Gardisil: is age an absolute contraindication?

[Lexington2012]

I had a 29 year old patient come in today and ask if we could give the "Gardisil 9" vaccine. He said that he went to the county health clinic and that they refused to give it to him because he is over 26. He said that he knew insurance wouldn't cover it, but he was willing to pay for it in cash (he knows it is $150 per shot).

Is age an absolute contraindication for the Gardisil 9 vaccination? The patient appeared to live the sort of lifestyle where he would benefit from this vaccine, and possibly prevent spreading it to others. His profile showed that he is taking acyclovir and he has a previous prescription for 1 gram of azithromycin (we all know what that means).

I can't give this vaccination in my state (I'm not sure about other state laws on this). I was unsure how I could help him out with this and mentioned that he might ask his family doctor at his next visit.

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[owlegrad]

I think having him ask his PCP was the right move.

 

[KARM12]

It is not recommended for males above the age of 26 because most of them would have already been exposed to those HPV strains and it is unlikey to be of any protection. I don't think it is an absolute contraindtication, but was not studied in that population. You could consider calling the manufacterer to see if there were any studies conducted in older adults.

 

[Lexington2012]

I think it would be good for him to get it. It is unlikely that he has been exposed to all 9 strains in the vaccine, but it seems likely that he will across them at some point if he keeps living his lifestyle.

 

[Unchained]

I would not recommend the Gardasil vaccine to anyone. It has a poor record of safety and its efficacy is not well established

 

[rph3664]

It's also not recommended for women over the age of 26 because the cells in the cervix change around that age in a manner that renders the vaccine relatively ineffective. In other words, it probably isn't harmful; it just doesn't convey any benefit.

 

[PharFromNormal]

I would not recommend the Gardasil vaccine to anyone. It has a poor record of safety and its efficacy is not well established

Unchained = anti-vaxxer

 

[zelman]

I would not recommend the Gardasil vaccine to anyone. It has a poor record of safety and its efficacy is not well established

 

[Unchained]

Unchained = anti-vaxxer

PharFromNormal= brainwashed drug rep who thinks he's performing a valuable service for his patients

 

[PharFromNormal]

PharFromNormal= brainwashed drug rep who thinks he's performing a valuable service for his patients

I can agree with I think I perform valuable service for my patients but not with the brainwashed drug rep part.
Do you disagree with my full statement that you are an anti-vaxxer meaning you oppose vaccines? You can jump to the mud slinging but I'm not sure why... If you are against them, own it. All I did was merely inform others about your position in which again I believe you would agree on. If there are other vaccines you do support I will readily admit I crossed the line and should adjust to stating you are anti-gardasil instead.

 

[MatCauthon]

The EU is currently re-evaluating the safety of Gardasil due to case reports of severe reactions to the vaccine.
They haven't changed their recommendations, but it will be interesting to see if anything becomes of this. Vaccines do get pulled from market occasionally.

https://www.washingtonpost.com/news...igating-reports-of-rare-but-severe-reactions/

 

[PharFromNormal]

The EU is currently re-evaluating the safety of Gardasil due to case reports of severe reactions to the vaccine.
They haven't changed their recommendations, but it will be interesting to see if anything becomes of this. Vaccines do get pulled from market occasionally.

https://www.washingtonpost.com/news...igating-reports-of-rare-but-severe-reactions/

First of all the EMA not the EU. Second of all its not currently. It's done.

http://www.ema.europa.eu/docs/en_GB...ean_Commission_final_decision/WC500196773.pdf

Edit: updated source

 

[Promethean]

Age is not an absolute contraindication.

I had to fight to get the vaccine myself, because I was already "too old" by the time it was on the market. My health department wouldn't administer it because of that, and my PCP at the time wouldn't budge either. Being over 26, however, is not a guarantee of having been exposed to all of the strains of HPV that the vaccine protects against. And even in instances where there may have been exposure, my new PCP says that there is evidence suggesting that Gardisil may help the immune system recognize the virus and mount a more effective response, so that he recommends the vaccine to anyone who wants it regardless of age.

 

[Unchained]

Corporations have an undue influence on our governments and the media in promoting vaccines. They have the power and resources to silence anyone who questions them. One thousand women were potentially harmed in Denmark by the vaccine and the studies were formulated purposely to filter them out. This is by design. Any person or parent who watches that video would never agree to be injected with Gardasil or have their child injected. This is all about money. Start being healthcare professionals again and stop recommending vaccines.

 

[Promethean]

Corporations have an undue influence on our governments and the media in promoting vaccines. They have the power and resources to silence anyone who questions them. One thousand women were potentially harmed in Denmark by the vaccine and the studies were formulated purposely to filter them out. This is by design. Any person or parent who watches that video would never agree to be injected with Gardasil or have their child injected. This is all about money. Start being healthcare professionals again and stop recommending vaccines.

Far more are actually harmed by HPV than are "potentially harmed" by the vaccine.

Benefits far outweigh risks where vaccines are concerned.

 

[PharMed2016]

Like Promethean has pointed out, the harm from HPV is far greater than any perceived harm from the vaccination itself. Not only does it cause cervical cancer in 90%+ of women but it now is eclipsing smoking as the leading cause of head and neck cancer.

 

[Unchained]

Like Promethean has pointed out, the harm from HPV is far greater than any perceived harm from the vaccination itself. Not only does it cause cervical cancer in 90%+ of women but it now is eclipsing smoking as the leading cause of head and neck cancer.

Not in Denmark. 100 women per year died from cervical cancer before Gardasil. 1000 women have been injured since Gardasil that they know of. Watch the video.

 

[zelman]

Not in Denmark. 100 women per year died from cervical cancer before Gardasil. 1000 women have been injured since Gardasil that they know of. Watch the video.

Was it approved there in 2006 (as it was in the USA)? Or is that 1000 in less than 10 years?

Also, you're comparing injury to death.

 

[PharFromNormal]

Only 1000 women have been injured since gardasil? I'd say that's a darn miracle drug. Must prevent domestic abuse, falls in the elderly, auto accidents, the whole bit. Any idea of how many women were injured before gardasil? I mean unless of course he means 1000 women were injured from gardasil but I think we can only speculate on that one as well.

 

[gwarm01]

PharFromNormal= brainwashed drug rep who thinks he's performing a valuable service for his patients

Am I crazy or do you never post unless someone mentions vaccines? Are you actually a pharmacist or just one of these anti-vaxx people? Forgive me if I'm mistaken, but I never recall seeing you discussing any other topic.

 

[PharMed2016]

Not in Denmark. 100 women per year died from cervical cancer before Gardasil. 1000 women have been injured since Gardasil that they know of. Watch the video.

Show me the official data from a reputable source for your statistic.

 

[Promethean]

The only references I could find to the documentary, which aired on Danish TV, are from way-out-there antivax sites. Nothing reputable came up in the search.

Seriously, if there were a story here, it would blow up. It hasn't, because there isn't.

EDIT: And, I've now watched it. All I saw was a lot of post hoc ergo propter hoc fallacy.

Young women sometimes get sick. If a large enough group of young women get a vaccine, some of them, who were going to get sick any way, are going to get sick after getting the vaccine.

There may be a real correlation, or there may not. Either way, exploitative popular journalism is not a substitute for scientific inquiry.

 

[Gosondth]

Corporations have an undue influence on our governments and the media in promoting vaccines. They have the power and resources to silence anyone who questions them. One thousand women were potentially harmed in Denmark by the vaccine and the studies were formulated purposely to filter them out. This is by design. Any person or parent who watches that video would never agree to be injected with Gardasil or have their child injected. This is all about money. Start being healthcare professionals again and stop recommending vaccines.

Andrew Wakefield must be your diety of absoltue scientific truths.

 

[Azianmunk]

Sorry just reread OP, information is irrelevant. Can't delete post.

Just watch out. Depending on your state, company, and if you're protocol/independent. You may not be able to give the vaccine even if you saw fit within your own medical reasoning, just make sure so if any problems arises, you were practicing within you own scope of practice. With me, I fear I would not be able to due to the age restrictions and would have to refer all off-label uses over to the PCP.

 

[BidingMyTime]

I think its stupid to have an age restriction on a vaccine. I can see having "recommended" ages, and I can see not using public funds on other than the recommended ages, but people are individuals, people don't magically change after having a birthdate, so if someone outside the recommended age wants a vaccine (and the vaccine is otherwise medically indicated and/or not contraindicated), why shouldn't they be allowed to get the vaccine?

 

[zelman]

I think its stupid to have an age restriction on a vaccine. I can see having "recommended" ages, and I can see not using public funds on other than the recommended ages, but people are individuals, people don't magically change after having a birthdate, so if someone outside the recommended age wants a vaccine (and the vaccine is otherwise medically indicated and/or not contraindicated), why shouldn't they be allowed to get the vaccine?

Vaccines can be prescribed off-label in the same way any other drug can. So, in essence, your argument is that someone should only not get something if they should not get it. I think we all agree.

 

[BidingMyTime]

Vaccines can be prescribed off-label in the same way any other drug can. So, in essence, your argument is that someone should only not get something if they should not get it. I think we all agree.

Yes, but we are talking about administering the vaccine. In IL, while a pharmacist can fill an off-label prescription, they can not administer a vaccine off-label, even with a doctor's prescription. My argument is, there shouldn't be a difference, if the pharmacist is confortable administering the vaccine off-label, and the law allows them to administer the vaccine, it seems stupid to say that a vaccine is different than every other medication and the pharmacist can't administer it off-label.

 

[zelman]

Yes, but we are talking about administering the vaccine. In IL, while a pharmacist can fill an off-label prescription, they can not administer a vaccine off-label, even with a doctor's prescription. My argument is, there shouldn't be a difference, if the pharmacist is confortable administering the vaccine off-label, and the law allows them to administer the vaccine, it seems stupid to say that a vaccine is different than every other medication and the pharmacist can't administer it off-label.

You sure?
ftp://www.ilga.gov/JCAR/AdminCode/068/068013300A00500R.html
A pharmacist, or student pharmacist under the direct supervision of a pharmacist, may administer vaccinations/immunizations to persons who are 14 years of age or older pursuant to a valid patient specific prescription or a standing order by a physician licensed to practice medicine in all of its branches under the Medical Practice Act of 1987 [225 ILCS 60].

 

[BidingMyTime]

You sure?
ftp://www.ilga.gov/JCAR/AdminCode/068/068013300A00500R.html
A pharmacist, or student pharmacist under the direct supervision of a pharmacist, may administer vaccinations/immunizations to persons who are 14 years of age or older pursuant to a valid patient specific prescription or a standing order by a physician licensed to practice medicine in all of its branches under the Medical Practice Act of 1987 [225 ILCS 60].

eh, not positive, I've given a vaccine or 2, but this isn't my specialty. IL pharmacists can only give under protocol with a doctor, and the protocol I've seen said we can only give within FDA approved guidelines for the vaccine, I had the assumption that was because of IL law, but it sounds like that was just because of that individual physician protocol and not based on law. My bad, I mix up federal and state laws too.....as long as I know what I'm allowed/supposed to do I'm good, I don't try to keep it straight on why I'm allowed/supposed to do that.