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29 year old male wanting to recieve Gardasil vaccine
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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29 year old male wanting to recieve Gardasil vaccine

Hello Dr HHH

My question is about the Gardasil Vaccine shot.

Could you explain the following to me please and give me your personal opinion?

1) If I already have a symptamatic strain and could of already been potentially exposed to the other strains previously. Is it still worth getting the Vaccine anyway, if im willing to pay for it and to put my mind at ease? (done lots of reseach on the net about this whole HPV thing, so im anxious to act upon it to prevent in anyway in the near future).

2) Why is it only recomended for males up to 26 years old? is this due to complication of the vaccine? can I really not have this shot because i'm 3 years past the recommended maximum age?

3) What are the potential health risks/complications of recieving this shot? I've read big things in the news in certian places that the HPV vaccince is regarded as a 'potent cocktail of doom'. I'm thinking that its no different from recieving your travel inoculations, such as yellow fever for example when you go away. The risks are still exactly the same no matter what shot you get?

4) When you get the 3 shots over the 6 months, is that it? you have immunity as best as we know it with the for the other strains out there, for the rest of your life? Do you ever need a booster at some point?

5) What is in the pipeline for developing 'theraputic' vaccines for symptomatic infections of HPV. Can we expect to see anything soon and on the market? (just interested)

6) I've read somewhere on the net (definatley an unreliable source no doubt) that actually recieving the HPV vaccine while having an existing strain of HPV can actually make your symptons worse!?. True or bull?

Best Regards
Tags: male, 29, gardasil
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Welcome to the STD forum.  You ask some great questions about the HPV vaccines -- not just Gardasil (Merck), but some of them also pertinent to Cervarix (Glaxo Smithkline).  For background for others, Gardasil protects against 4 HPV types, the two that cause 70%  of cervical cancer (HPV 16 and 18) and the two that cause 90% of genital warts (HPV 6 and 11).  Cervarix protects against HPV 16 and 18 only.

The vaccines were studied only in people up to age 26.  It's not that they are expected to be harmful or less effective in older persons, and studies (with Gardasil, not sure about Cervarix) are currently underway in older persons.  But drug approvals by the Food and Drug Administration (and FDA's counterpart in other countries) are limited to populations actually studied.  The reason for the 26 cut off in the original research was twofold:  a) The older a person is, the more likely s/he has had multiple HPV infection, and the lower the chance s/he is still susceptible to the types covered by the vaccines; and b) new HPV infections are most common in younger persons -- the chance of a new infection drops rather dramatically after age 26.

That said, many people over 26, both men and women, do remain susceptible to one or more of the vaccine-covered HPV types, and some such people clearly are at high risk for new infection.  Therefore, because the vaccines have few or no significant side effects, there is no reason for patients not to request them or providers to administer them.  However, in the US medical insurance coverage often is tied to the formally recommendations.  Therefore, at age 29 you likely would have to pay out of pocket. Expect a total of $500-600, for the vaccine itself ($360 for Gardasil) plus adminsitration charges and clinic visits to your provider's office.  The same applies for all men for Cervarix, not yet FDA-approved for use in men.

A final consideration that applies more to men than women:  Remember that almost all HPV infections are entirely harmless to men heterosexual men.  There is value in immunizing men to help prevent cervical and other cancers in women, and also in protecting gay men against anal cancer.  But you will gain little if any measurable health protection personally by being immunized.

To your specific questions:

1) My guess is that you have already been infected with at least 2 or 3 and very possibly all 4 of the Gardasil types and both the Cervarix types.  If I were in your situation, I wouldn't get immunized. But I strongly recommend it to younger men, especially teens and early 20s.  However, if you were my patient and you still wanted immunization after knowing all this, I would be happy to give it to you and help lighten your wallet.

2) See above.

3) Don't believe the media reports.  Every medication and every vaccine has the potential for weird, unexpected, and rare side effects.  Some such events have been reported with media horns blaring.  But the truth is that side effects are no more common than with any and all vaccines available and used routinely, like influenza, the routine childhood vaccines, and all the others.  Worry about side effects is definitely not a valid consideration in deciding whether providers should offer or patients should request or accept HPV immunization.

4) The duration of protective immunity isn't known.  There is reason for optimism that protection is lifelong, but it remains possible that a booster shot will be required sometime in the future.  If so, probably not before 5 or 10 years.  My personal bet is that boostering will not be necessary.

5) Most experts do not expect effective therapeutic vaccines in the next decade.  Beyond that, who knows?

6) Bull for sure.  (That's what B S stands for, right?) (Can't spell it out or put the initials together; MedHelp's software would bleep it!)  There is absolutely no evidence that immunization has any effect, good or bad, on HPV infections present before receiving the vaccine.

Thanks for the opportunity to address these very important questions.  I'm going to bookmark this thread for easy reference in response to similar questions in the future.

Best wishes--  HHH, MD
forgot to add, Ive had HPV for last ten months, but symptons are virutally impossible to see
I saw this before replying.

My statement about vaccine cost was poorly worded.  Gardasil per se about $360; total $500-600 includes clinic visit and other fees.  Last I heard, GSK had not announced a price for Cervarix, but probably it will be similar, or maybe just a little less.
A related discussion, Guardasil for Men Over 30 was started.
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