As a single man who does his best to stay as sexually active as possible, I try to stay abreast of advances in the medical field of direct relevance to my peni..uh, that is... of relevance to the sexual health of us all.

By now I hope everyone has heard about and encouraged the women in their lives to get vaccinated against HPV, the virus family that causes genital warts and can develop into cervical and penile cancer. If you haven't, you deserve to read up (CDC's FAQ below).  For the science fans its a major medical miracle: the very first cancer we are able to prevent via immunization.  For those who have loved and lost someone to a cancer we now know how to prevent, take a moment to share the information with people you care about.

But did you know that men can also benefit from the vaccine?  Although known to be effective in women, there was a delay in approving the vaccine in men - not because it is bad, just because they were able to bring it to market (and make money) faster for women.

I have taken the HPV vaccine myself as an off-label use, having read through the literature and carefully discussed the pros and cons with my personal physician.  At first was flummoxed at the request, upon subsequent discussion admitted "Other than the out-of-pocket expense, I really cant see any downside for you...and the upside can be significant."

Now before the poorly-informed go flaming me with "If you just use a rubber you wouldn't need the vaccine!", let me point out that condoms are not a barrier to the HPV virus; it is small enough to easily pass through the condom wall.

Which brings me to my Poll Q: Anyone else get the vaccine?

 -- Doc

-- Modified on 8/12/2007 10:39:52 PM

I got the 3 shot vaccine before I turned 27. My doctor said the women over the age of 27 should not consider it as it was basically ineffective. It was pretty costly too. I think I spent about $450 total.

It is not that the virus is too small to pass through a latex condom (it isn't)—it’s that a condom does not cover all of the areas of the genitalia that can be infected.

From an article on the CDC website:

  Laboratory studies have demonstrated that latex condoms provide an essentially impermeable
  barrier to particles the size of STD pathogens.

The article goes on to explain why condoms are less effective in preventing transmission of HPV than some other STIs.

  Condoms can be expected to provide different levels of protection for various sexually
  transmitted diseases, depending on differences in how the diseases are transmitted. Because
  condoms block the discharge of semen or protect the male urethra against exposure to vaginal
  secretions, a greater level of protection is provided for the discharge diseases. A lesser
  degree of protection is provided for the genital ulcer diseases or HPV because these
  infections may be transmitted by exposure to areas, e.g., infected skin or mucosal surfaces,
  that are not covered or protected by the condom.

All that supports your urging that men look into getting vaccinated.  

You make an excellent point about "the poorly-informed" flaming with "If you just use a rubber you wouldn't need the vaccine!" You're absolutely right! I've seen that response to recommendations to regularly getting tested for STIs.

Oops! I forgot the link. Here it is: http://www.cdc.gov/nchstp/od/condoms.pdf

-- Modified on 8/14/2007 12:56:58 AM

..is a Genius bright grl next door teaching me new things about sex I didn't know!

 You rock GND!

 -- Doc (and dont for a minute think I have forgotten about that sexy shot of you in leather you posted 2 years ago!)

From the Journal of American STD Association
March 1997, 24:3 An In Vitro Evaluation of Condoms...


   An In Vitro Evaluation of Condoms as Barriers to a Small Virus.

   Original Article
   Sexually Transmitted Diseases. 24(3):161-164, March 1997.
   LYTLE, C. DAVID PhD*; ROUTSON, LICIA B. BS+; SEABORN, GERALD B. BS++; DIXON, LURLENE G. BS++; BUSHAR, HARRY F. PhD*; CYR, W. HOWARD PhD*

   Abstract:
   Background: Because of the possible presence of small holes, the effectiveness of condoms as barriers to virus transmission is controversial.

   Goals: To determine the proportion of condoms that allow virus penetration and the amounts of virus that penetrate.

   Study Design: A sensitive, static test was used to evaluate different condom types as barriers to a small virus, including brands with or without lubrication and ones of different materials. The test included some physiologic-based parameters and some parameters that exaggerated expected actual use conditions.

   Results: Under test conditions, 2.6% (12 of 470) of the latex condoms allowed some virus penetration; the median level of penetration was 7 x 10-4 ml. Lubricated condoms performed similarly to nonlubricated ones. Polyurethane condoms yielded results higher than but not statistically different from those for latex condoms.

   Conclusions: Few condoms allowed any virus penetration. The median amount of penetration for latex condoms when extrapolated to expected actual use conditions was 1 x 10-5 ml (volume of semen). Thus, even for the few condoms that do allow virus penetration, the typical level of exposure to semen would be several orders of magnitude lower than for no condom at all.

Very cool that you did it - I too paid out of pocket, but considered the cost acceptable relative to the benefit.

As to a hard age limit, I wonder about the underlying data - there is no way a blanket age limit makes any sense, as each persons immune response is different.  

Why is the vaccine only recommended for girls/women ages 9 through 26?  From the CDC web site: "The vaccine has been extensively tested in 9 through 26 year-old females so information is only available about vaccine safety and protection for girls/women of this age group. However, studies on the vaccine are now being done in boys/men, as well as in women older than 26 years of age. The FDA will consider licensing the vaccine for these other groups when there is research to show that it is safe and effective in these groups. "

Its is a gamble, but a pretty safe one given the risks most folks reading here are used to taking in stride.  My bet is that later data will show the vaccine effective for men, women, and broader age groups.
 -- Doc

I inquired about the vaccine at the health dept. and was informed that the vaccine is only effective with certain strains(sp)of the virus which cause cervical cancer and NOT any of the strains(sp) that cause visible warts.

The vaccine has not been shown to be ineffective over age 27, it has just not been studied extensively in that age group and thus was not licensed for use because, as TheDoctor_IsIn cited, it has only been studied in the younger age group.  Studies in men have not been published (but are ongoing) - there is no reason to expect the vaccine will not work in men.  The important point is that the vaccine is only effective before one has been exposed to the HPV strains it is directed against.  The older we get and the more partners we have, the more likely we are to have been exposed to HPV (which is why the company picked the younger age group to study in the first place).  It should work in older women as long as they have not already been exposed to HPV.

-- Modified on 8/13/2007 10:30:13 PM

-- Modified on 8/13/2007 10:30:49 PM

Not exactly true - see link.

GARDASIL is the only vaccine that may help guard against diseases that are caused by human papillomavirus (HPV) Types 6, 11, 16, and 18:
• Cervical cancer
• Cervical abnormalities that can sometimes lead to cervical cancer
• Genital warts
HPV Types 16 and 18 cause 70% of cervical cancer cases, and HPV Types 6 and 11 cause 90% of genital warts cases.

I believe they just gave you bad information Zayzha, something I see waaay more often than you might suspect. The current vaccine covers the four strains that overwhelmingly cause the majority of severe health consequences - but not all.

Pulled from several sites:
The vaccine is targeted against four major strains of human papilloma virus. Strains 16 and 18 are responsible for 70% of cervical, vaginal and vulvar cancers. Strains 6 and 11 are responsible for 90% of genital warts and the potentially devastating juvenile respiratory papillomatosis, which can be life threatening in children and adolescents.

There are more than 100 strains of human papilloma virus and nearly 500,000 cases of cervical cancer worldwide diagnosed each year. Some 290,000 women die of the disease worldwide a year.

There are over 100 strains of HPV that can affect humans, and these are divided in two groups: high-risk and low-risk for cancer. The low-risk strains are not believed to cause cancer, but may result in genital warts. With 6.2 million new infections yearly, approximately 20 million Americans, ages 15-49, are currently infected with at least one strain of HPV — half of these are sexually active 15- to 24-year-olds. The majority of these infections are asymptomatic and clear up on their own without causing cancer, precancerous lesions, or genital warts; however, 1 percent of sexually active adults have visible genital warts at any given time.

The new vaccine is designed to protect against HPV strains 6, 11, 16, and 18. HPV 6 and 11 cause 90 percent of genital warts while HPV 16 and 18 cause 70 percent of cervical cancers.

Well summarized Péineas!  So doesn't it follow that if I DONT already have the strains of HPV that cause genital warts (or cervical cancer), and I DO want to stay sexually active with multiple partners (risking exposure), then wouldn't I be brain damaged NOT to get immunized & protected?

Seems such a no-brainer to me, hence my original poll question: why isn't *everyone* doing this?

 -- Doc

Gotcha. Thanks for the info.

P.S. I like smart men.

Or, so I've been told. That's why you see mothers talking about it for their daughters in TV commercials, but it's still misleading. Doctors have told me that it's most effective in girls before they reach puberty or have sex. Most of us already have the virus in our system. The only time they recommend giving the shot to women is if they're younger women. After a certain age, it's really not going to help. It's another hype by pharmaceutical companies to get you to buy the vaccine. But it is important for young girls to get vaccinated.

Once you get the virus it is usually not serious. Like I said, it's like a cold. However, this virus can stay in your system forever, unless it turns into cancer. The problem is labs keep getting false negatives and positives on it from current testing they're doing. So, unfortunately, it's hard to detect. After cancer has shown up, then the only alternative they can do is treat you for cancer. Unfortunately, most strains of HPV can cause also cause ovarian cancer, which is far more deadly. But cervical cancer is easier to treat than ovarian cancer. So, if a lady gets a pap smear, it may not show that she has developed cervical cancer from HPV. Clinicians are not specifically looking for HPV when they run a pap test. Like I said, the testing for HPV gives some false reports. So, this is what I've read and been told by five different doctors. However,if anyone has new information please let me know.

Hugs,
Ciara

-- Modified on 8/14/2007 4:41:11 PM

-- Modified on 8/14/2007 4:55:22 PM

My feeling was this ... each shot in the series cost me about the same amount of money as one night at the Hilton and less than one hour of my time hobbying.  To me, that is money well spent!

Because the virus is so common and widespread, you are spot-on right that testing is not effective.  

But the effectiveness of the vaccine has nothing to do with age, puberty, nor with having sex - only with prior exposure to the strains that cause disease.  

Whilst most everyone will eventually be exposed to multiple strains, only a few of these lead to disease ...these are the ones included in the vaccine. This is the very first cancer that can be prevented by a simple shot, a miracle of modern medical science barely a year old.  When you consider how few people can actually find a clitoris in the dark, widespread medical misinformation is to be expected - but not tolerated.

Bottom line: Anyone to whom condoms seem like a reasonable (but not perfect) way to limit risk should get protected against the disease-causing strains of HPV.  

From Rutgers Med School Website:

* Even in someone already infected with HPV, the vaccine still makes sense as it can protect against other strains of HPV.
* The vaccine protects against the most common strains of HPV, but not others.
* Since not all strains are covered, regular gyn exams and Pap smears are still necessary.

There are actually more than 100 different strains of HPV.  Of these, approximately 30 exist in the genital area and can cause genital warts (condyloma acuminata).  These 30 strains can be further broken down to "high" and "low" risk strains.

High risk strains may cause changes in a Pap smear which may rarely progress to cancer.  There are approximately 13 high-risk strains of HPV, of which two (16 & 18) are believed to cause about 70% of all cervical cancer.

Low risk strains sometimes cause changes in a Pap smear, but do not progress to cancer. Of the low-risk strains, two (6 & 11) are most likely to cause genital warts.

 -- Doc