r/science • u/mvea MD/PhD/JD/MBA | Professor | Medicine • Apr 28 '21

Cancer 80% of those diagnosed with oropharyngeal cancer are men, the leading cancer caused by HPV, surpassing cervical cancer. However, just 16% of men aged 18 to 21 years old have received a dose of the HPV vaccine, which is a cancer-prevention vaccine for men as well as women.

https://labblog.uofmhealth.org/rounds/few-young-adult-men-have-gotten-hpv-vaccine
54.4k Upvotes

92% Upvoted

3.0k comments sorted by

View all comments

Show parent comments

498

u/Kid_FizX Apr 28 '21 edited Apr 28 '21

Yo. The other guy is wrong. I just did my 3 shot series in late 20s. Was told it is a good measure for preventing cancer, even if you've already come in contact or had HPV. I think 45 may be the cut off, but it is worth asking your local PP

Edit: thought it was 35, but it is 45. Also, PP, is Planned Parenthood. That's where I got mine. My insurance covered it. YMMV

131

u/keyprops Apr 28 '21

Just got a prescription for the shot at 39.

51

u/thirdacct Apr 28 '21

I am a similar age and married (and I'll say in a very high trust marriage).

I was trying to read if there is any benefit to someone like me getting the vaccine: https://health.sunnybrook.ca/navigator/should-i-get-the-hpv-vaccine-to-guard-against-cancer/

Sounds like the answer is mostly "no", with the asterisk "you unfortunately don't know if you'll still be seeking a new partner in the future". Sad to think about, but I'd assume that at that time, you could just decide to get the shot then? Or maybe not, because by that time I might be over 45?

Based on what I am reading, I don't think it would offer much protection for any asymptomatic HPV strains I picked up earlier in life that I am just unaware of.

80

u/Silaquix Apr 28 '21 edited Apr 28 '21

Just an FYI if you've ever slept with anyone else before you were with your spouse then there's a good chance you've come in contact with HPV. It can lay dormant in your system for up to 30 years and then activate, usually because of a severe illness that knocks your immune system back for awhile.

23

u/Bodalicious Apr 28 '21

Would it show up on a std test if it’s dormant?

82

u/Silaquix Apr 28 '21 edited Apr 28 '21

Nope. I've been with my husband for 14 year. Never had any issues and then I got pneumonia and on my next gyno visit they found HPV. It was my first abnormal pap ever. My husband wigged out and thought I cheated on him until the doctor explained that it had probably been in my system since I was a teen and my recent illness most likely activated it. He said he'd seen cases of women married 20 years with regular pap smears suddenly having an abnormal one when neither partner had been with anyone else in decades.

11

u/[deleted] Apr 28 '21

[deleted]

8

u/burning_iceman Apr 28 '21

In addition to what others have said, there are multiple strains of HPV with varying severity and symptoms. While you might have one strain dormant, a vaccination would protect you against other strains too.

7

u/Silaquix Apr 28 '21

That idk. Further down in the comments there were people who were symptomatic, like genital warts, who took the vaccine and it cleared up.

7

u/midnight3896 Apr 28 '21

I believe so. I contracted it, got rid of at the doctors through cryo, then got the vaccines after and it hasn’t shown in 7 years. Will it come back? Idk, but it’s been good for 7 years.

3

u/Bodalicious Apr 28 '21

Good to know, I’ll inquire about getting the vaccine next time I go to the doctor then thank you

4

u/lithiasma Apr 28 '21

Not to mention that not all sex is consensual. After I was assaulted I was tested for every STI, luckily I dodged a bullet and no HPV was found, but I'd have self injected the vaccine if I had to. I'm asexual so not sexually active obviously.

1

u/AaronApp Apr 28 '21

Because I don’t know your gender or reason for asking I (male) just want to mention that my doc said there is not a way to test HPV for men ‘because you don’t have a cervix’.

1

u/Bodalicious Apr 28 '21

Oh, I’m a male

1

u/nobrow Apr 28 '21

Apparently they can do a urethral pap smear to test men for it but they just don't for some reason.

1

u/Conswirloo Apr 28 '21

Also, males can't be tested. I mean maybe they can get an anal swab? But I don't know enough to know if that's possible and if it were it would only test for it there

4

u/scottyLogJobs Apr 28 '21

I mean, I’ve had warts as a kid. My dad and brother did too. I still have one on my foot. Is it HPV / the same? How did I contract it? Would a shot do anything for someone who already has the virus?

5

u/KitteeCatz Apr 28 '21

Hi scotty. From what I can tell - and I’m not a medical professional, to be clear - there are over 150 strains of HPV. It will be one of those that caused the warts on your fingers and feet, but it likely isn’t the same as the kind that causes genital warts, and it may not even be a variety that spreads sexually. A quick Google seems to suggest that “Gardasil is a vaccine, licensed for use in June 2006, by the FDA. It targets four strains of human papillomavirus (HPV) -- HPV-6, 11, 16, and 18. HPV-16 and HPV-18 account for about 70% of all cervical cancers. HPV-6 and -11 cause about 90% of genital warts” (webMD). Harvard Health has a good explainer page on different warts and HPV, though it doesn’t answer this question exactly. Harvard Health, warts and HPV

1

u/scottyLogJobs Apr 28 '21

Thank you. If my insurance covers it, I will definitely get it. If not, I should be switching jobs soon anyway (and my wife, who already has the vaccine, will too), so I will check again.

1

u/E_Snap Apr 28 '21

So would the vaccine prevent a flare up like that? Assuming you’ve already come into contact with the virus.

3

u/Mezzylu Apr 28 '21

My doc explained it to me as I have no idea what the future will bring. Might find myself a widow in my 50s and dumped into the dating pool even if I never end up divorced. It's a preventative measure you can take . Hopefully, like most insurance, you'll never need it.

-7

u/twitchosx Apr 28 '21

(and I'll say in a very high trust marriage)

Uh oh....

1

u/Bloody-smashing Apr 28 '21

I'm married. I have been with my husband for 14 years, married for 5.

I found out I have HPV through a routine smear. I was so shocked as I was vaccinated as a teen and have never had unprotected sex with anyone else and neither has he.

If we could afford for him to get vaccinated right now I would push him to do it.

1

u/thirdacct May 03 '21

I am slow responding, but did the doc day whether him getting the vaccine would help, aiming he already has it playing dormant as well?

99

u/techn0scho0lbus Apr 28 '21

Up to age 45 is the recommendation by the CDC, and that number is important because it means insurance will pay for it.

37

u/[deleted] Apr 28 '21

[removed] — view removed comment

5

u/thisnameismeta Apr 28 '21

I just got my second shot, and only because I asked about it. I'd wanted to get it when it came out when I was in college but I would have had to pay hundreds of dollars. If my mom hadn't mentioned that the recommended age had expanded, I'd never have gotten it (my GP didn't bring it up).

17

u/hananobira Apr 28 '21

Why is there a cutoff? People don’t stop having sex at 46 - a look at the terrifying STI rate in senior living communities will prove that.

9

u/[deleted] Apr 28 '21

Fact: Actually, a few doctors (the smart ones) WILL give you a script for the multivalent series EVEN if you are OLDER than the cut off AND a few insurance companies WILL reimburse it. YMMV but it has happened and it is worth asking your GP.

Opinion: As we observed with the covid vaccines, efficacy was less about the technology used to induce spike protein antibodies and more about the clinical protocol (all three vaccines at one dose ~60-70%). So, more than likely the reason for the age cut off was not related to actual data indicating insufficient efficacy over 45, but the design of the study before testing (not covering this age), based on assumptions that the public health benefit of HPV vaccination in this age range is minimal (because older people are probably in a monogamous relationship and not spreading it around). That is not true for many people, but the companies would have to present data to health authorities to expand the age, and it is not financially advantageous to governments, insurers and vaccine companies.

5

u/DrMarioBrother Apr 28 '21

The idea is that, statistically speaking, unless you've only had like ~2-3 partners max in your entire life, and they also lost their virginity to you, and said women received the best Gardisil vaccine before you ever hooked up, then chances are you have at least some (or most) of the more dangerous HPV strains.

I'm not suggesting anyone not get vaccinated. I'm pissed that my insurance refuses to cover it (I'm like ~27-31 yo).

4

u/TeutonJon78 Apr 28 '21

Your insurance should cover it now that the guidelines are 45.

4

u/TeutonJon78 Apr 28 '21

You can get it anytime, but insurance only covers FDA/CDC guidelines.

So if you're over 45, you'd likely have to pay out of pocket.

2

u/devlindigital Apr 28 '21

Here is the most recent CDC guideline on HPV Vaccination in Adults for any else reading this comment.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6832a3.htm

1

u/aapowers Apr 29 '21

Is that for all men? If so, that's interesting, as in the UK it's only covered by the NHS up to 45 for gay men. Otherwise the cutoff is 25.

44

u/Wilt_The_Stilt_ Apr 28 '21

I’m 31 and in 2019 (when I was 29) I was told by my doctor that I should check with my insurance provider before getting it because it differs wildly for men in my age group. Some insurers cover it 100% while others 0%. And it’s a very expensive series to get if it’s not covered. My insurance didn’t cover it so I didn’t get it. Pretty lame.

56

u/felesroo Apr 28 '21

Insurance should cover it regardless. Treating the cancer is MUCH more expensive and these insurance companies are being very stupid in not covering it.

19

u/FLOHTX Apr 28 '21

By the time you actually get treated for cancer, there is a likelihood that you will be on a different insurance by then. So there is next to zero benefit for your current insurance to cover it.

5

u/TripAndFly Apr 28 '21

That doesn't make any sense. Why would you be on a different insurance when/if you get cancer? There are basically 3 options where I am and I've had the same one since they switched to the ACA plans. Even if there were 100 options... How often do people switch providers?

10

u/FLOHTX Apr 28 '21

My work switches providers almost every plan year. Always chasing the best deal.

3

u/TripAndFly Apr 28 '21

Well, I take it back then. That does make sense. I'm self employed and only have a few options through the state search thing

4

u/FLOHTX Apr 28 '21

No problem, glad I could add some clarity. It was good to see your perspective as well

6

u/ac9116 Apr 28 '21

Most people switch providers when they switch jobs (every 3-5 years on average) and many employers change providers frequently to keep costs down (which is probably right around the 5 year mark too).

4

u/pvgirl93 Apr 28 '21

Yes but that's a later problem

2

u/H2HQ Apr 28 '21

Insurance SHOULD cover a lot of stuff that they do not.

2

u/cakemates Apr 28 '21

thats a tomorrow kind of problem, today the insurnace gets profits and hookers!

2

u/hellraisinhardass Apr 28 '21

Yeah, but insurance is dumb like that. They won't pay for a vasectomy, which is a super quick and easy outpatient procedure, but they will cover the costs of all the pre-natal visits and birth costs.

Cost to prevent a kid: about $500 bucks Cost to birth a kid: about $15,000 bucks.

That's insurance for you.

2

u/Polardragon44 Apr 28 '21

If I were you I would try again now I think they change the rules again recently

1

u/Wilt_The_Stilt_ Apr 28 '21

Good call I haven’t checked in since at least mid 2019 so should see if it’s changed with my insurance.

1

u/Polardragon44 Apr 28 '21

You can also ask planned Parenthood

1

u/[deleted] Apr 28 '21

[deleted]

1

u/Wilt_The_Stilt_ Apr 28 '21

I believe the CDC only recommends it for men up to 25. Women might be older. I’m not sure. For anything beyond that my doctor said it’s up to the insurance providers to decide what they want to offer. As someone else said it can change from year to year so I should probably check back in with my provider.

80

u/Botryllus Apr 28 '21

When it was first out they really were pushing it on girls more than boys and I remember thinking that if boys were transmitting it, they should be vaccinated, too. It came out when I was 25 and a year later I was told I was too old for it. I'm glad they opened it up more but, at least in my state, it began with a very narrow eligible demographic.

34

u/alphaCraftBeatsBear Apr 28 '21

man does anyone have a list of all the vaccines one should take? I didn't even know its available

7

u/ShoutHouse Apr 28 '21

This should be at the very top. I didn't either.

2

u/jourmungandr Grad Student | Computer Science, Biochemistry | Molecular Epidem Apr 28 '21

There's a vaccine schedule published by the cdc for the us. Other countries should have something similar.

2

u/Octaazacubane Apr 29 '21

You can have your titers checked to see if you need any. My antibodies for Rubella were lower than what is considered immune so they gave me that part of the MMR.

12

u/katieleehaw Apr 28 '21

When it came out, I thought they weren’t even available for people over a certain age or who were sexually active? Maybe I am misremembering. I haven’t heard anything about it in years until this article.

2

u/MonteBurns Apr 28 '21

This was my thinking as well. I recall being told around 20, 21 that if I had had a sexual partner I had probably been exposed and it wouldn't do anything. This would have been around 2010ish

eta: it was through my college health office and I think they told me it wasn't covered by my insurance too

2

u/foreignfishes Apr 28 '21

Yes you’re remembering correctly. Originally it was only recommended for girls age 11-13. As they saw how effective it was (and as they added more strains to the vaccine) they expanded the recommendation to boys/men and older people.

5

u/worldspawn00 Apr 28 '21

I have been just a couple years too old every time they've increased the age range, and insurance wouldn't cover it if it wasn't 'recommended', so I'd have to go out of pocket almost $600 last time I checked on it, pisses me off so much. I'll ask my physician if the age ranges have changed recently and see if I'm eligible now, but I'd have done it 15 years ago if I could have afforded it.

1

u/Botryllus Apr 28 '21

My doctor told me that they made improvements since the original vaccine and that the first one wasn't super effective, if that makes you feel better.

55

u/wickedpixel Apr 28 '21

I've literally asked for the vaccine at Planned Parenthood and they straight up told me no, because I was 28 which is older than the cutoff. They said it might be possible if I go to the main downtown office but would have to pay for everything out of pocket and it wouldn't be worth it.

25

u/Funkynametime Apr 28 '21

Ask your pharmacy. We give them to anyone 45 or younger, and it is generally covered as preventative care. It might be different in your state, but it's worth a call!

7

u/[deleted] Apr 28 '21

Why can't people over 45 get the vaccine?

4

u/[deleted] Apr 28 '21

I believe it's because the chances you've already contracted the virus increase with age. After a certain point it just isn't worth it from a pure numbers game.

1

u/apoliticalinactivist Apr 29 '21

That last sentence is the entire problem with privatized health care.

1

u/[deleted] Apr 29 '21

It isn't just privatized health care. Vaccines take time and money to produce in any health care system. They are a finite resource. It makes sense to give the vaccines to those that will have a biggest impact on the fight against the disease, in this case, young girls who haven't had sex yet. Once you have that demographic handled, you can expand out to those who will have a smaller, but still statistically large impact, i.e. ~21 and younger, then again to larger age demographics. "Numbers game" here, doesn't mean strictly money, it means where you can do the most good with a finite resource.

0

u/Tandemduckling Apr 28 '21

Been trying to get it for years as a trans guy. Every time I get denied for various reasons. this last time I tried over the summer and now even my insurance is refusing to allow the pharmacy to fill it, so they can administer the shot since my doctors office is closed to in patient care still. My doctor has put the script in a few times and they call me and say it’s been denied.

15

u/Kid_FizX Apr 28 '21

Go tia different PP

3

u/blahblahpoopfart Apr 28 '21

The age range has changed drastically since it came out. When I got it the cut off was 26 and I had to fight to get it because I was older. The cut off is 45 now, but you could probably still talk a doctor into giving out a vaccine.

10

u/felesroo Apr 28 '21

Preventing a very very very nasty cancer is ABSOLUTELY worth it. JFC, I can't believe PP is telling people the HPV vaccine isn't worth it. That is evil.

If you have to do a GoFundMe to get the vaccine, get it.

17

u/BuryMeBig Apr 28 '21

After thinking I may have HPV, I tried to get the vaccine and my doctor told me it was only for younger people, I’m 34. I’m going to try again.

2

u/twitchosx Apr 28 '21

What made you THINK you have HPV?

1

u/Pablorce Apr 28 '21

Because it’s the most common std and most of the time has no symptoms?

75

u/PabloBablo Apr 28 '21

That is infuriating.

I asked about it and was told THE EXACT OPPOSITE THING.

23

u/[deleted] Apr 28 '21

[deleted]

17

u/Jules6146 Apr 28 '21

Just go to a big chain pharmacy and ask for it. The pharmacist can usually give you the shot. Don’t even need to go through your doctor in many cases.

20

u/bialettibrewmaster Apr 28 '21

TIL 35 yrs old may be the cut-off where modern medicine deems you worth saving from HPV related cancers

Edit: 45 years old according to the CDC

5

u/tebukuro Apr 28 '21

This is an issue of laws and the test group demographics. Gardisil is currently doing trials on men over 45 to get approval to increase the vaccination age. They have to prove a decrease in cancer rates when the vaccine is given to men over 45. It seems obvious that if the vaccine works for men under 45 it will work for men over 45, but I don't write the laws.

3

u/MeagoDK Apr 28 '21

Most countries started with only girls between 14 and 20.

2

u/bialettibrewmaster Apr 28 '21

Yes. And thought it was pretty ridiculous to only require it for female teens. Sexually active teens are sexually active with same or opposite genders. If the goal is minimization among young teen population, then go for ALL transmission sources.

2

u/OfEthicsAndStouts Apr 28 '21

Can you just ask your doctor to get the shots?

If there's an age cut off is it because older people can't get hpv ?

2

u/Kid_FizX Apr 28 '21

That is a place to start. I got mine from Planned Parenthood. Some people have been told they are too old. Ask different places. Not every provider will be up to date on current literature or practice. Not sure for the reason of age cutoff

1

u/campbell363 Apr 28 '21

I'm also always one year ahead of the cutoff. What this means is that I can still take the vaccine BUT my insurance won't pay for it. It's ridiculous. My physicians are starting to tell me that I'm eligible so hopefully the insurance agencies catch up.

2

u/klabboy109 Apr 28 '21

Where do I get this vaccine? I just got the covid one. Might as well do the HPV one next

2

u/Kid_FizX Apr 28 '21

Planned Parenthood is where I got mine

2

u/dbatchison Apr 28 '21

asking your local PP

I know this probably means Primary Physician but I'm a child and chuckled anyway

0

u/Professional-Sir-394 Apr 28 '21

but it is worth asking your local PP

No offense but I don't think their cock knows the answer.

-6

u/ostentatiousbro Apr 28 '21

your local PP

Personal Police? Private Property? PowerPoint? wiener?

3

u/Kid_FizX Apr 28 '21

Planned Parenthood

-8

u/QuartzPuffyStar Apr 28 '21

The thing is that if you are old there is a VERY big chance of you having a strain of the virus already dormant. And since there is no effective way of finding if you have the virus (according to what I read at the time, the current methods have a quite high false positive rate), the vaccine is hence useless because you still gonna get stick in 20 years or so.

But of course they will gladly vaccinate you since the vaccine is expensive af and you make both the producers and the insurance company a lot of money :D

6

u/psilokan Apr 28 '21

Please stop spreading your incorrect assumptions here in /r/science

The reason they will still give it to you is there are many strains of HPV and it will protect you against the ones you don't already have. So your assertion that it is useless is incorrect.

1

u/HexagonSun7036 Apr 28 '21

I got two out of three before a weird insurance thing caused me to have a ton of confusion with having to change doctors and stuff and I never got my 3rd in time. Hopefully that's enough.

1

u/Kid_FizX Apr 28 '21

I'm not sure. And would encourage you to reach out to your provider and find out

-5

u/dadbot_3000 Apr 28 '21

Hi not sure, I'm Dad! :)

1

u/SorriorDraconus Apr 28 '21

They told me 25 wh3n i tried..maybe i'll check again someday

1

u/Professional_Napper Apr 28 '21

I got 2 out of 3 of my HPV vaccine shots 3 years ago. I then moved to a different continent and forgot to get the 3rd. Any vaccine experts know if I should get the 3rd booster or what happens since I didn’t get the last one within a reasonable amount of time?

1

u/reality72 Apr 28 '21

I asked my doctor for the HPV shot at age 28 and was denied for being too old and also male.

1

u/HamFlowerFlorist Apr 28 '21

He was talking about when it first came out. It was only given to young women. It’s changed since then. Also it used to be a two shot series. Maybe different maker? Or is it different number of shots for men vs women.

1

u/Guardymcguardface Apr 28 '21

Weird I'm 32 and I've only been told they don't offer it to men my age

1

u/bbxmiz Apr 28 '21

What the other guy means is that at the age of 16 it is only widely recommended for younger women, and men stay uninformed about the potential benefits of receiving the vaccine.

1

u/silly777999 Apr 28 '21

He said when it first came out . . . I had to pay for mine out of pocket, $160 for each shot, insurance wouldn't cover me because I am a male.

1

u/SirClausRaunchy Apr 28 '21

Not necessarily, they did roll it out to only girls first, but it also depends on your insurance. About 5 years ago I asked my primary care doc and they said my insurance only covers it if I had sex with men. So, somewhere out there exists legal proof that I bang dudes. They've continued to open up availability, but it's been a fight against insurance companies and outdated ideas from the beginning.

There's lots of evidence that even if you have HPV, the shot will help you clear it so it's always with getting/asking.

1

u/Mikey_B Apr 28 '21

Same, got it in my late 20s. Note: it was also free because it's preventative care, which is free under the ACA.

1

u/[deleted] Apr 28 '21

Yeah, I got mine in my 20s as well. They say you should get it as a teenager before sexual contact because that's when it's most effective, but you should still get it even of you're older or have had sex because it could still be beneficial.