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I got the HPV vaccine (sh.itjust.works)
submitted 5 months ago by to c/dull_mens_club@lemmy.world
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I had been meaning to do this for a long time and finally got around to it. It's not free for people in my age group but it turns out my insurance from work covered the cost and I just paid an injection fee.

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[–] 12 points 5 months ago* (last edited 5 months ago) (13 children)

For children between the ages of 9–14 years, vaccination effectiveness is reported to range between 74% and 93%, decreasing to 12% to 90% for 15–18 year old adolescents.

According to Wikipedia. Effectiveness definitely goes down fast. Also crazy range. 12%-90% sounds like "could be anything". But yeah. Mostly a reminder to pay attention and have your kids get the vaccination on time. Doesn't say a lot about adults. I mean it's safe. And if insurance covers it, why not?

Edit: The linked metastudy has many more numbers. Seems the vaccine is super effective for young people. But most times there isn't any statistically significant effect left past 18 or 20yo. Sometimes they even check for sexual activity... It didn't matter either. Some other few studies still show some effects. But that's probably why there isn't any recommendation to take it. Vaccines only get a recommendation if they have some statistically significant effectiveness. And the numbers for adult groups are just all over the place, whether they take the vaccine or not.

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  • [–] 5 points 5 months ago (7 children)

    I come back time and again to the difference between reasonable and recommended. A recommendation in medicine is something you would be unwise to ignore as a doctor. Reasonable is something that you as a patient should do. A doctor is going to tell you all the recommended things because the way medicine works is all around what is shown to a reasonable statistical level to be a good idea, or at least seems that way. They will still recommend some things that are nonsense and they will still make mistakes, but they won't be sued.

    If you try something and that works for you then you have a sample of one. It may have done nothing and the problem resolved itself, it may have solved the problem, it may even have slowed your recovery, but if you have the same problem again it is fairly reasonable to do the same thing that seemed to work last time. It isn't proof, but it is reasonable to try again.

    Does having a kebab on the way home from a night of drinking actually prevent hangovers? Well, maybe, it does have salt and that is depleted during drinking, but is a doctor ever going to recommend that? No, never.

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  • [–] 1 point 5 months ago (4 children)

    Hmmh. I mean the general thing with statistics is... You never know if you're in the 95% of people or the 5% exception. Could very well be the opposite for you. But it's fairly straightforward if you're the doctor and see 100 people a day. You'd just say what makes sense 95% of the times.

    Btw, I had some interesting doctors. One knew every product test and the numbers on all homespun remedies. And we got to talk a bit on what to do, which specific supermarket to go to, to buy multivitamin juice. He also had some recommendations on what to eat with my fever and tonsillitis. I think he gave a short lecture on spices as well, I forgot, it's been a long time. I bet that dude has an opinion on Döner Kebab, though.

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  • [–] 2 points 5 months ago (3 children)

    Yeah, I agree with your thoughts on the 95% thing. Its like with pain management. I am completely non responsive to morphine. Most people respond well, it just feels cold in my arm and that's it. When I flayed my wrist they gave me tonnes of morphine, the maximum dose I could have, and I had almost no effect at all. I got more from the paracetamol they gave me after that which was good because they had to remove my temporary dressing from a very large open wound and any relief was helpful. Now I just ask for aspirin and paracetamol, though after a wonderfully fun heart infection I can't use aspirin for pain relief without considerable bleed risk. Oh well, paracetamol it is.

    But yes, if I go in for emergency care and tell them "no morphine, paracetamol only" they will probably not take it seriously without a doctor supporting it. Good thing I have a fairly high pain threshold.

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  • [–] 1 point 5 months ago* (last edited 5 months ago) (2 children)

    Hehe, first person I get to talk to who doesn't respond to a good amount of morphine. (Unless they do drugs on a regular basis.) But yeah my story ended kinda the same way. Got my tonsils removed. And got Novamin / metamizole(?) as a painkiller. It's popular here. Took the max dose for a day and most I got was a headache, and still a good amount of pain. Talked to the doctor and switched to Ibuprofen and Paracetamol. That did the job. Now I just tell them about my prior experiences. And luckily I don't have a lot of pain or maladies anyway, so I'm generally fine without pain meds. Unless there's some other reason to take them, like fever. And I got some opioid once after the surgery. That felt funny and did away with the pain immediately. But I didn't really enjoy it. I kinda dislike dizziness and my brain feeling off.

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  • [–] 2 points 5 months ago (1 child)

    There was a study on the efficacy of paracetamol with ibuprofen compared to morphine and it was a very close thing, within the margin of error. The combination of paracetamol and ibuprofen works on pain in two different ways at the same time, whereas opiates only work in one major way. It seems overall more effective in many cases.

    That said, some people report that morphine doesn't remove their pain as much as it removes their caring about it. It reduces the salience and therefore makes them respond less. I don't know from experience given the lack of response, but maybe that is part of why it is so addictive, you don't have to care any more about pain or other issues.

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  • [–] 1 point 5 months ago

    Thanks! I didn't know.

    Regarding morphine addiction, I think that's more the mechanism how to get addicted. After a while there's all these other addiction dynamics as well, it messes with the brain chemistry and the dopamine system. There's real nasty withdrawal symptoms... And the substance addiction becomes a thing in its own. I mean I also see with nicotine how psychological and physical effects go hand in hand... And smoking has literally no benefits, other than the mild fuzzy feeling for a minute. Which you don't even get a lot if you smoke many cigarettes a day. Yet, it's super hard to stop, for most people.

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  • [–] 4 points 5 months ago (3 children)

    If the studies don't control for people already infected (which the article doesn't outright answer and I cba to read the studies right now), then the extremely wide range would make sense. I don't know if there's a test that can easily screen for dormant HPV infections, so it could be that they practically can't even control for this.

    Controlling for sexual activity also has the problem that the sample size is small and, if they can't accurately screen for the virus, will rely on self-reporting... which on a topic like this will likely be quite inaccurate.

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  • [–] 2 points 5 months ago* (2 children)

    Well they say 60% of people have sexual activity at the age of 18. But that's basically also their take on it. We need more studies on those factors.

    I don't think controlling for infection makes sense. You'd just get the result, it's 95% effective if you're not infected. And maybe some if you are. Disregarding age and all other factors. That's how medication gets approved. But that's not what we're interested in so they specifically excluded those studies. What we want to know is, given you're a random person from the streets, you don't know if you have HPV or catch it tomorrow... What's your best option? That's why they're probing for other factors. If you already did a good test (which seems to be problematic) and know you're not infected, just get the shot, it's already proven to work, we don't need studies on that.

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  • [–] 3 points 5 months ago (1 child)

    I don't think controlling for infection makes sense. You'd just get the result, it's 95% effective if you're not infected. And maybe some if you are.

    But is it? It's possible it gets less effective with age even if you aren't infected. Adult immune systems are different from those of children and teenagers, after all.

    On the other hand, if you've never had (unprotected) sex, or at least have only had a very small number of partners, you can be reasonably certain that you are not yet infected. For people like this it would be useful to know if the vaccine is still effective even if they're older.

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  • [–] 3 points 5 months ago* (last edited 5 months ago)

    Hmmh yeah, from reading the article I'd say you can't be too sure. I didn't find any solid numbers to back up the claim. Seems to be like with other STIs and infections. Protection helps, but not fully. And as it's infectious, a low number of contacts shouldn't make you certain about anything. A lot of adults have it, so maybe once is one too many. And with this virus you kinda never know if you're infected because 90% of infections come without symptoms. You can also get them years later. And there doesn't even seem to be consensus what a negative test means. Could still have the virus in you, just at some undetectable level. And seems they're not yet really sure about what consequences that has on cancer. Also they detected virus strains on fingertips, hands. And there seem to be other ways of contracting it, although that's way less likely.
    I see one clear winner here. And that's the vaccine, before getting infected. Whatever that means for an individual. And sure, use protection, that lowers the odds of so many things, including this.

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