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
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.
forgot to add, Ive had HPV for last ten months, but symptons are virutally impossible to see