says it’s not recommended, what do I say?
I’ve never fallen in the recommended categories. I’ve been to doctors overseas where I do fall in the recommended categories, but even they say to follow the advice off my “home practitioner.”
And while I’m at it, how do I generalize the ethics behind this? Which medicines should I ignore doctors advice and take anyway?
So, unless you are a sex worker or similar, it's unlikely you "have" all of them to the point where the vaccine is completely useless. You might later get infected with a strain that you didn't yet have, and it's precisely the one that kills you.
The CDC says:
> Like all medical interventions, vaccines can have some side effects.
[1] https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...
> A temperature of 100°F during the 15 days after vaccination was reported in 10% to 13% of HPV vaccine recipients. A similar proportion of placebo recipients reported an elevated temperature.
If you take some research subjects, do nothing to them, and then ask how they did 15 days after, I would be surprised if 10-13% reported a 100F fever during that time. But, that's a reasonable result from a saline or hpv injection.
Definitely ensure you're requesting the 9 strain version.
As pm90 wrote, I strongly recommend getting vaccinated [2] unless a doctor tells you otherwise, even if you already have HPV or have had previous potential exposure.
[1] Circulating tumor human papillomavirus DNA whole genome sequencing enables human papillomavirus-associated oropharynx cancer early detection - https://academic.oup.com/jnci/advance-article-abstract/doi/1... | https://doi.org/10.1093/jnci/djaf249
[2] https://en.wikipedia.org/wiki/HPV_vaccine
(had three doses in my 30s via Planned Parenthood)
Isn't that basically everyone who's had sex with someone who had sex before the vaccine was common? I was denied when I asked my last doctor, on that logic. I'll ask my current doctor.
Something like 80% of people are sexually active at all will be infected with HPV at some point. You may not have been sexually active, but your future partners may have been. I personally have a friend who went through stage 4 cancer contracted from her (now ex) husband.
So, of course not literally everyone needs to take it, assess your own risks, but it's quite an easy, highly effective vaccine: don't overthink it.
“The route of HPV transmission is primarily through skin-to-skin or skin-to-mucosa contact. Sexual transmission is the most documented, but there have been studies suggesting non-sexual courses.
The horizontal transfer of HPV includes fomites, fingers, and mouth, skin contact (other than sexual). Self-inoculation is described in studies as a potential HPV transmission route, as it was certified in female virgins, and in children with genital warts (low-risk HPV) without a personal history of sexual abuse. Vertical transmission from mother to child is another HPV transfer course” [1].
You’ve got a low probability of getting polio, but there’s no reason not to be vaccinated if you can.
Even if you already have a strain, there are multiple types. In fact, people who got a vaccine early on, should consider an updated shot for more complete protection.
Wasn't it 3 doses before?
Apparently, it’s about as easy to get as an old-school medical marijuana card.
Results vary by state though. No need to travel to Canada or Mexico (yet).
https://publichealth.jhu.edu/ivac/the-power-of-a-single-dose...
You're very confused about the statistics here.
Conversely, almost every adult over 45 is carrying some form of HPV and a few of those forms cause cancer. If any of those adults has unprotected sex with someone without HPV who is unvaccinated, they almost certainly will transmit the virus. Even if condoms are used, HPV can still be transmitted. This is a much more contagious virus than HIV.
The HPV vaccine is both extremely safe and extremely effective. Suggesting that every human consider getting the vaccine -- with appropriate consultation with their healthcare provider -- is sound advice.
Common causes of hypertension are "contagious". Summary:
spousal concordance: one partner’s chronic disease raises the odds the other has it too. If one spouse has hypertension, multiple studies suggest the other spouse’s risk is about 1.3 to 1.5 times higher than their cohort.
Genetic causes can easily double risk over baseline cohort for children.
However there is a strong environmental/lifestyle effect in children. Studies in Scandinavia show that children adopted into hypertensive households carry an elevated risk compared to the general population. A hypertensive parent with an adopted child nudges the child’s later-life risk by about 20–30% higher than baseline.I don't take medical advice from internet strangers, especially when it contradicts my doctors'.
I'm not particularly interested in discussing the how's and why's. My doctor said he doesn't recommend I get it, so I don't.
I think it's weird and creepy people are selectively opting into vaccines that are not recommended for them.
It feels a bit like those ads that say "bring up Expedia with your doctor!"
This isn't a good PSA.
Should I be vaccinated against smallpox too? How about anthrax?
1 pin prick * 340,000,000 people > 340,000,000 people * 6.1 cases of cervical cancer * 0.9 efficacy / 100,000 people
Your world view assigns equally negative utility to at most 18,214 shots as 1 case of cervical cancer.
Put another way: If you were told you had to either take a shot every day, or you are guaranteed to get cancer, would you really choose the cancer?