[ceejayoz]

The CDC doesn't recommend it. By that age, you've probably been exposed already.

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.

[pazimzadeh]

I don't understand why they recommend against it. I guess the monetary costs don't outweigh the benefits, but that's only if you care more about saving money than potentially preventing cancer. It's not like the vaccine going to hurt you. But the HPV vaccine is not particularly cheap, so it sounds like the insurance companies have lobbied against it or something. In my opinion men should also be vaccinated for it since they are often carriers and can be affected too.

[jliptzin]

I don’t understand either. My doctor recommended I get it despite being older, because it’s possible there are strains of HPV it protects against that I have not yet been exposed to. He also said it could theoretically help clear an existing infection faster.

[chimeracoder]

> I don't understand why they recommend against it. I guess the monetary costs don't outweigh the benefits, but that's only if you care more about saving money than potentially preventing cancer. It's not like the vaccine going to hurt you.

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.

[volkl48]

Noted in my other comment, but mentioned here as well:

- 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.

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541142/

- https://pubmed.ncbi.nlm.nih.gov/38068369/

[londons_explore]

Since nearly everyone is infected with HPV, if you've had sex with a few people you're almost certainly already infected and therefore the vaccine will be of no benefit.

I guess if you were 50 and still a virgin, and planning to change that, it might be worth it.

[volkl48]

Yes, but being infected with one strain isn't the same as being infected with all of them in terms of the risks. You are unlikely to have all the strains known to cause problems already.

-------

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/

---------

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.

[gnicholas]

> Since nearly everyone is infected with HPV

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]

1: https://www.cdc.gov/std/hpv/stats.htm

2: https://www.cdc.gov/nchs/products/databriefs/db280.htm

[pazimzadeh]

How can you be sure there would be no benefit? When my mom was diagnosed with stage four HPV-positive cancer, they still gave her the vaccine on the off chance that it would induce an immune response.

[ksenzee]

Or you’ve been monogamous but are now getting divorced, or whatever. Not that uncommon.

[prepend]

It’s actually kind of frustrating how expensive that vaccine is (>$1000) as there’s no incentive to reduce cost.

And if you’re 45, then insurance won’t cover. Even if you test negative for hpv.

[ksenzee]

Ugh, I didn’t realize that. I got in just under the wire at 44—guess I’m glad my ex left when he did?

[LorenPechtel]

It's not approved above age 45 and thus insurance isn't going to pay. But that's simply a matter of not testing. It was intended to be used before exposure and the pool of people >45 who aren't exposed and might be is pretty low.

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.

[kolinko]

doesn’t recommend ≠ recommends against

[chimeracoder]

> The CDC recommends against it.

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.

[ceejayoz]

I'll update that to "The CDC doesn't recommend it", in that case.

[echelon]

> I'll update that to "The CDC doesn't recommend it", in that case.

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.

[ksenzee]

Agreed. I’d rather see “doesn’t actively recommend” or “is neutral” or something.

[ceejayoz]

There's a reason I cited the entire paragraph, yes.

[thedailymail]

It's a bit confusing, but often when a government agency issues a statement about something being "not recommended" it is intended to mean the government is not strongly encouraging people to do [whatever]. This is very different from the government recommending against people doing [whatever]. So here the CDC is basically saying we don't say people over 26 should definitely get an HPV vaccination, but we don't say they shouldn't either.

[kolinko]

doesn’t recommend ≠ recommends against