> Unless you plan to remain completely celibate

You can get HPV without sex too.

https://www.cdc.gov/sti/about/about-genital-hpv-infection.ht...

"HPV is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex"

This focuses on sex, but any virus that can be found on skin, also has a chance to be transmitted without sex just as well. Admittedly the chance here for HPV infection is much higher with regard to sex, but not non-zero otherwise. The HeLa cells also contain a HPV virus in the genome, though this was probably transmitted via sex:

"The cells are characterized to contain human papillomavirus 18 (HPV-18)"

HPV-18. I think HPV-18 may in general be more prevalent than HPV-16.

>> HPVs are extremely common: 80% of men and 90% of women will have at least one strain in their lives.

This statistic seems to be used by some people to avoid the vaccine - they figure they've already had it at some point. The biggest problem with that logic is that not all strains are as dangerous and they probably have not contracted 16 or 18 specifically. The other problem is there's still a good number of people who have never had it and shouldn't assume they have because its common.

Yeah I just did it at 50. Only got 2 gardasil shots though. They're so expensive because only young people get them subsidized.

I heard 1 shots already conveys a lot of protection so I'm wondering whether to take the third. I'm a bit late with it too

For those men wondering whether they should get vaccinated:

- HPV causes genital warts, HPV is permanent, doctors won't test you for HPV unless you demand it, and the tests aren't reliable, which is why they literally won't diagnose you unless you already have genital warts.

- Once you are confirmed HPV positive (again, you won't be confirmed without getting genital warts), you need to inform your partners, as it causes cancer in both men and women (but mostly women).

I, a male, got vaccinated with the Gardasil 9 vaccine shortly before turning 40. Convincing my doctor to prescribe it wasn't terribly difficult, I told them a few things about my sexual history and explained some of my sexual plans, and that was that.

I wish more people would get vaccinated.

Is there any issue for adult males vaccinating ? I seem to remember some mention of risk by my doctor when I asked about it, but I might be misremembering.

> While it won't clear an existing infection, it protects against different strains and reinfection (typically body removed HPV in 1-2 years). See: https://pubmed.ncbi.nlm.nih.gov/38137661/

The study you've quoted here is not definitive evidence of the claim you're making, and that claim is...let's just say that it's controversial. Conventional wisdom is that you're unlikely to benefit from HPV vaccination unless you have not already seroconverted for at least one of the 9 strains (6, 11, 16, 18, 31, 33, 45, 52, 58) in the current vaccine.

There's not much hard evidence to suggest that vaccination for HPV has strong ability to protect you from a strain after you've already been infected with that strain [1], as the best available data shows a substantial decline in efficacy for women over age 26 and for women of any age who had prior documented infection [2]. This study is small, unrandomized, and the measured primary outcome (anti-HPV IgG) doesn't really tell you anything about relative effectiveness at clearing an infection. The only real evidence they advance for this claim is:

> Persistent HPV infection after vaccination was significantly less frequent in the nine-valent vaccinated group (23.5%) compared to the control group (88.9%; p < 0.001).

...but again, this is a small, unrandomized trial. We don't know how these 60 people differ from the typical HPV-positive case. You can't rely on this kind of observational data to claim causality.

Vaccination is great, but let's not exaggerate or spread inaccurate claims in a fit of pro-vaccine exuberance. The HPV vaccine has age range recommendations [3] for a reason.

[1] For the somewhat obvious reason that your immune system has already seen the virus.

[2] See tables 2 and 3 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/

It's also worth calling out table 4, which shows the (IMO bad) efficacy data for biological men, which is why I only talk about women, above, and why anyone who recommends vaccination without mentioning this factor is not being entirely forthright. Few people are rushing to give older men the HPV vaccine because it's not really supported by data!

[3] I believe the current guideline is under age 45 in the USA.

> - Sooner is better, but vaccination can be done at any age. Guidelines often lag behind, but vaccination makes sense even if you are currently HPV-positive.

However, the vaccination is expensive (~1k) and it is difficult to find doctors who will do non-recommended vaccinations for self-payers.

YCMV

> Unless you plan to remain completely celibate

Uh, monogamy of both partners is also an option, not just celibacy. Not common in these times, I know, but you don't have to completely abstain from sex to be safe.

I don't think that's what the summary is saying.

My reading of the following is that the cost of each additional quality adjusted life year would be over $100,000, rather than that each vaccination prompts $100k in economic value

> Including preadolescent boys in a routine vaccination programme for preadolescent girls resulted in higher costs and benefits and generally had cost effectiveness ratios that exceeded $100 000 per QALY across a range of HPV related outcomes, scenarios for cervical cancer screening, and assumptions of vaccine efficacy and duration

I fail to see how e-boks makes this work. Younger people check their e-boks less frequently than average, so sending a physical letter to their address would work just as well if not better.

What makes it work is the public registers.

Okay, well Ireland has similar vaccination rates, broader childhood vaccination coverage, and no central medical records at all, so while e-boks may assist administration, it's certainly not necessary.

How did you know you were going to have girls?

"Lots of viruses are really oncogenic."

Hmm. Compared to what measurement? Most viruses are actually not oncogenic.

From cancer causes, oncogenic viruses are thought to be responsible for about 12% of human cancers worldwide:

https://www.mdpi.com/2079-7737/14/7/797

From what I remember, most viruses are not oncogenic in nature, so I am unsure whether the statement made is correct.

Sadly, no matter how good the data is, some societies will value opinions of uninformed celebrities above facts and reason, leading to a resurgence of preventable diseases.

EHRs are definitely not necessary for health surveillance and many countries perform equally or better without centralised records.

I'm a proponent of EHRs, but the key value is at patient-level, not population level where other approaches perform equally well.

I sometimes vouch for incorrectly flagged posts. You got me curious, so I took a look. What I found was a blog from an anonymous conspiracist vaccine opponent claiming to be a doctor. He's a decent writer but in my estimation a loon.

So I'm fine with it being flagged and decline to vouch for it.

It was a misleading post.

For the HPV section specifically, there were at least two major omissions.

First, in his table showing autoimmune adverse effects, he has chosen to crop out the next column in the table containing the control conditions - which show very similar rates of adverse effects to the vaccine condition.

Secondly, when discussing negative efficacy in the case of existing persistent infection, he only quotes the data from one of three studies that the linked report covers. The linked report indeed covers the negative efficacy in study 013 as an area of concern. However, study 015 (which had roughly twice the number of total participants as study 013) showed no real evidence of negative efficacy. When all 3 studies are pooled together, the point estimate still says negative efficacy, (at ~-12%), however the error bars are quite wide.

Why this is tragic, is because these two omissions do actually point to failures in public communication about the vaccine. For example, the control condition in the Merck trials were a mix of saline injections (this is the traditional placebo), as well as injections with just the adjuvant (AAHS). This is less standard, and raises legitimate questions about why Merck used an adjuvant as the control, instead of just saline. There a cynical/conspiratorial angle to this question, which I think would be directionally correct.

The second omission is because I think there is a reasonable question of "are there extra risks associated with getting the HPV vaccine while having an active persistence infection", even when taking into account the different and larger study populations within the original trial data. Once again, I think the idea that both companies and public health agencies don't want to deal with a vaccine that requires testing before hand is true. I also believe that on a population level, even if there was a modest increase in risk in that specific subgroup, it makes sense to implement broad vaccination campaigns.

That said, I think the unwillingness of public health agencies to engage with this tricky area of communication and education creates these types of opening for anti-vaccine messaging. If you want a sense of "conspiracy" - here's a random review study - https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/

Notice that when reporting results, the groupings for HPV status at enrollment time are "naive" and "irrespective" - the "test positive" grouping isn't broken out.

EDIT: The article that we're discussing is https://www.midwesterndoctor.com/p/the-perils-of-vaccinating...

Sounds like in countries like Denmark, they are already on their way to becoming the most prevalent.

Hope we'll develop vaccines against those too.

I don't know about Denmark, but the US CDC indicates that you can get the HPV vaccine starting at 9; with a recommendation do get it at 11 or 12.

https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.htm...

> Just truthfully tell the boys their dicks might fall off and see how all of them quicklky flock to the vaccine.

Every male above the age of 26 is locked out of the vaccine unless you pay out of pocket, which will be €300-€500 (or even higher).

It's led to this really weird situation, where HPV vaccination for men is now recommended up to 40s but only covered up to 26yr old, and that recommendation upgrade happened relatively recently. Which means there's a whole generation of men who are told they should get the vaccine, who would have had covered access to the vaccine in the past, but are now expected to go out of pocket.

Straight men are not getting anal cancer from HPV in any meaningful or measurable amount.

Statistics are useless and/or misleading without context.

Promiscuity is not a healthy lifestyle and we need to stop presenting it as one. The AIDS crisis of the 1980s should have been enough of a warning. If people don't sleep around then HPV's spread will be much reduced and they will be much less likely to catch other STIs.

You could probably have gotten away with it a decade ago but that is a very poor plan in the far more critical of public health world of today.

Statistically nobody even knows a guy who knows a guy who's dick fell off. Serious HPV problems for men are not even common enough to be viable urban legend. You have less to back up your DARE messaging than DARE did. It's just not gonna work. The nanosecond someone who took your bait shows up to be interviewed by some Youtube talking head about side effects the already severely damaged (compared to, IDK a decade ago) credibility of the medical establishment will go up in flames.

You need to tell the truth the whole truth and nothing but the truth and let people make their own decisions. People don't "trust the experts" anymore at the scale you need for stuff like vaccination campaigns so you have to operate based on that reality.