HPV Vaccine
November 29, 2022 2:30 PM Subscribe
If you're under 45, you can get vaccinated against HPV.
Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination. At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.
We'll see how my HMO feels about this IRL. I see this info on their webpage and I have to go in for another shot on Friday so I could ask the nurse, but I would bet I'll get some pushback about it if I ask.
posted by jenfullmoon at 2:48 PM on November 29, 2022 [2 favorites]
posted by jenfullmoon at 2:48 PM on November 29, 2022 [2 favorites]
Or are a victim of sexual assault. As a sexual naive, that's how I contracted HPV, and subsequent cervical cancer. Unlikely, but it happened to me.
posted by citygirl at 2:50 PM on November 29, 2022 [16 favorites]
posted by citygirl at 2:50 PM on November 29, 2022 [16 favorites]
Damn it, why am I old?
posted by sciencegeek at 3:14 PM on November 29, 2022 [5 favorites]
posted by sciencegeek at 3:14 PM on November 29, 2022 [5 favorites]
I got mine through Kaiser a few years ago, easy peasy. I can't remember if I even had a copay, Kaiser usually doesn't for vaccinations.
posted by ivan ivanych samovar at 3:16 PM on November 29, 2022
posted by ivan ivanych samovar at 3:16 PM on November 29, 2022
Damn it, why am I old?
It actually gets less effective based on how may sex partners you've had, not how old you are. You can still get it. Example link. And if you've had more sex partners, it's not ineffective, just less effective.
posted by aniola at 3:25 PM on November 29, 2022 [3 favorites]
It actually gets less effective based on how may sex partners you've had, not how old you are. You can still get it. Example link. And if you've had more sex partners, it's not ineffective, just less effective.
posted by aniola at 3:25 PM on November 29, 2022 [3 favorites]
I got my series last year, at age 36. After already popping weird cells on a pap, having a colposcopy, and clearing it. The HPV vaccine is for everyone, even you.
I had to sign a thing confirming I understood that insurance probably wouldn't cover it. I have a HDHP and didn't hit my deductible so I was still out of pocket for everything. It cost me $300.
Do it!!
posted by phunniemee at 3:33 PM on November 29, 2022 [2 favorites]
I had to sign a thing confirming I understood that insurance probably wouldn't cover it. I have a HDHP and didn't hit my deductible so I was still out of pocket for everything. It cost me $300.
Do it!!
posted by phunniemee at 3:33 PM on November 29, 2022 [2 favorites]
Via Sloan Kettering: Besides cervical cancer,
What other cancers does the HPV vaccine prevent? In 2020, the Centers for Disease Control and Prevention (CDC) approved the HPV vaccine to prevent even more cancers: head and neck cancers, like those in the back of the throat or base of the tongue. HPV is responsible for 70% of these diseases, which are grouped together as oropharyngeal cancer.
[HPV can cause: Cervical cancer, Anal cancer, Head and neck cancers, Penile cancer, Vaginal cancer, Vulvar cancer; some HPV-related cancers are related to oral sex, and infection can happen decades before the cancer actually develops.]
posted by Iris Gambol at 3:57 PM on November 29, 2022 [7 favorites]
What other cancers does the HPV vaccine prevent? In 2020, the Centers for Disease Control and Prevention (CDC) approved the HPV vaccine to prevent even more cancers: head and neck cancers, like those in the back of the throat or base of the tongue. HPV is responsible for 70% of these diseases, which are grouped together as oropharyngeal cancer.
[HPV can cause: Cervical cancer, Anal cancer, Head and neck cancers, Penile cancer, Vaginal cancer, Vulvar cancer; some HPV-related cancers are related to oral sex, and infection can happen decades before the cancer actually develops.]
posted by Iris Gambol at 3:57 PM on November 29, 2022 [7 favorites]
Do it! get the vaccine. I had just turned 50 when I noticed a lump in my throat one winter's day that wouldn't go away. Following, as I rarely do, my own good advice, i went to have it checked sooner rather than later and shockingly, it was Squamous Cell Carcinoma of the tonsil (or, in my case what was left of a tonsil that had been removed in childhood) mediated by HPV.
They tried surgery (get it OUT!) but couldn't get clean margins due to proximity to my carotid artery. So 7 weeks of 5 times per week radiation, plus once a week chemo to kill it dead. Lost 35 pounds, my sense of taste and most of the moisture in my mouth, but scans came back clean, and no lymph involvement (stage I thanks to my early screening) , so no additional surgery.
It's been 8 years cancer free, taste mostly came back (except I can't taste sweet dairy things) saliva mostly came back, so I'm pretty fortunate.
Also, I'm a dentist, and I screen for this in my practice. It's the most common cancer I see in males, and it can be devastating if not treated early.
But hey guess what -- it can be prevented, with a vaccine! So get it, and make sure your kids get it before they become sexually active.
posted by OHenryPacey at 4:17 PM on November 29, 2022 [30 favorites]
They tried surgery (get it OUT!) but couldn't get clean margins due to proximity to my carotid artery. So 7 weeks of 5 times per week radiation, plus once a week chemo to kill it dead. Lost 35 pounds, my sense of taste and most of the moisture in my mouth, but scans came back clean, and no lymph involvement (stage I thanks to my early screening) , so no additional surgery.
It's been 8 years cancer free, taste mostly came back (except I can't taste sweet dairy things) saliva mostly came back, so I'm pretty fortunate.
Also, I'm a dentist, and I screen for this in my practice. It's the most common cancer I see in males, and it can be devastating if not treated early.
But hey guess what -- it can be prevented, with a vaccine! So get it, and make sure your kids get it before they become sexually active.
posted by OHenryPacey at 4:17 PM on November 29, 2022 [30 favorites]
England's national HPV vaccination program has successfully almost eliminated cervical cancer in women born since Sept 1, 1995. (The Lancet, November 03, 2021)
90% of cervical cancer deaths occur in low- and lower middle-income countries; Gavi, the vaccine alliance, is working to make the HPV vaccine more accessible worldwide.
posted by Iris Gambol at 4:31 PM on November 29, 2022 [20 favorites]
90% of cervical cancer deaths occur in low- and lower middle-income countries; Gavi, the vaccine alliance, is working to make the HPV vaccine more accessible worldwide.
posted by Iris Gambol at 4:31 PM on November 29, 2022 [20 favorites]
Will insurance plans cover this now? Back when I asked they said that they could do it but you had to pay out of pocket.
posted by Selena777 at 4:56 PM on November 29, 2022
posted by Selena777 at 4:56 PM on November 29, 2022
Unless, like, something happens to your partner or relationship and next thing you know, you've aged out of the HPV vaccine and now having new sex partners. Not sure why they didn't account for this common scenario.
Because there is always a finite supply of vaccine, researchers have to account for how likely someone at 45 or older — regardless of current relationship status — is to have already been exposed to the most common HPV types out there, and the cost/benefit ratio almost certainly favors targeting and administration of the vaccine to younger cohorts whose sexual behavior is just beginning.
In other words, if you're older, it's nothing personal but you're just not in the target cohorts they are looking to innoculate. That said, if you have access to healthcare in a developed nation and you discuss it with your doctor, circumstances are such that it probably wouldn't be refused to you (even if it had very limited benefit, overall). You might have to pay for it, but I imagine that's not the barrier to access for most Americans who read this site.
posted by They sucked his brains out! at 5:04 PM on November 29, 2022 [2 favorites]
Because there is always a finite supply of vaccine, researchers have to account for how likely someone at 45 or older — regardless of current relationship status — is to have already been exposed to the most common HPV types out there, and the cost/benefit ratio almost certainly favors targeting and administration of the vaccine to younger cohorts whose sexual behavior is just beginning.
In other words, if you're older, it's nothing personal but you're just not in the target cohorts they are looking to innoculate. That said, if you have access to healthcare in a developed nation and you discuss it with your doctor, circumstances are such that it probably wouldn't be refused to you (even if it had very limited benefit, overall). You might have to pay for it, but I imagine that's not the barrier to access for most Americans who read this site.
posted by They sucked his brains out! at 5:04 PM on November 29, 2022 [2 favorites]
aniola: "If you're under 45, you can get vaccinated against HPV."
If you're in the US, correct?
posted by signal at 5:05 PM on November 29, 2022
If you're in the US, correct?
posted by signal at 5:05 PM on November 29, 2022
Unless, like, something happens to your partner or relationship and next thing you know, you've aged out of the HPV vaccine and now having new sex partners.
Literally happened to me. Sought HPV vaccine when I started dating after my husbands death. Was not eligible, got hpv, the cancer causing kind and have had to have 2 colposcopies so far. Either I was infected twice or had a false negative in there, which sucks. Last pap was the first one post 2nd colposcopy, and it was negative. My doctor didn’t want to recheck in a year because guidelines but look, that was the practice after the first negative pap after first colposcopy, and it was only because I pushed for a pap when I briefly didn’t have insurance and was going to planned parenthood.
When I became eligible for the injection, I got the vaccine anyway. I was told it could help with other cancer-causing strains, and somewhere I read it might even help the immune system identify and suppress active infections, though I honestly can’t recall if there was medical evidence or was just someone’s hopeful hypothesizing.
posted by [insert clever name here] at 5:09 PM on November 29, 2022 [6 favorites]
Literally happened to me. Sought HPV vaccine when I started dating after my husbands death. Was not eligible, got hpv, the cancer causing kind and have had to have 2 colposcopies so far. Either I was infected twice or had a false negative in there, which sucks. Last pap was the first one post 2nd colposcopy, and it was negative. My doctor didn’t want to recheck in a year because guidelines but look, that was the practice after the first negative pap after first colposcopy, and it was only because I pushed for a pap when I briefly didn’t have insurance and was going to planned parenthood.
When I became eligible for the injection, I got the vaccine anyway. I was told it could help with other cancer-causing strains, and somewhere I read it might even help the immune system identify and suppress active infections, though I honestly can’t recall if there was medical evidence or was just someone’s hopeful hypothesizing.
posted by [insert clever name here] at 5:09 PM on November 29, 2022 [6 favorites]
It actually gets less effective based on how may sex partners you've had, not how old you are. You can still get it. Example link. And if you've had more sex partners, it's not ineffective, just less effective.
Well, I mean this is true but its not exactly correct. More partners mean you are more likely to have already contracted HPV so you may already have a strain of HPV. More partners in and of themselves don't cause the vaccine to be less effective against the strains you do not currently have, it's just that HPV is incredibly common.
I have a similar quibble with age. It is actually less effective with age, but it still shows enough protection and reduction of risk that it's a good idea to get. IIRC this is because of a less robust immune response.
posted by [insert clever name here] at 5:20 PM on November 29, 2022 [5 favorites]
Well, I mean this is true but its not exactly correct. More partners mean you are more likely to have already contracted HPV so you may already have a strain of HPV. More partners in and of themselves don't cause the vaccine to be less effective against the strains you do not currently have, it's just that HPV is incredibly common.
I have a similar quibble with age. It is actually less effective with age, but it still shows enough protection and reduction of risk that it's a good idea to get. IIRC this is because of a less robust immune response.
posted by [insert clever name here] at 5:20 PM on November 29, 2022 [5 favorites]
OK, ok, I'd been meaning to make an appointment and now I have!
posted by Blue Jello Elf at 5:34 PM on November 29, 2022 [2 favorites]
posted by Blue Jello Elf at 5:34 PM on November 29, 2022 [2 favorites]
Interestingly, my insurance paid without complaint at age 34 or so. Of course, I had shockingly good insurance at the time.
posted by hoyland at 5:46 PM on November 29, 2022 [1 favorite]
posted by hoyland at 5:46 PM on November 29, 2022 [1 favorite]
I am just out of this age range - in my late middle 40s, as Hedwig might say - and I wonder if I should try to get this.
posted by Lawn Beaver at 6:12 PM on November 29, 2022
posted by Lawn Beaver at 6:12 PM on November 29, 2022
I got my series this year because I finally had insurance that would cover it for me! I’m so glad I did.
posted by bilabial at 6:14 PM on November 29, 2022 [1 favorite]
posted by bilabial at 6:14 PM on November 29, 2022 [1 favorite]
@Selena, not a diffinitive answer, but I kept skipping it for YEARS because I’m 34 and I was always just outside the “on label” use and it would have meant paying out of pocket. I finally got my first two shots this fall because of the extended age ranges and insurance paid for it completely.
Obviously, check your insurance covered, but there’s a good chance it may be covered now even if it wasn’t before
posted by raccoon409 at 6:20 PM on November 29, 2022 [1 favorite]
Obviously, check your insurance covered, but there’s a good chance it may be covered now even if it wasn’t before
posted by raccoon409 at 6:20 PM on November 29, 2022 [1 favorite]
How long does the vaccine last? I think I got it just under the wire when the top age (for US Americans) that insurance would cover was 26.
posted by subdee at 6:34 PM on November 29, 2022
posted by subdee at 6:34 PM on November 29, 2022
If you're in the US, correct?
You're right, the countries with more money have higher vaccination rates. Here's a detailed answer to the question. It doesn't really address age. I was hoping to communicate that this vaccine does not only work on teenagers and is more widely accessible than it used to be.
posted by aniola at 6:53 PM on November 29, 2022
You're right, the countries with more money have higher vaccination rates. Here's a detailed answer to the question. It doesn't really address age. I was hoping to communicate that this vaccine does not only work on teenagers and is more widely accessible than it used to be.
posted by aniola at 6:53 PM on November 29, 2022
I just sent a message to the shot nurse I have an appointment with on Friday to ask. I don't have high hopes, but also my eligibility for THIS one expires in a few months, darn it.
posted by jenfullmoon at 6:55 PM on November 29, 2022 [1 favorite]
posted by jenfullmoon at 6:55 PM on November 29, 2022 [1 favorite]
Hoyland, it might depend when you got it. IIRC its been a year or two since it was "official" for over 26.
I also wonder if it has anything to do with where you live. For me in a midwestern state, I could not get it off label from either planned parenthood or my doctor, but a friend in California was able to get it in his 30s covered even though off label, through his insurance easy peasy. We even discussed me getting it there when I visited next, but I didn't get there for a while, and by then I was already positive for HPV. From a monogamous partner(probably)! Still very low numbers of sexual partners!*
I also only started the series a couple months before my 45th birthday, but was able to get the rest of the series without any problems.
*I'm still salty about having tried to prevent hpv and getting told I could not get the vaccine and then shortly after testing positive during routine screening. It could have been prevented; I was trying to do right and it was pretty clear the initial age limit was a combination of mistaken beliefs about women - either they wouldn't be dating at that age or they'd have a high number of sexual partners and have been exposed. I think it even 45 is an arbitrary limit - I suspect the same mistaken social beliefs about women are at play here and 40s is when a lot of marriages dissolve and a lot of people are dating and those people are going to want sexual relationships with new partners. The belief seems to be either women won't be having sex with new partners at that age or have already been exposed is a dumb dumb dumb misguided reason.
posted by [insert clever name here] at 6:57 PM on November 29, 2022 [8 favorites]
I also wonder if it has anything to do with where you live. For me in a midwestern state, I could not get it off label from either planned parenthood or my doctor, but a friend in California was able to get it in his 30s covered even though off label, through his insurance easy peasy. We even discussed me getting it there when I visited next, but I didn't get there for a while, and by then I was already positive for HPV. From a monogamous partner(probably)! Still very low numbers of sexual partners!*
I also only started the series a couple months before my 45th birthday, but was able to get the rest of the series without any problems.
*I'm still salty about having tried to prevent hpv and getting told I could not get the vaccine and then shortly after testing positive during routine screening. It could have been prevented; I was trying to do right and it was pretty clear the initial age limit was a combination of mistaken beliefs about women - either they wouldn't be dating at that age or they'd have a high number of sexual partners and have been exposed. I think it even 45 is an arbitrary limit - I suspect the same mistaken social beliefs about women are at play here and 40s is when a lot of marriages dissolve and a lot of people are dating and those people are going to want sexual relationships with new partners. The belief seems to be either women won't be having sex with new partners at that age or have already been exposed is a dumb dumb dumb misguided reason.
posted by [insert clever name here] at 6:57 PM on November 29, 2022 [8 favorites]
Thank you for the clarification, aniola. As you can see above, I have strong opinions on this one.
posted by [insert clever name here] at 6:58 PM on November 29, 2022
posted by [insert clever name here] at 6:58 PM on November 29, 2022
No worries! I was responding to signal, who lives in a "Bargain-bin pre-apocalyctic cyberpunk dystopia".
The belief seems to be either women won't be having sex with new partners at that age or have already been exposed
Also! This vaccine can prevent cancer in people of any sex/gender!
posted by aniola at 7:13 PM on November 29, 2022 [4 favorites]
The belief seems to be either women won't be having sex with new partners at that age or have already been exposed
Also! This vaccine can prevent cancer in people of any sex/gender!
posted by aniola at 7:13 PM on November 29, 2022 [4 favorites]
... not that the US isn't also a Bargain-bin pre-apocalyctic cyberpunk dystopia, but yay vaccines where available!
posted by aniola at 7:29 PM on November 29, 2022 [2 favorites]
posted by aniola at 7:29 PM on November 29, 2022 [2 favorites]
Yes, get the HPV vaccine. Can absolutely confirm that it causes cancer in dudes. I take care of lots of patients with oropharyngeal cancer from HPV. These are typically men in their late 40s to mid 50s.
posted by etherist at 7:30 PM on November 29, 2022 [4 favorites]
posted by etherist at 7:30 PM on November 29, 2022 [4 favorites]
I hesitate to share this because, frankly, Metafilter has not felt the safest place for me lately. Most people are kind but some people are piling on critiques that feel like personal attacks and it's unfortunate. That said, I'll share because I feel it's useful; I hope any responses will be supportive of me and/or helpful to others.
I am almost 40. I got the first HPV vaccine as soon as it was available and I was back in the US, so about 15 years ago? A few years ago I got a high-risk form of HPV, which was a worst-nightmare scenario for me as someone with OCD and PTSD. After testing positive again I had a colposcopy (that was OK); it was tested every six months, and then I stopped testing positive. It felt like a miracle to have a body that was able to heal itself; I went on an SSRI in part to control the fear and feelings of self-loathing around it because I knew the emotional duress was hindering my physical recovery. For some people it simply be part of life but for me it was hell. Additionally, my partner at the time, who happened to also be female, was very unkind about it. Sadly, there are so many misconceptions (shitty) and fears (understandable.)
But then I got better (and we broke up.) I feel so lucky but worry that another strain could cause cancer; I worry less about cervical cancer and more about oral cancers. It's not fun but I manage it. In a way, my diagnosis and the eventual recovery was freeing in that I had to face one of my worst fears. I spent a lot of my life suppressing my sexuality; I realized you could be very careful and still get HPV. The friends who have had abnormal paps and eventually needed surgery had a very limited number of sexual partners. It's so unfair!! And it sucks that we haven't yet developed the same tests for people who are AMAB because the burden continues to be on people who are AFAB, unless the former develops a form of cancer.
There is so much shaming around STIs in the US and it's not cool. Yes, we want to take precautions to avoid them but they are part of life and a risk that comes with sexual contact. I use the term safer sex, not safe sex, for example. I am lucky that HPV was the only STI I've had and that it went away (so far) but I don't judge people for having an STI. I encourage literally everyone of all ages to get the HPV vaccine!! If I could take a booster or newer version, I absolutely would. But I don't judge people for not having gotten the vaccine and/or getting sick. Life can be so unfair and really suck at times; HPV certainly falls into this category. I'm glad we finally have a vaccine to help prevent it; I hope access becomes more universal, and prevention and treatment more advanced.
posted by smorgasbord at 9:05 PM on November 29, 2022 [11 favorites]
I am almost 40. I got the first HPV vaccine as soon as it was available and I was back in the US, so about 15 years ago? A few years ago I got a high-risk form of HPV, which was a worst-nightmare scenario for me as someone with OCD and PTSD. After testing positive again I had a colposcopy (that was OK); it was tested every six months, and then I stopped testing positive. It felt like a miracle to have a body that was able to heal itself; I went on an SSRI in part to control the fear and feelings of self-loathing around it because I knew the emotional duress was hindering my physical recovery. For some people it simply be part of life but for me it was hell. Additionally, my partner at the time, who happened to also be female, was very unkind about it. Sadly, there are so many misconceptions (shitty) and fears (understandable.)
But then I got better (and we broke up.) I feel so lucky but worry that another strain could cause cancer; I worry less about cervical cancer and more about oral cancers. It's not fun but I manage it. In a way, my diagnosis and the eventual recovery was freeing in that I had to face one of my worst fears. I spent a lot of my life suppressing my sexuality; I realized you could be very careful and still get HPV. The friends who have had abnormal paps and eventually needed surgery had a very limited number of sexual partners. It's so unfair!! And it sucks that we haven't yet developed the same tests for people who are AMAB because the burden continues to be on people who are AFAB, unless the former develops a form of cancer.
There is so much shaming around STIs in the US and it's not cool. Yes, we want to take precautions to avoid them but they are part of life and a risk that comes with sexual contact. I use the term safer sex, not safe sex, for example. I am lucky that HPV was the only STI I've had and that it went away (so far) but I don't judge people for having an STI. I encourage literally everyone of all ages to get the HPV vaccine!! If I could take a booster or newer version, I absolutely would. But I don't judge people for not having gotten the vaccine and/or getting sick. Life can be so unfair and really suck at times; HPV certainly falls into this category. I'm glad we finally have a vaccine to help prevent it; I hope access becomes more universal, and prevention and treatment more advanced.
posted by smorgasbord at 9:05 PM on November 29, 2022 [11 favorites]
somewhere I read it might even help the immune system identify and suppress active infections, though I honestly can’t recall if there was medical evidence or was just someone’s hopeful hypothesizing.
Here's one (bit of both, maybe?).
Anecdotally I can also report that I have had a minor mouth sore erupt in the corner of my mouth once every few years since I was a child. Shortly after my final HPV vaccine, it started getting ready to erupt... and then disappeared without erupting and was gone in half a day. It has never done that before.
posted by aniola at 9:38 PM on November 29, 2022
Here's one (bit of both, maybe?).
Anecdotally I can also report that I have had a minor mouth sore erupt in the corner of my mouth once every few years since I was a child. Shortly after my final HPV vaccine, it started getting ready to erupt... and then disappeared without erupting and was gone in half a day. It has never done that before.
posted by aniola at 9:38 PM on November 29, 2022
Is there any reason that those who got the vaccine when it was first available couldn’t get the current vaccine (which covers more strains) now?
posted by rivenwanderer at 10:11 PM on November 29, 2022
posted by rivenwanderer at 10:11 PM on November 29, 2022
> Is there any reason that those who got the vaccine when it was first available couldn’t get the current vaccine (which covers more strains) now?
I asked and couldn't convince my health care providers a few years ago (possibly the combo of "too old" and "you've probably been exposed," despite the fact that my exposure level has not changed since the first series). But maybe it's time to try again. Because hot damn, vaccines that prevent cancer by arming the immune system to fight of a specific virus family - what a goddamn marvel!
posted by ASF Tod und Schwerkraft at 10:27 PM on November 29, 2022 [4 favorites]
I asked and couldn't convince my health care providers a few years ago (possibly the combo of "too old" and "you've probably been exposed," despite the fact that my exposure level has not changed since the first series). But maybe it's time to try again. Because hot damn, vaccines that prevent cancer by arming the immune system to fight of a specific virus family - what a goddamn marvel!
posted by ASF Tod und Schwerkraft at 10:27 PM on November 29, 2022 [4 favorites]
I asked and couldn't convince my health care providers a few years ago (possibly the combo of "too old" and "you've probably been exposed," despite the fact that my exposure level has not changed since the first series)
If you're in the US, you should be able to just make an appointment at a pharmacy and avoid having to argue with anyone about it.
posted by Blue Jello Elf at 11:17 PM on November 29, 2022 [1 favorite]
If you're in the US, you should be able to just make an appointment at a pharmacy and avoid having to argue with anyone about it.
posted by Blue Jello Elf at 11:17 PM on November 29, 2022 [1 favorite]
I've been frustrated for most of my adult life that I was in the last or penultimate school year of kids who didn't get this vaccine in the UK, right before free HPV vaccination was rolled out across schools. I could get it done privately, but at a cost of £400 of my own pounds, which is a tough sell when folks only a couple of years younger got them for free, at school.
Recently I got my regular cervical screening done at a trans-specific clinic in London for the first time. It was a standout medical experience overall; the nurse was so kind and gentle, and even thanked me for coming in and getting the screening done. It was amazing compared to the brusque, unhelpful service that makes assumptions about my gender on offer at the local GP surgery.
But the absolute best part was that the nurse counselled me for what felt like a very long time (probably no more than five minutes in reality, but I'd had a little valium on the tube and was feeling expansive) about my own actual personal HPV risk. A few years back I had a gynaecologist (god we need to find a better name for that profession) strongly recommend I get the vaccine, regardless of it costing £400 of my own pounds, simply because of my age range and the fact I didn't get it at school. So ever since then I felt vaguely guilty about my unwillingness to spend a decent chunk of cash on the vaccine. But this nurse went into detail about my screening history (always HPV negative) and risk profile (in a monogamous relationship of almost a decade with someone who hasn't colonised me with HPV in all that time), and told me that my risk level was pretty low overall. She also told me that if I wanted to, for peace of mind, I could make an appointment at that clinic and they'd do it for free.
It's unusual to have super positive experiences, especially medical ones, as a trans person living on TERF-panic WPATH-defying island, but this was a rare and wonderful example of receiving better care as an out trans person than I ever did as a fake cis person.
posted by terretu at 11:47 PM on November 29, 2022 [13 favorites]
Recently I got my regular cervical screening done at a trans-specific clinic in London for the first time. It was a standout medical experience overall; the nurse was so kind and gentle, and even thanked me for coming in and getting the screening done. It was amazing compared to the brusque, unhelpful service that makes assumptions about my gender on offer at the local GP surgery.
But the absolute best part was that the nurse counselled me for what felt like a very long time (probably no more than five minutes in reality, but I'd had a little valium on the tube and was feeling expansive) about my own actual personal HPV risk. A few years back I had a gynaecologist (god we need to find a better name for that profession) strongly recommend I get the vaccine, regardless of it costing £400 of my own pounds, simply because of my age range and the fact I didn't get it at school. So ever since then I felt vaguely guilty about my unwillingness to spend a decent chunk of cash on the vaccine. But this nurse went into detail about my screening history (always HPV negative) and risk profile (in a monogamous relationship of almost a decade with someone who hasn't colonised me with HPV in all that time), and told me that my risk level was pretty low overall. She also told me that if I wanted to, for peace of mind, I could make an appointment at that clinic and they'd do it for free.
It's unusual to have super positive experiences, especially medical ones, as a trans person living on TERF-panic WPATH-defying island, but this was a rare and wonderful example of receiving better care as an out trans person than I ever did as a fake cis person.
posted by terretu at 11:47 PM on November 29, 2022 [13 favorites]
> I asked and couldn't convince my health care providers a few years ago (possibly the combo of "too old" and "you've probably been exposed," despite the fact that my exposure level has not changed since the first series)
If you're in the US, you should be able to just make an appointment at a pharmacy and avoid having to argue with anyone about it.
As a failsafe you can also say what I said to my gynecologist which is "there are so many people I haven't even met yet who I'm going to have sex with" and she said "ha of course, I think it's a good idea. I'll send the nurse in after you're dressed."
posted by phunniemee at 4:06 AM on November 30, 2022 [2 favorites]
If you're in the US, you should be able to just make an appointment at a pharmacy and avoid having to argue with anyone about it.
As a failsafe you can also say what I said to my gynecologist which is "there are so many people I haven't even met yet who I'm going to have sex with" and she said "ha of course, I think it's a good idea. I'll send the nurse in after you're dressed."
posted by phunniemee at 4:06 AM on November 30, 2022 [2 favorites]
I did this! The HPV vaccine was approved for people up to age 26 when it first came out and I was 27. I could still have gotten it at that time if I was able to pay out of pocket but I could not afford three shots that, if I’m remembering, would have cost over $600 each. Plus whatever the doctor’s appointments cost on top of that.
But I saw the studies showing that, even taken on average, it is still effective and worth doing up until people are in their mid-40s. And as people have noted, that is just an average and doesn’t take into account individual risks of exposure that may differ from the mean. It also doesn’t account for the fact that shit happens.
I am pretty sure that I have had more sexual partners than the average USian not because I have had a ton of partners but because the number is surprisingly low. I say this not to brag but to note that I was tested for a bunch of strains of HPV before I was given the vaccine and the test still came back negative. So much for, “You’re old so you probably already have it so there’s no point in protecting you.” And it’s a multivalent vaccine! Even if you are positive for one strain it can still protect you from strains you don’t have!
I did have to field several dumb, awkward small talk questions about why I was doing it (“Aren’t you in a long-term relationship? Are you planning on cheating?” Seriously, folks?), but I got the shots. And my insurance covered it. And I am grateful, though it would have been cool if anyone had prioritized my well being over the previous 15 years, too.
(Do men have an easier time of getting the vaccine now? I had partners who tried to get it when they were younger but were literally turned away because “it’s only about getting cervical cancer and that’s a problem for women.”)
posted by evidenceofabsence at 6:45 AM on November 30, 2022 [5 favorites]
But I saw the studies showing that, even taken on average, it is still effective and worth doing up until people are in their mid-40s. And as people have noted, that is just an average and doesn’t take into account individual risks of exposure that may differ from the mean. It also doesn’t account for the fact that shit happens.
I am pretty sure that I have had more sexual partners than the average USian not because I have had a ton of partners but because the number is surprisingly low. I say this not to brag but to note that I was tested for a bunch of strains of HPV before I was given the vaccine and the test still came back negative. So much for, “You’re old so you probably already have it so there’s no point in protecting you.” And it’s a multivalent vaccine! Even if you are positive for one strain it can still protect you from strains you don’t have!
I did have to field several dumb, awkward small talk questions about why I was doing it (“Aren’t you in a long-term relationship? Are you planning on cheating?” Seriously, folks?), but I got the shots. And my insurance covered it. And I am grateful, though it would have been cool if anyone had prioritized my well being over the previous 15 years, too.
(Do men have an easier time of getting the vaccine now? I had partners who tried to get it when they were younger but were literally turned away because “it’s only about getting cervical cancer and that’s a problem for women.”)
posted by evidenceofabsence at 6:45 AM on November 30, 2022 [5 favorites]
I got mine around age 30, right after a new vaccine was approved to cover more strains (I'm guessing this was gardasil 9). I can't recall if it was due to age or if it just wasn't covered by my insurance at all, but I had to pay out of pocket, about 200 CAD per shot x 3 shots. It was pricey on a grad student salary and I was in a long-term relationship (which I'm still in years later) after statistically likely exposure to HPV in my 20s, so a pretty low expected benefit but it was still worth it to me to have a chance at avoiding cervical/other cancers.
I'm so very happy that I'll be able to vaccinate my daughter before she's exposed to HPV at all! It's miraculous to have such a potent defense against a subset of cancers.
posted by randomnity at 8:44 AM on November 30, 2022 [3 favorites]
I'm so very happy that I'll be able to vaccinate my daughter before she's exposed to HPV at all! It's miraculous to have such a potent defense against a subset of cancers.
posted by randomnity at 8:44 AM on November 30, 2022 [3 favorites]
I got a call from my HMO saying sure, I can get the vaccine, just "drop by the triage unit and ask!" Which doesn't exist at my medical facilities, so I'm utterly confused. Then they left an electronic message saying they'd reach out for an appointment, so hell if I know.
posted by jenfullmoon at 1:19 PM on November 30, 2022
posted by jenfullmoon at 1:19 PM on November 30, 2022
IANYD, but FYI you can almost always get your doctor to give you this vaccine series at any age. You'll just have to pay for it out of pocket, and it's expensive, so be prepared for that (e.g. $240 for each of three doses, the last time I checked in on this in California). You can try to have your insurance cover it, but if you're outside the approved age ranges I'm going to say you're 99.9999% going to get rejected. Try it, it's still worth a shot (ba dum bum).
posted by late afternoon dreaming hotel at 3:15 AM on December 1, 2022
posted by late afternoon dreaming hotel at 3:15 AM on December 1, 2022
As a cis man in his 30s I was able to get it through Planned Parenthood. Neither my GP nor local pharmacies carried it.
posted by jedicus at 5:11 AM on December 1, 2022 [1 favorite]
posted by jedicus at 5:11 AM on December 1, 2022 [1 favorite]
Ok, so I went over to my HMO for my BC shot today and asked about this and the shot nurse said "Oh, I was working on that all day yesterday." My gyno has permitted me to get the shot--she said some people are eligible and some are not, I am because I never had a bad Pap smear test. Though I guess there was some debate about the age limit being 44 instead of 45, which made me choke. Anyway, I got the first one while there today, get another one after 30 days and another after six months--I said "but then I turn 45" and she said it was ok as long as I'd started now.
She also said she heard about the age limit 10 years ago and was pissed off too.
So, I now have the first shot! Woo hoo!
posted by jenfullmoon at 9:44 AM on December 2, 2022 [4 favorites]
She also said she heard about the age limit 10 years ago and was pissed off too.
So, I now have the first shot! Woo hoo!
posted by jenfullmoon at 9:44 AM on December 2, 2022 [4 favorites]
In all my years* of working with package inserts (mostly writing them and also enrolling clinical trials to back them up) "through 45 years old" means "until the day before the 46th birthday".
*caveat: US regs only
posted by Tandem Affinity at 10:23 AM on December 3, 2022
*caveat: US regs only
posted by Tandem Affinity at 10:23 AM on December 3, 2022
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Unless, like, something happens to your partner or relationship and next thing you know, you've aged out of the HPV vaccine and now having new sex partners. Not sure why they didn't account for this common scenario.
posted by aniola at 2:32 PM on November 29, 2022 [29 favorites]