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Denmark close to wiping out cancer-causing HPV strains after vaccine roll-out

pm90

If you're living in the US: please consider getting the vaccine, ragardless of your age. It was covered by my (rather shitty) health insurance. It consists of just 2 (EDIT: 3 for adults!) doses. It is recommended for both Males and Females.

rtaylorgarlock

And note i believe they just increased the recommended age of administration up to ~40yo? Throat cancer sucks. Get the vax.

sillyfluke

Why is there an age limit on an all encompassing vax, wasn't the famous posterchild for this disease Michael Douglas?

ZeroGravitas

This is mostly guesswork but I think you need to get the vaccine before you catch it and lots of people have it as they get older.

If you have a limited supply the greater bang per buck would be to start with the young people who almost certainly haven't caught it yet and then work your way up.

JumpCrisscross

> Why is there an age limit on an all encompassing vax

Vaccines are subject to stringent safety standards since they’re administered to healthy people. The age limit may suggest that at the time of the recommendation, in the relevant jurisdiction, the manufacturer had not studied its safety and efficacy in >40 year olds.

(I also don’t think it’s an age limit as much as the upper end of a recommendation.)

JohnTHaller

It's likely that they haven't tested it as thoroughly in older folks and that most older folks have already been exposed to HPV.

Fomite

To be blunt: Cost-effectiveness.

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rogerrogerr

If you’re not sexually active, is it still worth doing?

JumpCrisscross

Yes.

“The route of HPV transmission is primarily through skin-to-skin or skin-to-mucosa contact. Sexual transmission is the most documented, but there have been studies suggesting non-sexual courses.

The horizontal transfer of HPV includes fomites, fingers, and mouth, skin contact (other than sexual). Self-inoculation is described in studies as a potential HPV transmission route, as it was certified in female virgins, and in children with genital warts (low-risk HPV) without a personal history of sexual abuse. Vertical transmission from mother to child is another HPV transfer course” [1].

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC7579832/

pitpatagain

The protection from the vaccines lasts (probably) a lifetime, and HPV is quite widespread because it is: very easily communicable, and infections linger for potentially long periods of time without any obvious symptoms

Something like 80% of people are sexually active at all will be infected with HPV at some point. You may not have been sexually active, but your future partners may have been. I personally have a friend who went through stage 4 cancer contracted from her (now ex) husband.

So, of course not literally everyone needs to take it, assess your own risks, but it's quite an easy, highly effective vaccine: don't overthink it.

toomuchtodo

Life is long and unpredictable, while the cost is very low.

Fomite

If you ever intend to be, yes.

comrade1234

Any way to test for previous exposure? I'd be pretty surprised if I didn't already have antibodies. I suppose it doesn't matter though.

toomuchtodo

HPV tests are of low value (as an adult, if ever sexually active, you likely have it but can do nothing about it); a new biomarker test that can detect the cancers is being developed [1]. Ongoing cancer surveillance is all you can do once exposed without having been vaccinated.

As pm90 wrote, I strongly recommend getting vaccinated [2] unless a doctor tells you otherwise, even if you already have HPV or have had previous potential exposure.

[1] Circulating tumor human papillomavirus DNA whole genome sequencing enables human papillomavirus-associated oropharynx cancer early detection - https://academic.oup.com/jnci/advance-article-abstract/doi/1... | https://doi.org/10.1093/jnci/djaf249

[2] https://en.wikipedia.org/wiki/HPV_vaccine

(had three doses in my 30s via Planned Parenthood)

Insanity

Doctor recommended it to me when I was almost 30. So yeah, I'd say still go for it.

tonfa

Note that the modern vaccine covers 9 different strains.

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Obscurity4340

Not sure but theres zero downside to getting it

hedora

I went to my local megacorp pharmacy out here in California, and asked about the COVID vaccine that’s no longer recommended by our anti-vaxxer overlords.

Apparently, it’s about as easy to get as an old-school medical marijuana card.

Results vary by state though. No need to travel to Canada or Mexico (yet).

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arcticbull

Kaiser is continuing to cover it for everyone.

slaw

If you live outside of the US, you should get vaccine too. Even one dose is effective.

https://publichealth.jhu.edu/ivac/the-power-of-a-single-dose...

justin66

> It consists of just 2 doses.

Wasn't it 3 doses before?

pm90

you're right its 3, updated message

abeppu

... did you finish the series? I think for adults it should be 3 doses. https://www.cdc.gov/vaccines/vpd/hpv/hcp/administration.html

baldr333

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blindriver

The goal wasn't to eliminate the HPV strains, it was to decrease cervical cancer. Has Denmark encountered a drop in cervical cancer? If so, that's a great outcome!

JumpCrisscross

> it was to decrease cervical cancer

HPV can cause cancers in the cervix, vulva, vagina, penis, anus and back of the throat [1].

[1] https://www.cdc.gov/hpv/about/cancers-caused-by-hpv.html

sjsdaiuasgdia

This seems to have some data that suggests they have seen a decline: https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.35081

There's a chart about 2/3 down the page that shows a drop in several age groups, and a particularly striking drop in the 20-29 age group: https://onlinelibrary.wiley.com/cms/asset/fd3e820c-4610-4c4e...

justin66

> The goal wasn't to eliminate the HPV strains

Those monsters. Don't they know those viruses have a right to live?

boxerab

key quote here

"Despite this good news, roughly one third of women screened during the study period still had infection with high-risk HPV types not covered by the original vaccines – and new infections with these types were more frequent among vaccinated women, compared to unvaccinated ones."

Not to mention the unavoidable side effects that every injection causes.

Is there a net positive benefit to this shot, other than to GAVI and the manufacturer's bottom line ? Nobody knows.

vhcr

> Is there a net positive benefit to this shot?

Yes

https://ourworldindata.org/hpv-vaccination-world-can-elimina...

boxerab

Doesn't answer the question. Other vaccines, for example DTP, have been shown to cause higher long term mortality rate over those who didn't get it.

https://bmjopen.bmj.com/content/2/3/e000707

everdrive

Does the vaccine benefit you if you've already been infected?

abirch

There are multiple strains of HPV and most people haven't been infected with all of the strains.

from https://www.health.harvard.edu/diseases-and-conditions/by_th...

Fomite

Potentially, yes. HPV infections are cleared over time, and there are many strains of HPV.

everdrive

That's really interesting, and from that I would assume that the risk of cervical (or other cancers) from HPV is associated with how often someone is reinfected? ie, someone who got HPV once in college doesn't have HPV their whole life? And potentially has a lower cancer risk than someone who is repeatedly re-infected?

Am I understanding that correctly?

Fomite

> someone who got HPV once in college doesn't have HPV their whole life?

Doesn't necessarily have HPV their whole life - time-to-clearance is somewhat variable.

And yes, both slower clearance and just more infections are both associated with increased risk.

tialaramex

In a sense no, hence the choice to vaccinate younger children who will mostly not be sexually active yet.

But because the modern versions of these vaccines cover many strains (initial vaccines were two, Denmark chose a 4 way vaccine, now a nine way) it's very possible that you get a meaningful benefit by being protected from say six strains your body has never seen, even though the three it has already seen wouldn't be prevented.

Fomite

It should be noted that the decision to vaccinate younger children is a combination of disease prevention and cost, not just vaccine effectiveness.

giantg2

I've heard of it being administered post exposure as a way to help the body fight the existing infection. Seemed a little odd when I first heard it as HPV should clear on it's own.

Fomite

The key is you want it to clear as quickly as possible.

perihelions

By way of contrast, America's current top "doctor" is a conspiracy theorist who organized a class-action lawsuit against the HPV vaccine.

https://www.reuters.com/business/healthcare-pharmaceuticals/... ("Kennedy played key role in Gardasil vaccine case against Merck")

> "Details of the Gardasil litigation show how Kennedy took action beyond sowing doubt about the safety and efficacy of vaccines in the court of public opinion and helped build a case against the pharmaceutical industry before judges and juries."

> "Kennedy, a longtime plaintiffs' lawyer, became involved in the Gardasil litigation in 2018 in collaboration with Robert Krakow, an attorney specializing in vaccine injury cases, Krakow said"

api

It's okay, he'll have us treat cervical cancer with a juice cleanse and vibes.

unethical_ban

I remember this being a big controversy in Texas in the 2000s. Our Republican governor, forcing girls to get the vaccine! What does he think Texan girls are, lusty?

Not like disease prevention is a universally good thing and some people tend to have sex.

At the end of the day, religious radicals like STDs because it enforces their worldview that having multiple sexual partners in a lifetime is a sin.

etchalon

We have the first leaders.

YeahThisIsMe

And I can't get the shot in Germany because I'm "too old" and just assumed to be infected with it already, anyway.

What a great system.

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n1b0m

Can you pay for it?

riggsdk

In Denmark you can. I was in my mid thirties when I went to my doctor to ask them to prescribe it. Before each shot I would go to the pharmacy and buy one dose and go to the doctor to have them administer it for me (if I wanted to). At that time I think it was free for teenage girls, now it's free for teenage boys as well.

Fomite

The evolution of who gets HPV vaccines is really interesting. At first it was young women, as vaccinating young men had a very marginal decrease in cervical cancer rates via indirect protection (which itself is a function of how many young women are vaccinated). Then as HPV infection was linked to more cancers, vaccinating young men crossed the cost-effectiveness thresholds many governments use.

Vaccinating older populations is similarly just a less clear-cut case, but it's a cost-effectiveness argument, not one purely driven by if the vaccine offers protection.

bartman

Generally yes. I asked my primary care physician and would have been able to get the vaccine dose from the pharmacy (paying for it myself) and she would have administered it.

NooneAtAll3

Cervical cancer (uterus), not skin cancer from a bad papillomas as I thought after looking up what HPV meant

tialaramex

It turns out a human body has a lot of surfaces facing the "outside" in some sense and we forget about the parts we can't see. Most of this surface is not covered in what we'd conventionally consider skin. It's bit like if you were looking at surfaces in a house and forgot the walls and ceiling.

Fomite

Humans (and most animals) are just tubes with extra bits.

mitb6

Also throat, mouth, tongue, anal and penile cancers.

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inglor_cz

Good news.

Bad news is that many countries came close to wiping out measles et al. too, but it takes sustained effort to keep things like that.

chris_wot

Amazing how badly the United States is regressing. Literally measles is making a comeback due to idiots like RFK.

_moof

And even before the antivax nutters here went from fringe to a significant social force, HPV vaccines were already being decried for "promoting casual sex." Our culture is so broken in so many ways.

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Fomite

"Why haven't you cured cancer yet?"

"We have a vaccine to prevent some very serious cancers."

"But it might turn my daughter into a hussy."

inglor_cz

This is now a global problem. The guy who started it, Andrew Wakefield, is British, and we have long had antivaxxers in Europe too.

Prior to Covid, the antivaxx scene was vaguely left-and-green oriented, biomoms, vegans and other "very natural" people; you would expect them to vote for Greens or even more alternative parties. This changed abruptly and now the antivaxx scene is mostly rightwing, but the common base is still the same distrust.

I wonder if this is the price we pay for radical informational transparency. Nowadays, democratic countries with reasonable freedom of press cannot really prevent their own fuckups from surfacing in the worst possible way. Some people react by complete rejection of anything that comes from "official" channels and become ripe for manipulation from other actors.

squigz

> I wonder if this is the price we pay for radical informational transparency. Nowadays, democratic countries with reasonable freedom of press cannot really prevent their own fuckups from surfacing in the worst possible way. Some people react by complete rejection of anything that comes from "official" channels and become ripe for manipulation from other actors.

Such people have always existed, unfortunately. I don't think it's a result of anything particularly new.

skdhhdj

> Literally measles is making a comeback due to idiots like RFK

The more likely explanation is the massive amounts of immigration from 3rd world countries. But yes, he’s not helping any.

tchalla

Sorry, can you explain how this relates to immigration?

giantg2

Unlike the measles, HPV is not a good eradication candidate due to the existence of non-human reservoirs.

AnimalMuppet

I think you said that backwards. HPV does not have non-human reservoirs, per Wikipedia. (Do you have evidence that it's wrong?)

russdill

Hence the "H"

giantg2

Ah, looks like I might have read the paper wrong. It's theorized that some HPV strains could also be carried by non-human primates.

gigatexal

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toomuchtodo

There are people who will do the right thing, there will be people who you can teach to do the right thing, and there will be people who will ignore you no matter what. Optimize for the first two. "Pick better parents" is unfortunately unactionable advice.

Australia has almost eradicated cervical cancer through HPV vaccination efforts, other countries will get there as a function of uptake and cohort replacement. There is a recently developed blood test that can detect the biomarkers from HPV related cancers years before they would traditionally be diagnosed, but prevention via vaccination remains key.

https://www.who.int/news/item/17-11-2023-global-partners-che...

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...

https://en.wikipedia.org/wiki/HPV_vaccine

https://academic.oup.com/jnci/advance-article-abstract/doi/1... | https://doi.org/10.1093/jnci/djaf249

mkfs

I'm not a woman, but I wonder how necessary pap smears (one of them most invasive procedures to which women are subjected) are if everyone's vaccinated against HPV? https://www.cuimc.columbia.edu/news/cervical-cancer-screenin...

ejstronge

> I'm not a woman, but I wonder how necessary pap smears (one of them most invasive procedures to which women are subjected) are if everyone's vaccinated against HPV? https://www.cuimc.columbia.edu/news/cervical-cancer-screenin...

It will continue to be necessary because there are more strains of HPV than those that are targeted by vaccines.

The way this article is broken into sections is a bit misleading - the recommendation for cervical cancer hasn't been annual screening for a long time. This is acknowledged in the text, but even there is unclear.

giantg2

It looks like your sibling post has a link from WHO showing screening will be a continued effort.