People read the recommendation guideline, and brainlessly follow it without care of why it's in place. If you haven't had a reason to be exposed by 30, 30 is as good of a time to get the shot as 9.

One of the few times I can say the majority of medical practitioners don't know what they are talking about when they spit dogma instead of life-saving sense.

My doctors have generally refused vaccinating me for years (Male/43yo), but finally a new (female) doctor told me it's a good idea. I'm not in a risk group, so I have to pay for the vaccine: Gardasil 9, 3 doses, 3 months away of each other, ~€200 each, although studies say that 2 doses might be enough.

In reality, you can pay to a private doctor so they write you a prescription, but I feel more validated if my doctor says it's OK :)

From top of my layperson head: bruised insertion sites, tainted needles, tainted vaccine supply, customer capacity crowding for the pharmacy, squeezing supply capacity for actual target demographics, etc etc etc.

Things have tradeoffs, even if they are subtle. Relentless follow-through on marginal protocols should generally be treated with suspicion.

Stranger danger advocates brush off the criticism that most abductions occur among family with the "if there's a small chance it would make a difference" argument, but this ignores the real harms of teaching children to fear everyone by default.

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.

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.)

There are two factors here:

1) Vaccine-derived immunity is a function of the individual's immune response, which in general, weakens significantly with age. It is not unrealistic for a vaccine to simply fail to elicit any response in someone old enough.

2) It is very, very difficult to recruit folks without HPV that are over 40 for a clinical trial. Most people of that age, who were never immunized, most likely have had it. This significantly convolutes the signal.

3) This is all especially confounded once something becomes "standard of care". Every year there are fewer and fewer people age 40+ with HPV.

For these reasons, the vaccine is currently officially ??? in people over 40. Most doctors will prescribe it anyways if you ask. It may or may not infer immunity. It almost certainly will not harm you.

And over 45s that engage in casual sex have almost certainly been exposed. Those who don't have prior exposure probably have few or one partner in a marriage or marriage-like situation and thus are not likely to be exposed. Yes, they could be cheated on or the like but exposure is not expected so effectiveness can not be measured.

I know you are very well intentioned, but American's actually have very good doctors.

Isn't that basically everyone who's had sex with someone who had sex before the vaccine was common? I was denied when I asked my last doctor, on that logic. I'll ask my current doctor.

Definitely ensure you're requesting the 9 strain version.

The CDC says:

> Like all medical interventions, vaccines can have some side effects.

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

It was a stupid decision to leave out the boys. I mean hindsight is 20/20, but if heterosexual women were getting cervical cancer from HPV, and HPV is spread by sexual activity, then vaccinating the boys along with the girls would have been the logical thing to do in order to stop the spread.

I assume this wasn't done because they didn't do any studies on boys at first, because they were looking for cervical abnormalities to gauge vaccine effectiveness, and maybe it would have been hard to recruit a bunch of boys for a vaccine study that would probably not benefit them.

With that same hindsight we now know that HPV vaccination also prevents some oral cancers, and that leaving out the boys was a very stupid decision indeed.

These days most places do seem to also vaccinate boys. I got an HPV vaccine at some point in my 30s, and I pretty much had to wrestle my doctor into submission in order to get a prescription.

2) Take a look in the mirror and try blaming the people who have made "getting a vaccine" a culture war political statement rather than something routine and uncontroversial. If vaccines were uncontroversial, medical exemptions from them would also be rare and uncontroversial.

Common causes of hypertension are "contagious". Summary:

  spousal concordance: one partner’s chronic disease raises the odds the other has it too. If one spouse has hypertension, multiple studies suggest the other spouse’s risk is about 1.3 to 1.5 times higher than their cohort.

  Genetic causes can easily double risk over baseline cohort for children.

  However there is a strong environmental/lifestyle effect in children. Studies in Scandinavia show that children adopted into hypertensive households carry an elevated risk compared to the general population. A hypertensive parent with an adopted child nudges the child’s later-life risk by about 20–30% higher than baseline.

I think it's weird and creepy people are selectively opting into vaccines that are not recommended for them.

It feels a bit like those ads that say "bring up Expedia with your doctor!"

This isn't a good PSA.

Should I be vaccinated against smallpox too? How about anthrax?

Perhaps it is less common to say positive things about other countries in the US unless you are making some point about domestic politics. Sometimes I am deeply critical of the USA but this wasn't one of those times.

So just to be really clear eradication of HPV and by extension elimination of some forms of cancer is a really noble thing for humanity to be doing and is being pursued by many countries, including ones that aren't as privileged and wealthy as Australia and Denmark. It's a group that historically included the USA which clearly means there are people there who deeply care about this stuff as well.

The people who oppose public health programs like this are just evil in my opinion wherever they are.

Humor is welcome here, but it needs to have some substance behind it.

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.

It's incredibly prevalent, but most people clear it within a couple years, and won't even know that they had it. The time to clear it is just variable and depends on your body's immune response, the longer you go without clearing it the higher the cancer risk.

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.

https://www.theguardian.com/us-news/ng-interactive/2025/jun/...

medically, not really. the vaccine acts the same. epidemiology wise, it makes it more effective, assuming the correct coverage.

I would just suggest that stating that an entire continent of different races/culture/religions "having multiple simultaneous partners" smells just a little bit of "savages over there", which given that we are talking about _evidence_ based outcomes, jars somewhat.

I also wonder if 'number of births' is not largely a proxy instead for the shift in the immune system of a woman while pregnant; in effect they tend to become slightly immunocompromised, probably as a means of preventing an immune response from harming the baby.

[1] - https://www.who.int/news-room/fact-sheets/detail/cervical-ca...

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

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

with radical information transparency, id expect both views to be equally easy to parse and to be recommended both, in which case the choice would be obvious to everyone, or at least they could very well describe their risk tolerance to different risks, or laziness, for why they made a certain choice.

i expect im not up to date on all the vaccines i should be, but its on laziness rather than gwtting bad information. ...also a lack of information on which ones i should have.

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

Measles is highly infectious, you need a very high percentage of the population immune in order to maintain herd immunity. So long as you have herd immunity the only source of infection is travel--but note that this works both ways. It's much more likely to be Americans catching it while traveling than immigrants bringing it. They at least used to trace the original case in such outbreaks, it was normally someone who had been abroad.

We saw the same thing with Covid--quarantine against Chinese people, while ignoring Americans returning from the very same places even when they said they had symptoms. (And irrelevant besides, the strain from Europe quickly dominated.)

HPV is a double-stranded DNA virus with very high replication fidelity. The emergence of types like 16 and 18 happened hundreds of thousands of years ago.

I did know it was quite slow but not just how slow. Very long term vaccine efficacy is expected.

16/18 were chosen because they are highly carcinogenic and cause the most cancer, they are the two most aggressive high risk types. They cause 70% of all the cancer but are much less than 70% of the cases of high risk strains.

It takes real mental gymnastics to downplay how positive this vaccine is.

And note that it's possible for a vaccine to have a negative survival benefit yet be a good idea--in a population with herd immunity a vaccine provides little benefit to those who receive it so long as enough people receive it to provide the herd immunity. But if too many don't get it the risk from not getting it goes up considerably. Look at what has been happening with measles--measles was basically unheard of, the quacks said not to vaccinate (remember, Wakefield was attacking a specific vaccine that he stood to profit from the controversy, Worm Brain doesn't believe in infectious disease in the first place), now we have people dying of measles.

this reads like a big grain of salt on the results.

from the paper, its more specific that girls who got the DTP vaccine and also not another vaccine afterwards have a higher mortality rate.

but also that its wildly different by location

Sure. This one hasn’t.

That said, I frankly think people should be free to vaccinate as they please, and cities, states and private businesses free to include and exclude folks based on vaccination status as they please. (I’m also in favor of letting insurance companies choose if they want to cover diseases someone chose to get by going unvaccinated.)