Also, this cohort would be age 28-36 years currently. The lowest median age for HPV cancer diagnosis is 50. https://www.cdc.gov/cancer/hpv/statistics/age.htm
Statistical literacy is difficult to develop, statistical intuition even moreso, even among well-intentioned and very intelligent people.
In Québec they did the vaccination to all the kids at 12yo, boys and girls.
Up to the voters I guess.
[0] https://academic.oup.com/jnci/advance-article-abstract/doi/1...
I think a more practical benefit to boys is the prevention of many strains of general warts and general herpes.
The USA has the most aggressive vaccine schedule for children in the world. If Vaccines are so effective we should see either lower per capita health care costs and/or superior aggregate health statistics. However US pee capita health cost are substantially higher than any other country and the health indicators are poor.
If you regressed health level on vaccination it would likely come out a non-factor. The mania around Vaccines is profit driven; greedy pharma bullies and scares everyone into buying their product, because it's the only class they have that doesn't require waiting for someone to get sick.
Vaccines are a medical miracle. Never except that being an anti-vaxxer (or a "vaccine skeptic", which is the sanitized name for the same thing) as being on equal footing. Vaccines are evidence-based. Anti-vaxxers are vibes-based.
Why the arbitrary line at 12?
Why does 12 sound arbitrary to you?
HPV causes penile, anal, mouth-throat and cervical cancer.
I‘d argue that all of those cancers are much, much worse than cervical cancer. After all, they can cause permanent disfigurement, chronic pain, inability to ever speak again and loss of the penis. Infertility? Woe is me!
Anyone who is not celibate should really get the HPV vaccines. Tell a teenager he‘s risking to lose his dick and he‘s gonna get vaccinated tomorrow.
It doesn't need to be perfect at the individual level to cause that - and in fact many vaccines at the individual level actually have pretty bad metrics - like for example only preventing half of cases.
However, note that this is in a population where there will no doubt be leaks. Even if everyone in the area got the jab that doesn't mean they won't have sex with people who didn't. Thus an infection rate of zero is a good showing.
Also, HPV causes head and neck cancers in men and women. These are very unpleasant and not recommended: https://jakeseliger.com/2023/09/09/life-swallowing-tasting-a...
> In a retrospective analysis of data from two qHPV vaccine efficacy studies in young women who underwent cervical surgery or were diagnosed with genital warts or vulvar/vaginal disease related to infection present before vaccination (Figure 1), prior qHPV vaccination was associated with a significant reduction (46.2−64.9% for those who underwent cervical surgery; 35.2% for those diagnosed with infection-related disease) in any subsequent HPV-related disease, including high-grade disease.6 Other studies demonstrated that HPV vaccination before and after surgical treatment for cervical lesions reduced the risk of subsequent cervical intraepithelial neoplasia (CIN) grade 2 or higher, related to HPV16/18 (88.2% efficacy 60 days or more post-surgery),8 and the risk of recurrent CIN 2–3 post-surgery was higher in qHPV vaccine non-recipients compared with recipients (hazard ratio [HR] 2.840).
Seems to say that for a subset of people HPV infection is latent. But current vaccines aren't useful against latent infections. Quick skimming says therapeutic vaccines are an area of research. "Numerous DNA-based vaccines have been developed to target persistent HPV infection and are currently in various stages of clinical study"
My thought is watch this space.
https://www.cdc.gov/hpv/parents/vaccine-for-hpv.html
> HPV vaccination is not recommended for everyone older than age 26 years. Some adults ages 27 through 45 years who were not already vaccinated might choose to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and possible benefits of vaccination for them. HPV vaccination of adults provides less benefit, because more people in this age range have been exposed to HPV already.
The CDC does not recommend against getting vaccinated for people in their 30s. They don't issue a general recommendation for vaccinating people in their 30s.
That's an extremely important distinction.
When I asked her about it, since it seemed like her risk of contracting HPV would be very low, she mentioned she was doing it to mitigate the risks she faced as a woman who was barely 5 feet tall and didn't weigh 100 pounds soaking wet. She said she already has to keep her head on a swivel against the possibility of assault, and she'd really rather not have to worry about a virus that could cause cancer in addition to that risk.
I had the privilege of not ever having had to pay much attention to the risk that my current sexual situation might change without my consent, but it was sobering to be reminded that was something that she had a reason to have on her radar.
https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac...
Well, and a couple hundred thousand deaths annually worldwide. https://www.who.int/news-room/fact-sheets/detail/cervical-ca...
Even if this was the only issue cervical cancer potentially caused (it’s not, you forgot death, among others), this is a really insensitive comment.
Awareness of other cancers doesn’t need to come at the cost of reducing cervical cancer awareness. Seems like a really immature thing to have a pet peeve about.
Is this the place where I can tell you to fuck off?
Maybe today that has been fixed.
Do you think infertility is the only consequence of cervical cancer? Do you mock children with with leukemia saying, "Oh, you feel a little tired? Get over yourself?"
For many people treatment goes smoothly and the can get on with their lives. For some they get treatment, it comes back, they get more treatment, it comes back, and they die, and there is a range of options in between. Maybe they don't die but they can no longer have intercourse. Maybe the financial strain of many rounds of treatment puts them in life-changing debt.
Don't be so glib with the misfortune of other people.
The vaccine prevents against up to 9 HPV, including many genital wart [0] strains.
So I was wrong about herpes but my point was that it protects males against STIs and is just a handy vaccine to protect sexually active men against something they don’t want (some genital warts) and that seems like a greater motivator than reducing transmission to protect women from cervical cancer.
So people are concerned with the risk of having throat cancer more than the risk of death if they get it. And this seems reasonable. As I have a very high risk of death in many improbable situations and I care more about lower risk of death in very common situations.
10k cases of throat cancer in men each year in the US [0]. Although HPV-related cancer, oropharynx, is less than that and harder for me to find a good incident rate. Almost 14k cases of cervical cancer in women each year in the US [1]
[0] https://www.cancer.org/cancer/types/laryngeal-and-hypopharyn...
[1] https://www.cancer.org/cancer/types/cervical-cancer/about/ke...
But that's my point: the incidence of cervical cancer in women and throat cancer in men is in the same order of magnitude, but the incidence of cervical cancer is stable or even declining due to screenings and HPV vaccination, while the incidence of back of the throat cancer in men is five fold higher than throat cancer in women already. And what's more, it is rising - also five fold over the past decade - due to (unprotected) oral sex becoming more common.
The cost to vaccinate all americans is on the order of $100B.
Neither is the fact that "lives will be saved" a sufficient justification. You need to compare that against the lives saved with the alternative policy options available with the given resources.
Because it is?
> they felt the need to draw the line somewhere to prevent hypothetical five year olds
> probably the sense that at 12
I think you get the point. 12 is entirely arbitrary. Some children might well be able to make sound choices like this at that age. Some definitely will not. You're advocating for a line at which parents lose their right to be parents while maintaining the rest of the responsibility for raising the child. You want to put the government in control. I think you need more than a sense before taking that step.
This is one of those ideas that sounds good mostly to people who don't have the responsibility of being parents.
And I'm not advocating for anything, I just hate the insincerity that comes from people asking questions like that. Its also a little whiffy that you're trotting out the 'some kids will make good choices' bit with regards to this age range and the ability to ask a doctor for a vaccination - we normally reserve that line of reasoning where making a bad decision is attractive and an adult might also not behave responsibly.
Also point of order - what are you talking about, 'government control'? The topic at hand was literally whether 12 was an appropriate age to start respecting a persons wishes when it came to seeking a vaccination. It is troubling that you see that as government control, and troubling that you see this as 'losing your right as a parent'
Don't be a dick. It was a legitimate question. And no amount of insinuations or insults on your part changes that. Your points are very weak for someone advocating for getting the gov't more deeply involved in everyone's affairs.
And if you don't think some 12 year olds are wildly incapable of making good medical choices, I don't know what to say.
As a native speaker, even that language feels as though the CDC discourages vaccination despite the literal meaning not implying that. This is a case where it's probably best to be more verbose and explain in full details.
I don't know why the CDC themselves choose to use this language. It's confusing.
All vaccines have a nonzero risk of adverse outcomes. That can be as simple as the risk of physical injury due to incorrect administration of the needle. That's weighed against the risk of nonvaccination.
In almost all cases, the balance is so extremely skewed that it's safe to issue general recommendations in favor of vaccination. For HPV, the issue is that there's literally zero benefit after exposure, and it's difficult/infeasible to test for exposure, but from epidemiological data we know that most people over the age of 25 have already been exposed.
> In my opinion men should also be vaccinated for it
The recommendation is for all genders, and has been for well over a decade.
- Exposure to a strain is not the same as exposure to all strains. Few are likely to have been infected with all of the strains that the vaccine protects against, and infection by multiple strains is not a rare event.
- There's research being done on if the vaccine can reduce symptoms to people who already have HPV. Early results seem promising. Certainly nothing large enough for the CDC to be making recommendations on yet (that I know of/could find from a quick search), but worth noting - there may well turn out to be a significant benefit to the vaccine even after exposure, we just seem to be relatively early in that research.
I guess if you were 50 and still a virgin, and planning to change that, it might be worth it.
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Additionally (something I only became aware of from knowing a person dealing with it) - there's a modest body of clinical research suggesting that vaccinating for HPV in someone who already has it and is symptomatic (warts) can significantly lessen or eliminate their symptoms.
It was recommended for the person I know on that basis by their doctor as a thing to try, and they've noticed significant improvement. Anectdata, but mentioning anyway.
These are very small studies and I won't claim that this is definitive (nor that I've put that much effort into a review of all literature), but to provide some support for my claims that this is a thing being suggested/investigated in research:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541142/
- https://pubmed.ncbi.nlm.nih.gov/38068369/
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I believe that it's too early in the research for that to be factoring into the analysis going into current CDC recommendations, but it's an additional possible upside of vaccination (reducing symptoms/likelihood of symptoms, even if already infected) if the research continues to pan out.
Not quite, though the messaging on this is muddy. The CDC simultaneously says:
> HPV is so common that nearly all sexually active men and women get the virus at some point in their lives. [1]
and
> During 2013–2014, any genital HPV prevalence among adults aged 18–59, was 42.5% in the total population, 45.2% among men and 39.9% among women; high-risk genital HPV prevalence was 22.7% in the total population, 25.1% among men and 20.4% among women. [2]
And if you’re 45, then insurance won’t cover. Even if you test negative for hpv.
However, there is a case where it makes sense: Someone who went into a monogamous relationship early and it has now ended. I'm not a sex-only-in-marriage type but I ended up taking my first partner down the aisle--chances are I was never exposed. I'm still with her, but all relationships end eventually.