HPV shot dilemma: Should gay boys be targeted?

  • Posted by a hidden member.
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    Nov 12, 2010 9:57 PM GMT
    http://www.msnbc.msn.com/id/40114932/


    I think just make the vacine available and let whoever wants it, get it. The government needs to stay out of making health decisions for everyone.
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    Nov 13, 2010 2:17 AM GMT
    I think it will be much better if its not targeted. Esp for men who are closeted, for they will never for opt for it otherwise.
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    Nov 13, 2010 3:24 AM GMT
    jockgymboy saidhttp://www.msnbc.msn.com/id/40114932/


    I think just make the vacine available and let whoever wants it, get it. The government needs to stay out of making health decisions for everyone.


    yeah but the problem is it becomes a public health issue! Once something has the potential to affect a group rather than an individual public health agencies have the responsibility to implement a plan after undergoing some sort of surveillance.

    ...just saying...that's how it works
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    Nov 14, 2010 3:11 AM GMT
    I'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.
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    Nov 14, 2010 3:16 AM GMT
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Sounds like you're echoing the tea party crap, but don't forget that less than half a century ago, it was government immunization programs that lead to the eradication of killer diseases like pox and polio.

    And in a country like the US where the religious zealots refuse vaccination, there is a very good reason why some health decisions DO need to be forced by the government.

    Not saying that this would apply to this particular vaccine - just trying to add some nuance to your thinking.
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    Nov 14, 2010 3:21 AM GMT
    jockgymboy saidhttp://www.msnbc.msn.com/id/40114932/


    I think just make the vacine available and let whoever wants it, get it. The government needs to stay out of making health decisions for everyone.


    Especially when being a "gay boy" doesn't even necessarily put you at risk for anal cancer. As is the case when you don't practice anal sex.
  • neosyllogy

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    Nov 14, 2010 3:25 AM GMT
    jockgymboy saidI think just make the vacine available and let whoever wants it, get it. The government needs to stay out of making health decisions for everyone.


    [sarcasm] Right, because most people have the expertise to make health decisions without any direction or suggestions from medical and epidemiological professionals. And because health issues are in no way a public concern, especially not issues related to contagious disease... [/sarcasm]

    In any case. The government is merely deciding whether or not to recommend the vaccine to certain groups. It's not breaking into your house and vaccinating you against your will.
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    Nov 14, 2010 3:32 AM GMT
    Personally, I think everyone who is sexually active should get the HPV vaccine. HPV not only causes anal and cervical, but also penile and vulvar cancer, so no matter what parts of your nethers you're bumping and grinding, you're at risk if HPV is involved (and the types of HPV that cause cancer likely won't even cause visible warts, so you never really know when HPV is involved).

  • offshore

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    Nov 14, 2010 3:48 AM GMT
    Tazo995 said
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Sounds like you're echoing the tea party crap, but don't forget that less than half a century ago, it was government immunization programs that lead to the eradication of killer diseases like pox and polio.

    And in a country like the US where the religious zealots refuse vaccination, there is a very good reason why some health decisions DO need to be forced by the government.

    Not saying that this would apply to this particular vaccine - just trying to add some nuance to your thinking.


    Very much agreed! Health might be a private matter, but if that may impact public health I'm all in for the goverment to step in.

    Same as smoking - it's your private matter if you want to induce cancer in your own private space, but I'm 100% behind banning smoking in public places because someone's entitlement to hurt themselves shoudn't affect toehrs who are not willing to do so.

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    Nov 14, 2010 4:06 AM GMT
    Gardasil protects against only four HPV genotypes... Types 6 and 11, which are the two most common wart viruses, and types 16 and 18, which are the two most common viruses found in squamous cell carcinomas of the cervix and anus. There are well over 100 HPV types, dozens of which cause warts ('low risk') and dozens of which can lead to dysplasia/cancer ('high risk'). If you get an anal PAP smear and ask for 'HPV typing', you can find out which types you are infected with. if you are already infected (anally) with a known high risk virus other than 16 or 18, there is no point in getting Gardasil. and you don't have to bottom to get HPV... it's a 'field' effect that begins the day you are born.

    all gay men should see a well-informed clinician. they can then make appropriate decisions about how to manage HPV infections and the pathology that results. these forums are definitely not the place to be getting information that might seriously affect your health.

    btw, the federal government makes recommendations and 'sets policy'... it can't force anyone to get vaccines, so the complaint about government staying out of our lives (with regard to this vaccine) rings a bit hollow.
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    Nov 22, 2010 7:47 PM GMT
    Anyone can get Gardasil. The approval is based on data only from female patients and from what I understand the manufacturers are trying to get male patient data in there to amend the FDA approval. A physician can prescribe for "off label" uses, which in this case would be for prevention of HPV in a male patient.

    That being said, because there are national recommendations for all girls to get this vaccine to prevent cervical cancer, there are a lot of health plans that will cover the fairly high cost of the vaccine ($360 for the whole series). If you are a guy that wants the vaccine you will be paying for it out of pocket unless you have a super cush health plan.
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    Nov 23, 2010 1:20 AM GMT
    skifan08 saidPersonally, I think everyone who is sexually active should get the HPV vaccine. HPV not only causes anal and cervical, but also penile and vulvar cancer, so no matter what parts of your nethers you're bumping and grinding, you're at risk if HPV is involved (and the types of HPV that cause cancer likely won't even cause visible warts, so you never really know when HPV is involved).



    Agreed. If I had my way, I would offer it to all kids in high school.
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    Nov 23, 2010 3:06 AM GMT
    Animus said
    jockgymboy saidhttp://www.msnbc.msn.com/id/40114932/


    I think just make the vacine available and let whoever wants it, get it. The government needs to stay out of making health decisions for everyone.


    Especially when being a "gay boy" doesn't even necessarily put you at risk for anal cancer. As is the case when you don't practice anal sex.


    You can get those warts carrying HPV from FROTTAGE. icon_rolleyes.gif HPV isn't going to necessarily give you cancer at the site of infection, it can give you cancer elsewhere.

    -Doug
  • DCEric

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    Nov 23, 2010 3:07 AM GMT
    jockgymboy saidThe government needs to stay out of making health decisions for everyone.


    Overly broad statement is overly broad.
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    Nov 23, 2010 3:19 AM GMT
    wysiwyg84 saidAnyone can get Gardasil.


    But not everyone should. If you're already infected with known high-risk viruses other than the two Gardasil protects against, you're wasting your money (see prior comment).
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    Nov 23, 2010 3:23 AM GMT
    skifan08 saidPersonally, I think everyone who is sexually active should get the HPV vaccine.



    Not necessary or useful (see above comments). ALL sexually active individuals should have cervical and anal PAP smears BEFORE using Gardasil so you don't waste your money. Do people actually read these threads?
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    Nov 23, 2010 3:25 AM GMT
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Are you for real? ANYONE can walk into their doctor's office and get the damned vaccine. I got it three years ago and my GP didn't so much as bat an eye at the request. The government doesn't control so much as sets "suggested" guidelines that you and your physician are free to ignore. icon_rolleyes.gif
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    Nov 23, 2010 3:32 AM GMT
    [quote]
    You can get those warts carrying HPV from FROTTAGE. icon_rolleyes.gif HPV isn't going to necessarily give you cancer at the site of infection, it can give you cancer elsewhere.
    -Doug [/quote]

    Not sure where you're getting your info. HPVs can be spread by mucous membrane to mucous membrane contact but they don't 'circulate' in the bloodstream. The population of viruses a given individual is infected with CAN be in multiple locations on the person's body (that's the 'field' effect previously alluded to), but the primary impact of a particular virus is at the point of infection. Pathology from high-risk HPVs usually occurs on the cervix of the uterus, in the anal canal at the squamocolumnar junction or in the oral cavity. The worst outcome of infection is squamous cell carcinoma, and it can occur in the head/neck, cervix or anus.
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    Nov 23, 2010 3:34 AM GMT
    GuerrillaSodomite said
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Are you for real? ANYONE can walk into their doctor's office and get the damned vaccine. I got it three years ago and my GP didn't so much as bat an eye at the request. The government doesn't control so much as sets "suggested" guidelines that you and your physician are free to ignore. icon_rolleyes.gif


    What Guerilla said is true.... make sure you know why you're getting it.
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    Nov 23, 2010 4:01 AM GMT
    rightasrain said
    GuerrillaSodomite said
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Are you for real? ANYONE can walk into their doctor's office and get the damned vaccine. I got it three years ago and my GP didn't so much as bat an eye at the request. The government doesn't control so much as sets "suggested" guidelines that you and your physician are free to ignore. icon_rolleyes.gif


    What Guerilla said is true.... make sure you know why you're getting it.


    3rd on this opinion, is correct. Having worked in the pharma industry for numerous years in clinical trials, physician/patient relationship trumps whatever government intrusion you think it might be reaching in the examination room.

    A physician has the liberty with patient consent and knowledge to prescribe any medication/vaccine 'off label' if the medication has not been given clearance by the FDA in such manner. Manufacturer, can not claim that is has been clearance to promote for such indication until a valid clinical trial has proven this, but it does not hand-cuff the physician/patient relationship and what the physician thinks is best for the patient and prescribe. Many new insights to 'off-label' medications came from physicians who prescribe these medication for other uses, which then force the manufacturer to do a clinical trial and hence then FDA or regulatory body to clear the medication for such use.

    Government may give guidance and guidelines, but it will never be far reaching inside the examination room between physician/relationship to stop this.
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    Nov 23, 2010 1:33 PM GMT
    rightasrain said[quote]
    You can get those warts carrying HPV from FROTTAGE. icon_rolleyes.gif HPV isn't going to necessarily give you cancer at the site of infection, it can give you cancer elsewhere.
    -Doug


    Not sure where you're getting your info. HPVs can be spread by mucous membrane to mucous membrane contact but they don't 'circulate' in the bloodstream. The population of viruses a given individual is infected with CAN be in multiple locations on the person's body (that's the 'field' effect previously alluded to), but the primary impact of a particular virus is at the point of infection. Pathology from high-risk HPVs usually occurs on the cervix of the uterus, in the anal canal at the squamocolumnar junction or in the oral cavity. The worst outcome of infection is squamous cell carcinoma, and it can occur in the head/neck, cervix or anus.[/quote]

    Thanks rightasrain, I should have said point of contact, not infection (for example, oral/swallowing can move the wart virus during initial contact). I was advised by a Doc pal that warts can be transmitted with skin contact (the shaft of the penis, and the buttocks as examples), not necessarily mucous membranes. There's also research coming out about increased risks of skin cancer - squamous not basal.

    -Doug
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    Nov 23, 2010 6:56 PM GMT
    Tazo995 said
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Sounds like you're echoing the tea party crap, but don't forget that less than half a century ago, it was government immunization programs that lead to the eradication of killer diseases like pox and polio.


    Ohhh snap.... I wonder if we are being trolled, or whether the OP has just been brainwashed.
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    Nov 24, 2010 12:24 AM GMT
    Lostboy said
    Tazo995 said
    jockgymboy saidI'm all for making the vaccine available to those who want it, but the government should not be legislating decisions that should only be made between a doctor and the patient. Our government is getting way to controlling of people's lives which is harming people more than helping them.


    Sounds like you're echoing the tea party crap, but don't forget that less than half a century ago, it was government immunization programs that lead to the eradication of killer diseases like pox and polio.


    Ohhh snap.... I wonder if we are being trolled, or whether the OP has just been brainwashed.


    He's too young to remember polio, lostboy. I think he's also misunderstanding the article, which is talking about recommending the vaccine, not forcing you at gunpoint.

    -Doug
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    Dec 04, 2010 4:58 AM GMT
    rightasrain said
    skifan08 saidPersonally, I think everyone who is sexually active should get the HPV vaccine.



    Not necessary or useful (see above comments). ALL sexually active individuals should have cervical and anal PAP smears BEFORE using Gardasil so you don't waste your money. Do people actually read these threads?


    To assert that being infected with a mutagenic strain other than 16, or 18 makes vaccination useless is a bit of an exaggeration.

    Being infected with other mutagenic strains is not a guarantee that those strains will cause neoplastic change. It also does not give you immunity against strains 16 or 18. That means you can still get infected with strain 16 or 18 (or any other strain besides the one you've been infected with already) and infection with multiple high risk strains actually increases your risk for neoplastic change even more than infection with just one.

    Plus, even if you've already been infected with 16 and 18, there is still some benefit to getting the vaccine since the vaccine will protect you against non-cancerous genital warts caused by strains 6 and 11.

    In actuality, the only time the vaccine is completely useless, is if you have already been infected by all four types that the vaccine is against. This is the only time that it will not protect you against cancer OR warts.

  • Posted by a hidden member.
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    Dec 04, 2010 5:34 AM GMT
    skifan08 said... "To assert that being infected with a mutagenic strain other than 16, or 18 makes vaccination useless is a bit of an exaggeration."

    that's not what I said. that's your interpretation of what I said. I said 'not necessary or useful' to someone who suggested that all sexually active individuals be vaccinated with Gardasil.

    Scientists have linked 8 human papillomavirus (HPV) strains to over 90 percent of the cases of cervical cancer. (By extension, these same eight are responsible for most anal cancers) This information is the result of examining 60 years worth of data that involved 10,575 cases of cervical cancer in 38 countries. In descending order of frequency, strains 16, 18, 45, 33, 31, 52, 58, and 35 have been linked to that majority of cases of cervical cancer.

    when I said 'not necessary or useful'... that was an accurate statement. it depends on the individual's previous sexuaI exposures. i then suggested that every sexually active adult considering vaccination with Gardasil should have an anal PAP smear before Gardasil use to ensure that the cost is justified... another true statement. I'll point out again that if you are infected with ANY high-risk HPV other than the two Gardasil protects against (types 16 and 18 ) AND you already have the process of dysplasia underway (determined by the PAP I suggest you get), then vaccination with Gardasil won't necessarily protect against anal cancer as the other high-risk HPVs are already causing neoplasia. While you can still get protection against the two low-risk (i.e. wart) viruses that Gardasil protects against (types 6 and 11), it's hard to justify for two reasons.... first it is a rare gay man (or human for that matter) that doesn't have a few wart viruses already (yes, in their anal canal and yes even if they don't bottom... it's a 'field' effect) and second wart viruses don't cause cancer... they are a nuisance but not the 'danger' that the high-risk viruses are.

    Unfortunately, everything in medicine comes down to risk and money. As an ASCCP certified anal health specialist who has done over 300 high-resolution anoscopies, biopsies and IRCs, I will suggest again that 'random' use of Gardasil is not smart. Getting an anal PAP smear to perform cytological analysis on cells from the squamocolumnar junction of the anus and to determine the population of viruses you are infected with is the appropriate starting point for a well informed discussion with your care provider.

    If you want to discuss wholesale vaccination of youth who aren't sexually active yet, that's a different talk show.