Getting the HPV vaccine

October 7, 2011

in Economics, Science

I decided to get vaccinated against human papillomavirus (HPV) with Gardasil. HPV causes genital warts, as well as cervical, anal, penile, and throat cancer. The vaccine covers four of the many strains of the virus – types 6, 11, 16 and 18 – including those that cause most genital warts and cancer cases.

Gardasil is normally prescribed to girls who are young enough that they are presumed to have had no sexual contact with others. Adults are assumed to have been exposed to HPV already. That is probably true in most cases. Still, there is a benefit in getting protection from the four most problematic strains, or at least any of the four that you have not already been exposed to. On that basis, doctors seem quite happy to prescribe the vaccine to adult women and men.

I got the first shot yesterday. There will be another in two months and a third in six months.

The vaccine is expensive, which is the main reason why it is not given to everybody. Still, it seems like a good investment. If enough people get vaccinated, one of the most prevalent sexually transmitted infections could be virtually eliminated and many cancer cases and deaths could be prevented.

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{ 21 comments… read them below or add one }

Padraic October 7, 2011 at 9:48 am

I can’t tell from your post – is the cost covered by OHIP or not?

Milan October 7, 2011 at 6:12 pm

It is not covered, and it costs about $150 a shot.

Milan October 7, 2011 at 7:21 pm

As someone who is used to getting inoculations in high school gymnasiums, it was strange to buy a syringe at a pharmacy and take it to a drop-in clinic to be administered.

Matt October 7, 2011 at 7:44 pm

What was the cost of the vaccine and what was the cost to get it injected? An enterprising person could self-administer, I imagine.

Milan October 7, 2011 at 8:00 pm

No cost for injection – that was covered by the Ontario health plan.

dp October 7, 2011 at 8:20 pm

The political controversy about the vaccine is absurd, and demonstrative of how parents and the state both feel like they own the bodies of young women.

Doctor: Good news! We have a vaccine that could help your daughter avoid getting cancer!

Parent: Amazing! Sounds great!

Doctor: There is one minor drawback – it also prevents a kind of sexually transmitted infection. As a result, it may remind you that at some point your daughter may have some sort of sexual contact with one or more human beings.

Parent: How terrible! I was hoping I wouldn’t have to think at all about my daughter’s sexual future for years yet. Better to wait until she has probably already been exposed, then let her buy the shots for herself.

dp October 15, 2011 at 5:46 pm

Millions of women are regularly tested for  human papillomaviruses. Isn’t it smarter to vaccine them so they won’t get it in the first place. After all, it cannot be cured once it has been detected.

. October 25, 2011 at 3:21 pm

An advisory committee to the U.S. Centers for Disease Control and Prevention will soon issue new recommendations that pre-adolescent boys be vaccinated against Human Papilloma Virus (HPV). The disease is sexually transmitted, endemic in the sexually active, can cause genital warts in both men and women, and is the primary cause of cervical cancer, which kills hundreds of thousands of women globally each year. The three-dose vaccination has been available for several years and is already recommended for pre-adolescent girls. Vaccinating boys should further reduce transmission.

dp October 26, 2011 at 8:02 pm

People are so selfish!

Some feel it’s unlikely that most families will agree to get their sons vaccinated primarily to protect girls. An estimated 50 per cent to 80 per cent of men and women are infected with HPV in their lifetimes, although most clear the infection without developing symptoms or illness, according to the CDC.

Not to mention shortsighted – eradicating HPV would be good for everybody.

anonymous November 1, 2011 at 4:49 pm

The problem of HPV comes from uncircumcised males who do not shower as often as they should. It is a dirty little secret no one is talking about. Maybe if baby boys were circumcised again as they once were in this country, we wouldn’t have to vaccinate the poor hapless girls who now have no choice but to “be” with guys who don’t keep themselves clean.

Matt November 1, 2011 at 6:14 pm

To anonymous above:

Care to cite a source? Here’s an interesting fact for you:
“The percentage of circumcised men reporting a diagnosis of genital warts [due to HPV] was significantly higher than uncircumcised men, 4.5% (95% CI, 3.6%-5.6%) versus 2.4% (95% CI, 1.5%-4.0%) .” Source

The fact is, circumcision does not prevent transmission and immunity due to vaccination does.

Besides, circumcision of babies is by definition involuntary genital mutilation, which is an appalling thing to advocate for.

anonymous November 1, 2011 at 9:23 pm

Both of my sons were circumcised and they have thanked us for it. (Not kidding.) One of them has a son who was not, as his mother didn’t want it, and that grandchild has had horrible painful looking infections. I think doing a procedure on a 3 day old infant who will not remember it, is far more compassionate than waiting for the inevitable infections later on, when they will remember it.

As for the research, we can find anything we want online to support our own position. Your research statistics come from organizations whose sole reason for being is to support their own agenda. Here is a more unbiased report: (reported in the Lancet medical journal and Johns Hopkins. )

Researchers have documented yet another health benefit for circumcision, which can protect men against the AIDS virus, saying it can protect their wives and girlfriends from a virus that causes cervical cancer.

Wives and girlfriends of circumcised men had a 28 per cent lower rate of infection over two years with the human papilloma virus or HPV, which causes warts and cervical cancer, they reported in the Lancet medical journal on Thursday.

MORE RELATED TO THIS STORY
Support for female circumcision declining in Africa, study shows
The circumcision debate: Should it be outlawed?
Circumcision health benefit virtually nil, study finds
“Our findings indicate that male circumcision should now be accepted as an efficacious intervention for reducing the prevalence and incidence of HPV infections in female partners. However, protection is only partial; the promotion of safe sex practices is also important,” Dr. Maria Wawer and colleagues at Johns Hopkins University in Baltimore wrote.

Matt November 2, 2011 at 12:49 pm

Your anecdotal evidence about your family isn’t relevant to the issue. Also, my source was not from “from organizations whose sole reason for being is to support their own agenda.”

In fact it was from a single source, the official journal of the American Sexually Transmitted Diseases Association. Had you clicked the link I provided you would have seen that.

Circumcision is not medically indicated at birth. If complications arise for non-circumcised boys or men (which is rare), it can be performed later in life.

Regardless of whether or not circumcision minimally impacts infection rates (you haven’t provided a link to a source which so states), the vaccine reduces risk of infection to nearly zero. Obviously one is much more important to the prevention of infection.

anonymous November 2, 2011 at 2:53 pm

This conversation started with an anecdotal comment.
I did click on your link. Here is mine: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62273-8/fulltext
and:
http://www.sciencedaily.com/releases/2011/10/111006133022.htm
There is also the issue of the HPV vaccine itself: the fact that it has been known to cause a number of serious health issues and even death.

Milan November 2, 2011 at 6:30 pm

I agree with Matt. The vaccine seems a superior protection against the four most problematic strains of HPV.

I also have my doubts about the ethics of circumcision. We have every reason to believe that infants feel as much pain as older people, even if they have no language with which to complain. Forcing such a bodily modification upon them seems dubious.

anonymous November 2, 2011 at 8:59 pm

Skepticism is the first step toward Truth.

Milan November 3, 2011 at 9:42 pm

Being skeptical doesn’t mean you are right, and organizations like the U.S. Centers for Disease Control and Prevention have a lot more credibility (and capacity to be effectively skeptical) than anonymous internet commenters.

. November 30, 2011 at 10:14 pm

Can male circumcision stem the AIDS epidemic in Africa?

As a preventive measure, voluntary male circumcision is gaining favor as a large-scale attack against HIV’s spread.

Katherine Harmon

30 November 2011

For the Xhosa in South Africa, a boy’s coming of age is often marked by an elaborate and lengthy set of rituals. One of the ordeals is circumcision, which is traditionally performed by a healer and occasionally leads to an ineffective cut, infection or even death. The young men who emerge from the ceremony healthy, however, achieve not only new social status but are also much less likely to become infected with HIV.

Adult male circumcision, in which the foreskin of the penis is surgically removed, has emerged as one of the more powerful reducers of infection risk. Some studies are finding that it decreases the odds that a heterosexual man will contract HIV by 57 percent or more. With HIV vaccine research still limping along, condoms being underused and the large-scale vaginal gel trial Vaginal and Oral Interventions to Control the Epidemic (VOICE) just called off early last week after disappointing results, the operation has been gaining ground.

Milan December 10, 2011 at 2:52 pm

I have now had two of the three HPV vaccination shots.

I still think it makes sense to vaccinate everyone at an age where they are unlikely to be sexually active. Over time, doing so could virtually eliminate the four most problematic strains of HPV within the population at large.

I also think it’s a good idea for individuals to get the vaccinations, especially if they have supplemental health insurance that covers part of the cost.

. April 15, 2012 at 1:21 pm

Free HPV vaccine urged for boys
$500 immunization covered for girls but not boys

Boys should have access to free HPV immunization, currently only for girls, in order to protect more people against cancer, a growing chorus of Canadian doctors say.

The human papilloma virus, or HPV, causes disease and death from cancer in both men and women. For nearly five years, girls have been offered the HPV vaccine for free at vaccination clinics and schools across the country, to protect them from cervical cancer.

This week, the Canadian Cancer Advocacy Coalition called on provinces to pay for the vaccine for boys, too. In January, the National Advisory Committee on Immunization recommended HPV vaccination for males aged nine to 25.

. July 11, 2013 at 4:28 pm

According to the Centers for Disease Control and Prevention, every year in the United States there are more than 2,370 women — and more than 9,350 men — diagnosed with HPV-related oropharyngeal cancer. The discrepancy between the sexes has always been there with oropharyngeal cancers, but we used to understand why it existed. For most of the 20th century, these cancers were primarily linked to smoking and drinking — activities that, on average, gentlemen have traditionally engaged in with more gusto than their female counterparts.

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