But this misunderstands how HPV works. First, there are many strains. Typical tests for oncogenic variants measure around 30 types. The vaccine I received (Gardasil-9, which I took as a male at age 35) protects against nine specific strains.
Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body).
People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case!
Parent is overstating the case. Neither infection nor vaccination provides sterilizing immunity [1], but the general reasons to prefer vaccination are (in order of descending quality of evidence & reasoning):
1) you probably haven't had all N strains yet.
2a) you likely haven't been infected with the ones that cause cancer, because they're relatively rare.
2b) ...that is especially true if you're young and not sexually active.
2) being infected with one strain does not provide sterilizing cross-immunity against the other strains.
3) even if you've been infected with a strain, some of the vaccines have been shown to prevent reinfection and reactivation better than natural infection alone.
4) in general, the vaccination-mediated immunity might last longer or be "stronger" than the natural version, since the vaccines are pretty immunogenic, and the viruses are not.
But for point 4, it's well-known that vaccine efficacy is lower for people who have already seroconverted (cf [1]), so there's clearly some amount of practical immunity provided by infection.
[1] The vaccines are roughly 90% effective for the major cancer-causing strains, but it's not a simple answer, and varies a lot by how you frame the question. See table 2 here: https://pmc.ncbi.nlm.nih.gov/articles/PMC8706722/
Also be sure to see table 4 if you're a man. The data for biological men and women are surprisingly different!
A question for your doctor and your partner (and of course, you can read the data in the link I posted above and use that to influence your conversation and decision!)
I'm not being avoidant here -- medical decisions are always subjective and multi-factor, and I can't begin to tell you what you should do. (But I also sincerely believe that propagandists try to reduce nuanced data to talking points, which is equally wrong.)
Please note the caveat about gender that I just added. The data for biological men and women are very different. Also, I haven't discussed risks at all, which is the other side of the ledger -- these vaccines are pretty darned safe, but everything comes with risk, and only you can decide what level of risk is appropriate for your life.
I usually am pro vaccine. But the HPV vaccine discussion seems politicized to me. As someone who is monogamous and over fifty, I had trouble following the risk vs reward discussion. The CDC says it is only recommended for young adults so I interpret that for my case the answer is negative.
All vaccination is now heavily politicized in the US. HPV vaccination was an obvious focal point initially because of why we'd do it when we do.
The initial data says you should vaccinate somewhere around 12-14 year old girls because most of them will be HPV naive but if you wait longer they won't be any more. But too many US parents cannot imagine their little girl ever having sex and if they never have sex they almost certainly won't contract HPV so, why are we vaccinating them? Are you trying to make my daughter a slut?
If you've been a teenage American this should strike you as very silly, and doubly so if you understand biology. Teenage girls are not, in fact, celibate by default, so some of them will get horny. And if you understand biology the viral infections aren't caused by the same mechanism as pregnancy "sexual activity" is a shorthand, you can easily get infected while steering clear of anything that would get somebody knocked up. A peck on grandma's cheek is unlikely to work, but if you're sucking face for most of a Stranger Things episode that's definitely enough that you might contract HPV.
> recommended for young adults so I interpret that for my case the answer is negative.
You need to be careful making assumptions.
Previously that recommendation was due to limited vaccine production and trying to prioritize young women.
There were CDC recommendations during covid that were not about what was best for you individually.
As always with health, the right answer is to seek professional advice. But also to take personal responsibility for your own choices (that depend on your specific circumstances).
Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents.
> Same, what is the risk/reward for someone who is and plans to be monogamous. Young or old. Cost not a concern. Give me the info and let me decide for myself, my kids, my parents.
Did I read this correctly? You are going to decide for your children based on their plans to be monogamous?
And you’re also going to decide for your parents? I can only assume you’re in the unfortunate situation where your parents are no longer capable of making decisions?
I don't want to assume, so I'll ask if you're willing to share - are you making the implicit assumption that your kids are and/or will be monogamous, and is that assumption a key factor in your decision on their vaccinations?
The CDC recommendation to get it at 11 or 12 does not make sense to me. I know they aren’t having sex - and I know that some kids do. We will discuss, together, the pros/cons as they get older to see if it makes sense. As they get older, they’ll make these decisions themselves. Until then, I’m weighing the pros/cons and in our case, it doesn’t seem they are at risk in the near future.
The early recommendation age just falls out of the data that shows the vaccine is substantially more effective if you haven't been infected yet, together with the fact that it's a multi-dose vaccine where the second dose comes months later, and realistically for many that's going to mean a year or more before completing the series.
I think there's truth to the idea that the specific 11-12 range is somewhat arbitrary: as much as anything it's that because there was a preexisting "slot" in the vaccine schedule at 11-12. The American Academy of Pediatrics differs from the CDC's panel on this... but on the earlier side: they would start the recommendation at age 9. I think to a significant degree the thinking there is that if you go earlier the messaging and reaction is more "your child will probably eventually have sex and this is an effective time to give the vaccine" and less "your child will be having sex like, tomorrow."
I am a parent who vaccinated my daughter at 9 for HPV, and my son will be vaccinated as soon as he’s old enough, without delay or hesitation. It is my opinion you are doing a disservice to your children with a suboptimal mental model, potentially driven by emotion instead of data.
Your children will have sexual contact with another human eventually as they grow into adults, and there is very low risk with an HPV vaccine. There is, in my opinion, no reason not to vaccinate as soon as possible (considering the material reduction in future cancer risk, and that there is no cure once infected, only prevention via vaccination). You might have feelings, as many have strong feelings, but they won’t matter once your kids are 18 and you no longer control them. Google the stats on parental estrangement.
Try to do better, you are a guardian of your children, not an owner, and your values will potentially not be their values. I don’t care with who or when my children have sexual experiences with once they are old enough to consent, what matters is they are respected, as well as protected from harm and poor health outcomes from these experiences they will certainly have eventually during their lifetimes. If you don’t think your kids are going to have sex when they’re older, or think you can control it, you are lying to yourself. So, protect them from what you can, which in this case is HPV.
Let me start by saying I am mostly in agreement with what you've written. But I do not understand why there is the urgency to vaccinate them when they are 9 (as you did).
Because the United States is rapidly devolving, including around vaccine recommendations and what availability and access might look like because of that, and my child and I were already at the pediatrician that day. Administering the vaccine and me asking the pediatrician “can we do it today?” cost me nothing beyond the time. If I need to find them their second dose elsewhere six months after the first (unlikely, but possible), I am prepared for that, but once they have that second dose, they have the persistent health benefit with very little effort required (regardless of what the future looks like). I’ve just lowered their future cancer risk, with no more than an hour or two of time.
I work in risk management, and have for almost a decade, so that’s how my brain is wired to evaluate and manage risk. I understand others may decision and action differently. Low cost, low risk, high reward choice? That’s a damn good deal, I’ll take that deal.
Pretty sure this line never convinced anyone of anything. We all want to do "better" but have different definitions of what that constitutes.
> If you don’t think your kids are going to have sex when they’re older, or think you can control it, you are lying to yourself.
I don't think anyone thinks this. Some people do hope and expect their children not to have sex outside of a monogamous marriage. If you give your kid a vaccine that is primarily meant for people who do not do this, you are letting your kid know that you don't really have faith in them.
That sends a strong message that some people do not want to send. As GP said, you're free to raise your kids different, and if you don't place value on reserving sex for marriage, it would make sense that you would do differently.
"Sending a message" is generally a cover term for evil.
And there is no issue of having faith in them--you are trying to make a decision you have no right to make. You're a parent, not a slavemaster.
The real world data is that the "good" girls are more likely to get pregnant, more likely to get STDs. And more likely to end up in bad marriages.
And lets add another data point. I used to have a bunch of coworkers from a very conservative background. An unmarried person would not be able to buy a condom in town type conservative. Over the course of many years I became aware of many marriages--and every single marriage was either arranged or due to pregnancy. Every single one. Remember, one of the definitions of insanity is keeping trying the same thing and expecting a different outcome.
Neither does a parent, based on all available evidence, and multiple jurisdictions make vaccination compulsory without exception. Parents aren’t special, and they are failing in this regard by believing they should have a right to say no, simply for being a parent. Anyone, broadly speaking, can have children. That does not make them good or qualified parents unfortunately. It just makes them temporary guardians (until their children are adults) with an opinion.
~54% of Americans read below a sixth grade reading level, for example. We would trust your average American’s judgement on vaccination need or schedule, especially for their children, why?
> based on all available evidence, and multiple jurisdictions make vaccination compulsory without exception
Can you share which jurisdictions mandate the HPV vaccine and have no exceptions? I am aware of only a few jurisdictions where it is required, and all such jurisdictions have exceptions.
They also only require it for kids in schools, so any kid who is homeschooled is not subject to the mandate in the first place.
More importantly, the vast, vast majority of jurisdictions have no mandate whatsoever, so any parent can also choose to move to one of those, in addition to the homeschool option.
Ah ok I'd be curious to know what those are, though I would find them to be less persuasive/relevant from a policy perspective. There are countries that have no freedom of speech, outlaw non-govt schools, etc., and I don't want to be taking cues from such countries.
Regardless, I would imagine that very few jurisdictions, and a relatively small percentage of the world, lives somewhere that mandates these vaccines and has no opt-outs.
No, you have an obligation to do the best job you reasonably can with raising children. We generally do not permit parents to do things which pose an undue risk to their children, and most of the exceptions to this involve religion being given a weight it shouldn't get.
Trying to make sex more dangerous to me falls squarely in the realm of child abuse.
For a 9, 10, or 11 year old? I'm definitely not encouraging them to have sex.
I surely hope we go after actual child abusers than parents who delay or opt-out of this OPTIONAL vaccination for their kids.
The problem here is the do-it-later crowd is going to wait too long. Same thing as we see with sex-ed, knowledge is treated as encouraging when reality says it's exactly the opposite. Honest sex ed leads to later sex and fewer problems.
Well, hope and faith are not effective strategies. Good luck to those who operate from this perspective, they will face disappointment, which is theirs to own. Monogamous marriage is a shrinking minority of potential outcomes [1] [2] [3] [4] [5] [6], and ~40% of first marriages end in divorce [7] (rates are higher for second and third marriages).
The kids of these people get a chance to do better when they become adults, and that's all we can hope for: that they make better choices than their parents. Better luck next generation I suppose.
[1] How has marriage in the US changed over time? - https://usafacts.org/articles/state-relationships-marriages-... - February 11th, 2025 ("In 2024, US adults were less likely to be married than at almost any point since the Census Bureau began tracking marital status in 1940. The percentage of households with a married couple peaked 75 years ago: in 1949, it was 78.8%. That percentage has been below 50.0% since 2010, when the rate was 49.7%. In other words, less than half of American households have included a married couple for over a decade.")
[2] Charted: How American Households Have Changed Over Time (1960-2023) - https://www.visualcapitalist.com/how-american-households-hav... - November 6th, 2024 ("More Americans today are delaying or forgoing marriage altogether, with just 20% of women and 23% of men aged 25 being married—the lowest on record. Projections indicate that by 2050, one-third of Americans aged 45 may remain unmarried.")
[3] Morgan Stanley: Rise of the SHEconomy - https://www.morganstanley.com/ideas/womens-impact-on-the-eco... - September 23rd, 2019 ("Based on Census Bureau historical data and Morgan Stanley forecasts, 45% of prime working age women (ages 25-44) will be single by 2030—the largest share in history—up from 41% in 2018.")
> Well, hope and faith are not effective strategies. Good luck to those who operate from this perspective, they will face disappointment, which is theirs to own.
Hm, worked great for many people I know. I can imagine it would depend on a number of factors.
But looking at your links, they don't seem especially relevant to the question of whether more people are having sex before marriage than before. They don't even mention the word "sex" in fact. And of course, the relevant question isn't whether people in general are having sex before marriage less, it's whether people raised in families where abstention is valued are upholding that value in their lives.
But congrats on sharing lots of links, which makes it look like evidence is on your side!
As to whether "hope and faith are not effective strategies", it probably makes sense to listen to the experience of people who rely on such hope and faith in their lives, and who have many friends/family who do. People who express outward disdain for such things are probably not the best source of reliable info on the matter.
I understand that religiosity (faith and hope) is negatively correlated to intelligence, so I also understand faith driven mental models are an uphill climb to better health outcomes at scale. "It is what it is." As I mentioned, perhaps we'll have better luck next generation, when systems have improved in this regard.
(edit: facts and data are not unkind, they just are, and I feel like I have been very polite in my delivery of all facts and data presented; if you are unhappy about the facts and data presented, that is an internal issue to reconcile)
That's a pretty longwinded ad hominem you've got right there.
Forgive me for not digging into your links again...fool me once, shame on you; fool me twice, shame on me.
You're entitled to your opinion, but when you go around spouting about faith not being a good strategy and then cite a bunch of unrelated articles, you've shown that you are yourself not very intelligent (or kind).
"Faith" is fundamentally belief without knowledge. Thus you by definition have no reason to rely on it. (Although the word also gets used in situations where there is a track record to rely on but no specific evidence in the particular case.)
And you're using the wrong yardstick. What you should be looking at is the number of adverse events. STDs. Unintended pregnancies.
Everyone hopes for and has faith in their kids with regard to some actions. It could be going to class, staying out of gangs, not drinking/doing drugs. We don't know for a fact our kids will do what we hope, but we act in a way that shows we have faith in them, so as to avoid undermining their confidence.
I don't need to use the yardstick you propose. There are many confounders in aggregate data, and there are not public polls that capture the demographics and beliefs of my family. It would be a fool's errand to pretend that publicly available data is somehow more important than my own understanding of my kids.
It's funny how you think I shouldn't be able to make decisions for my children, but you seem to think that you know better than me what is right for them.
The available data indicates that you're wrong. You *think* you know, you don't.
Would it be acceptable to not belt your kids because you have faith in your driving skills? (And never mind that the one time in my life where a seat belt mattered was when I was essentially PITted by someone who didn't look left. I walked away with nothing but a pulled muscle and because I was belted my foot correctly found the brake pedal while I was spinning around and totally disorientated.)
Or how about the woman from ~30 years back that said that DUI doesn't really matter if your faith is strong enough as god will protect you.
Not belting your kids when you put them in the car is unsafe and is illegal. However, not getting your 9 year old a vaccine for STDs is not unsafe if that kid is not sexually active, and therefore not at risk for contracting the STD. As the kid gets older, the calculus changes because they are more independent. But pretty much any responsible parent has a very accurate sense of whether their 9 year old is having sex.
And the parents who have a sexually active 9 year old that they do not realize is sexually active are probably not taking them in for their regular doctor appts and vaccines.
It's not that they'll be active at 9. Rather, that you don't know when they'll be active and the ones who see this as encouraging sex will delay too long. Thus it's better to do it early.
I'll never understand how differences of opinion can make people so extreme. Child abuse is a serious issue and you have gone through some mental gymnastics to conflate child abuse with my decision to not vaccinate my 9, 10 or 11 year old child for HPV.
You get to make your own health choices here, but as someone who got the vaccine in my 30s, I am glad as I didn’t know about my future divorce when I got vaccinated.
Consider that it's possible that the person's partner may have exposed them to their then-unknown extra partners, creating one of the conditions for the divorce.
There are other STDs that you'd still be at risk of getting/giving in the case of infidelity, so getting this one vaccine doesn't actually make things all good. I imagine for some people, the thought of possibly bringing home a disease would actually be a sufficient deterrent to prevent infidelity. Not just because they wouldn't want to infect their partner, but because they know it could lead to them getting caught.
I'll elaborate: if you are worried about being unfaithful, or your spouse being unfaithful, then protecting yourself against one STD might seem like a good idea. And if the risk of unfaithfulness is very high, then it is better to mitigate one STD rather than none.
But the fact remains that you are still at risk of many other STDs, so you can still bring home (or have brought home) plenty of other diseases.
The last point, which I knew some people here would dislike, is that the possibility of HPV transmission could, on the margin, discourage some people from being unfaithful. This is because it would be a telltale sign of infidelity, and would cause the spouse to investigate.
Granted, this is only the case where the spouse knew he/she did not have HPV before (mostly people who remained celibate before marriage). If you had many partners before marriage, this advice probably doesn't resonate, but for people who did it makes perfect sense. It acknowledges the risk of infidelity and creates additional accountability by not shielding one's self from a likely telltale sign.
Think about your future health while your mind is clear. After the trauma of divorce is not the time.
Also, I think these questions are in bad faith.
It is actually hard to get people to change any behavior. The public health benefits should be a primary concern. Avoid vaccination if there is a downside to you personally, but that isn’t what I’m hearing from your comments.
Ha, we had this conversation with our doctor and they said not to worry about the vaccine if you are married and monogamous. It would likely have zero benefit to us at that point in time.
Now maybe that changes if you get divorced and get a new sexual partner.
It's never a guarantee in practice, the CDC says "More than 98% of recipients develop an antibody response to HPV types included in the respective vaccines 1 month after completing a full vaccination series"
Second, the body normally clears HPV naturally after 1-2 years. However, natural infection often does not provide immunity, so reinfection can easily occur (even from the same partner or a different part of your own body).
People often assume that HPV is either a lifetime infection or that recovery guarantees immunity - neither is the case!