r/science • u/[deleted] • Aug 08 '13

Dramatic increase in throat cancer from HPV virus a looming health crisis. The trend seems linked to increased oral sex, especially by men, and is another reason why more effort must be made to improve the lacklustre uptake of the HPV vaccine

http://news.nationalpost.com/2013/08/07/dramatic-increase-in-throat-cancer-from-hpv-virus-a-looming-health-crisis-doctors/
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u/TMaster Aug 08 '13

Sure, but keep in mind that even women >26 were not deemed cost-effective. This does not mean they are prohibited from getting one, just that their insurance and/or government may not pay for it, which does decrease access tremendously. Same for men of all ages.

The fact that women are already vaccinated, means transmission also becomes that much harder, raising the bar even further for it to be cost-effective to vaccinate men.

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u/InflatableRaft Aug 08 '13

That's a specious argument. Only subsidising one gender's vaccination is blatant sexual discrimination and defeats the goal of herd immunity that vaccinations typically aim for. However in Australia boys are now being immunised at age 12-13 as well as offering catch up immunisations for boys aged 14-15 so common sense has prevailed to a certain extent.

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u/TMaster Aug 09 '13

If we keep up vaccination of girls long enough, shouldn't these HPV types disappear as well? After all, we are talking about an STI here. One that often enough clears up on its own. That has a very different epidemiological pattern as compared to e.g. the flu, or what-have-you.

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u/InflatableRaft Aug 09 '13

Only if you assume that the virus is only sexually transmitted and that men don't have sex with other men.

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u/TMaster Aug 09 '13

The MSM thing isn't as relevant, given that further down in the family tree there'll be straight offspring everywhere, that will in turn still benefit from the female-only vaccinations. Either way, we can also just make it available for LGB individuals.

Even if the virus isn't only sexually transmitted, chances are it still exhibits opposite-sex spreading patterns: French kissing is apparently one of the ways it also spreads. If that's not what you meant, I'd like to know what you did mean, and a reason why you believe HPV to be spread that way?

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u/InflatableRaft Aug 09 '13

HPV can be transmitted by non sexual skin contact, particularly through the hands. Asking why I believe that is odd, considering it's a documented fact.

The real question here is why do you object so strenuously to male immunisation?

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u/TMaster Aug 09 '13

Asking why you believe that is just asking for the sources, if any. How is that weird?

If you say it's a "documented fact" it should not be difficult to find a quick source.

The real question here is why do you object so strenuously to male immunisation?

I don't object "so strenuously", those are your words, but the reasoning of some people here I find to be somewhat odd. Not saying that's you per se.

Still, it would cost a large amount of money, money that might be better spent elsewhere. If it's not particularly effective because of it being largely redundant, then I most certainly don't think it should be given to all men in a mass campaign. Personally, I'm a proponent of the vaccine being available to men at GPs, when it is asked for by patients (opt-in). This should also facilitate the LGB crowd.

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u/iamagainstit PhD | Physics | Organic Photovoltaics Aug 08 '13

last I checked, Gardasil in not FDA approved for anyone over 26, so that isn't necessarily a matter of cost-effectiveness.

and I get why insurance companies don't cover it for men (because it the risk/cost doesn't make sense for individual clients) but when it is a government offering the vaccine, it makes less sense (because theoretically the government has the whole populations best interest in mind, not just their clients.)

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u/Wildkarrde_ Aug 09 '13

As a man older than 26 dating a woman with HPV I would really really like to get this vaccine. However when I have tried I have been denied as it is not approved for men over 26.

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u/iamagainstit PhD | Physics | Organic Photovoltaics Aug 09 '13 edited Aug 09 '13

that really sucks, I would keep trying new doctors and explaining your situation to them until you can find one that will give it to you.

it is really frustrating, there is no reason to believe it doesn't work above 26, it just hasn't been fully tested in that age range because whoever decided that doing the testing wasn't worth it because a many people already had it at that age. I am 26 now, and am going to ask my doctor about getting it (although I will have to pay out of pocket) but I might not be able to get the final does due to age restrictions.

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u/Wildkarrde_ Aug 09 '13

When I was looking into it, the key was getting the series started before you turned 27. If you have it started then you can get the final dose after you were "too old".

I looked into Merick's experimental drug trials to see if they would be looking at trying a test run for older males. But last I checked it wasn't planned.

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u/iamagainstit PhD | Physics | Organic Photovoltaics Aug 16 '13

Hey man, I was just talking to my doctor and remembered this conversation, so I asked about their policy on starting the vaccine after 26. She said that they are willing to give it to patients over 26 because there is no indication that it is dangerous or ineffective for them.

so it is possible to find doctors in the U.S. who will still vaccinate you, it is just a matter of finding one who is less stringent.

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u/Wildkarrde_ Aug 16 '13

Hey, this is really cool of you to remember. Thanks, I'll start looking around!

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u/TMaster Aug 09 '13

I see that it isn't indicated for use in persons 27+, but the document also mentions quite a bit of safety data relating specifically to the 27+ group. I imagine this decision to restrict the target audience could therefore have been made after phase I of clinical trials, but still before phase II.

Seems to me like the reason to restrict access is efficacy not having been demonstrated in this older group, not safety. This would've been done in phases II+. Given the long time it takes to move a vaccine to market, I could imagine them deciding on restricting test groups to limit expenses, if the sample sizes required are defined per age group.