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What are your feelings about the HPV vaccine?

Discussion in 'Medical Students - MD' started by seamonkey21, Feb 28, 2007.

  1. seamonkey21

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    There is so much controversy surrounding the Guardisil vaccine and whether it should be mandatory for young girls. What do you think?

    Personally, I have HPV and I WISH I had the vaccine as a young child! I just don't think it should be up to the parents because you are playing with potential cancer. Just my two cents.
     
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  3. kerplunk112

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    im all for where texas stands on the issue...somewhat mandatory with and option to opt out. 70% is pretty damn effective. the side effects at this point seem to be minimal ie slight malaise muscle pain etc. just hope there are no significant long term effects...these are out kids after all.
     
  4. lilnoelle

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    Clear up something for me.... I've been told that HPV is a virus that is normally easily warded off in a healthy immune system and that a high percentage of sexually active females end up with the virus during their teens and twenties (which should be when their immune systems are at their strongest). So if this is true, individuals with a healthy immune system shouldn't be at a high risk for cervical cancer because they have "self-immunized" and only high risk individuals with a weaker immune system will have trouble with cancer later on.
    Am I just not thinking this through correctly? If the above is true, it seems like cervical cancer would not be as significant in our population as it is. Or is it that it isn't significant in numbers but it is a terrible cancer and therefore is talked about - and of course it is desireable to prevent it.
     
  5. Divine Furor

    Divine Furor Academician
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    To be honest, you need to be a little more informed on the nature of HPV before assuming that people can "self-immunize" due to immune system status. First of all, there are many different strains of HPV, some more caustic and cancer-inducing than others. Some forms of HPV are resident in the body for a person's entire lifetime, causing recurring symptoms as conditions escalate. And the last thing I'll say is that while there's a direct correlation between HPV-infection and cervical cancer occurence, the two are not mutually exclusive, so necessarily saying "HPV immunity means less risk for cervical cancer" is not a valid statement. And yes, I know you didn't say that exactly.
     
  6. lilnoelle

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    And thats why I asked for clarification.
    All I know is what I heard on the radio via a couple of doctors who were excited about the vaccine. We haven't talked about it in med school yet.

    So, give me more info. Teach. Is HPV only transmitted sexually? And you said that some forms are resident for the entire lifetime - are those the forms that are thought to cause cervical cancer?

    Yes, I realize I should do my own research, but I have tons of other things to do and my daughter is 3 1/2 and so therefore I don't need to make a decision on this for quite a while.
     
  7. Divine Furor

    Divine Furor Academician
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    Technically no, HPV is an STD but spread through mucous membrance contact and cutaneous contact as well. It's a hardy little virus and lasts a long time in external environments.

    If you don't have time for thorough research, try scanning http://en.wikipedia.org/wiki/HPV for a general overview....actually a very good article.
     
  8. Schaden Freud

    Schaden Freud MiSanthrope II

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    HPV is prevalent and serious enough where mandating vaccination sounds like a good idea. Herd immunity in the hizhouse.

     
  9. lilnoelle

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    awww, wiki, I can't believe I momentarily forgot about wikipedia. Thanks!
     
  10. lsumedgirl

    lsumedgirl Livin' the dream!

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    A vaccine that has the potential to ultimately prevent a type of cancer... I don't see any negative effects.

    And to answer a question that hasn't even been brought up yet (although I'm sure it will be)... I highly doubt that giving the vaccine to young girls will all of sudden make them rush out and start having sex. (If a teenager wants to have it, they'll do it regardless of whether or not they get a certain vaccine.)

    So I say, go ahead with the vaccine.
     
  11. TIGIBedHead

    TIGIBedHead Fever to Tell

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    http://www.nytimes.com/2007/02/28/health/28hpv.html?ref=health

    What do you make of the finding that only 3.4% of women have the strains of HPV against which Gardasil would vaccinate? Those strains are the ones most likely to cause cervical cancer, right?

    Even so, the following statement makes me wary:

    I wonder how necessary mandatory vaccinations are, especially given that we don't know the long-term effects, if any.
     
  12. Law2Doc

    Law2Doc 5K+ Member
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    I don't think there's a whole lot of controversy in the medical community, just among the lay public. I've yet to meet a physician who thought the vaccine was a bad thing. It would be interesting to hear from folks at the med schools with more religious underpinnings weighing in.
     
  13. MiesVanDerMom

    MiesVanDerMom D.o. or Die

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    yeah, why worry about the longterm effects of injecting our children with foreign genetic material? pffft! why stop with the 24 mandatory vaccines we have now? why not vaccinate for everything that might possibly go wrong?:thumbup:
     
  14. indo

    indo Feed me a stray cat

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    You're right. Also, we can't create an invironment where there are no physical consequences to having sex! Sex should be painful, shameful, and deadly!

    Pat Robertson '08

    <----------Princess had an HPV vaccine and look at what is happening to her!
     
  15. angel03

    angel03 Member

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    While 3.4% does seem like a low number, I read an article about the same thing (on CNN) that pointed out that 3.4% is equal to 3 million women nationally. If we could prevent even 2 million of these infections that may/will lead to cancer, I think it is worth it definitely.
     
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  17. ForbiddenComma

    ForbiddenComma Tanned for Bowling

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    Q: What is the only way to get a Republican to vote for HPV vaccination?




    A: Tell them that HPV can also cause penis cancer. :eek:




    any by the way VanDerMom, are you saying that you did not vaccinate your children?
     
  18. indo

    indo Feed me a stray cat

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    I think, based on her signature, that she is saying that the government shouldn't mandate anything involving our personal lives. I'm with that.
     
  19. MeMoMa

    MeMoMa Junior Member

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    from my understanding the vaccine covers 4 strains: 2 that are "high risk" which could possibly be linked to cervical cancer and 2 that are low risk that cause genital warts...

    but thats just what i was told when i got the vaccine... but they arent lying when they tell you it makes your arm sore
     
  20. Law2Doc

    Law2Doc 5K+ Member
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    That's well and fine but it's hard to deny that lots of diseases have been held in check because of government imposed vaccines.
     
  21. TIGIBedHead

    TIGIBedHead Fever to Tell

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    I agree that it's a useful vaccine, just that it seems too early to make it mandatory. I was reading that the drug company was pushing for it to become mandatory now because others are working on HPV vaccines as well, so they stand to make the most profit right now while they have a monopoly on the market. I have absolutely nothing against the vaccine and I don't care for the argument that it will increase sexual behaviors, I'm simply thinking about it from the drug company perspective.
     
  22. Sounds like they gave you good information. According to Gardasil's website, "Gardasil is the only vaccine that may help guard against diseases that are caused by human papillomavirus (HPV) types 6, 11, 16, and 18... HPV Types 16 and 18 cause 70% of cervical cancer cases, and HPV Types 6 and 11 cause 90% of genital warts cases."
     
  23. angel03

    angel03 Member

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    While I am all for vaccines, they are actually not the total reason infections declined. It was actually in increase in sanitation and the like which led to a very large decrease in the spread of these infections. No doubt that vaccines do continue to help keep them at bay though.
     
  24. StritchMD2011

    StritchMD2011 Member

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    If I recall correctly - wasn't there a thread a few years back where you got in a relatively heated debate about vaccinations with a few physicians on the forum?

    Wasn't your main point of contention that there was a study (which has mostly been discredited) which linked vaccinations to autism?

    I'm just curious why you seem so against vaccinations? I can understand not wanting to be TOLD how to deal with your child, but I can't understand why you wouldn't want to protect your child against some of those nasty diseases out there...
     
  25. Law2Doc

    Law2Doc 5K+ Member
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    This is a frequent reason people are hostile toward vaccines. But after pretty significant study, the current position of the medical field is that there is no such link. Lay people and various tabloids have continued to dispute this. But most med schools now seem to be comfortably teaching their students that vaccines are not the culprit.
     
  26. ForbiddenComma

    ForbiddenComma Tanned for Bowling

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    Taken to extreme, it becomes crazy. Do you think the government should not intervene when a parent is starving her child or beating him with a horsewhip?

    Or for a less clear-cut example: how about the ultrareligious parents who occasionally make the news when they refuse any medical treatment for their kids, and rely only on faith healers. In those cases, the state terminates their parental rights in order to save the life of the child. Is that a bad thing?

    Respecting parents' rights not to vaccinate is nice in theory... until her child develops Hib meningitis. Not only are the parents endangering the life of their own child, but also of the children around them, especially ones that also have parents who refuse to immunize for illogical and unscientific reasons.
     
  27. StritchMD2011

    StritchMD2011 Member

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    I did mention that it has been mostly discredited, but that it still does pervade the layperson's information about vaccinations. I didn't read that particular study, nor the ones that found data which refuted its findings, however.

    I looked back through MiesVanDerMom's posts, and it appears she likes to chime in with very opinionated posts any time vaccinations are discussed on these boards. I'm not calling her out or anything, but I can't understand her rationale for not vaccinating her child, and furthermore, how she gets around the mandatory vaccinations required by schools.

    I'm sure she'll tell us more about how we're all biased and how vaccinations aren't necessary, though...
     
  28. ForbiddenComma

    ForbiddenComma Tanned for Bowling

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    If it's really true that she refuses to immunize, and if God forbid her children ever become seriously ill with a life-threatening, vaccine-preventable illness such as Hib... then in a more just world, she should be brought up on criminal charges and have her parental rights terminated.

    No, I'm not joking.
     
  29. Sol Rosenberg

    Sol Rosenberg Long Live the New Flesh!
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    I think the HPV vaccine is great, and will voluntarily vaccinate my daughter (when she gets to be the recommended age,) but I think mandating the HPV vaccine is going a bit too far (and, indeed, here in TX is due to Gov. Rick Perry's strong ties to Merck.)

    So long as my family is vaccinated, I don't particularly care if others choose not to. There are other ways to help prevent the spread of HPV (certain forms of birth control are another way) so it's not like other diseases where there are no other realistic alternatives to the vaccine to stop the spread of the disease.

    But, because of my position (I will voluntarily vaccinate against HPV anyway,) I'm not getting too upset by the Governor's decree.
     
  30. Sol Rosenberg

    Sol Rosenberg Long Live the New Flesh!
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    There was a very early "House" episode where House put the smack-dab down on a parent that refused to vaccinate. My wife and I were literally cheering him on during the whole thing, becuase we find the "anti-vaxers" to be irresponsible to the point of negligence, as well.

    (Like I said in my previous post, I think HPV, as an STD, is a bit different, however.)
     
  31. TMP-SMX

    TMP-SMX Senior Member
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    Diptheria is on the rise for a reason. Children are no longer being immunized for it because some do fear the link to autism.

    As for the people claiming that sanitation is the only reason for the reduction in many diseases. Of course it's a huge benefit, but there are a lot of organisms we have no long-term vaccine for such as many bacteria in the enterobacteriacaea like E. coli and Salmonella. The reasonn salmonella has been reduced in the US population is of course water sanitation. However, there are certain organisms like Giardia that can't be touched by chlorine so there needs to be other forms of defense. Smallpox and polio have mostly been eradicated because of the vaccine.

    Then again, with all the histeria about spinach and peanut butter it seems to me that there should be other ways of getting defense from microbes besides trusting the food industry to police themselves. Vaccines would be great.
     
  32. lilnoelle

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    All you have to do is sign a paper saying you are against vaccinations to get around the vaccination requirement for schools. Then if there is some sort of outbreak in the city, your children can not attend school until it resolves.
    (as far as my understanding)

    While my children are vaccinated, I support the right of the parent to make such decisions and perhaps the reason Mies reacts strongly to this type of thing is because everyone seems to attack an individuals 1)education and 2) parenting when they are simply doing what they believe is right for their children. While it might be bad for our children's health if there was no vaccinations given to children, the occasional parent who refuses is not likely to risk their children or others as long as the population as a whole is vaccinated.

    Note: I haven't done any research concerning the above and am relatively uneducated about it (M1) so don't attack me if I'm obviously wrong.
     
  33. ForbiddenComma

    ForbiddenComma Tanned for Bowling

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    So are the parents who only take their children to faith healers. It does not make them any less ignorant or morally repugnant.

    It is little different than outright physical abuse. Crime of commission vs. crime of omission.
     
  34. Ladyfingers

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    I agree there has to be a limit on how much the government tells you what to do, and therefore with this I think there should be the right to opt out. When it is ok to opt out, I can't say. However I do agree that this seriously puts the kids at risk and I think everyone who is able to be vaccinated should be. If it was simply an opt in program I don't think a lot of poorer individuals would end up getting it (unless it was somehow paid for by the government and they were highly educated about it; yeah right).
     
  35. indo

    indo Feed me a stray cat

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    Well, government intervention should come in the form of laws. In the first situation a crime is being committed so it is clear cut.

    The second one is a bit messy because the kid probably isn't able to defend his or her own liberty independently. The kid isn't really standing on his own principles if he refuses treatment because of the influence his parents have on what he believes. As a country we have decided that kids are able to think for themselves at 18 years old. Until then, mom and dad are in charge. Should the government intervene in order to increase the overall health of our country? Maybe. Who decides what situations call for government intervention? Well, we could pass a law and fox news could cover the court case of the family that is suing for the right to not be forced to act against their beliefs...more wasted money. Can you imagine what would happen if we forced Christians to sin for the sake of public health until they were 18? Then, at 18 the government said, "Okay, feel free to stop sinning whenever you want now that you're 18." They would collectively shart and I wouldn't be all that suprised if most of the government was assassinated.

    So, to me, the only option is to arm people with as much information as possible and then let them make their own decisions. Where this becomes sticky is when various groups begin tainting the flow of information with bias. For example, Catholics want sex to be associated with sin and pain and burning in hell. So, why would we want to promote a drug that tries to prevent God from punishing fornicators? Or, maybe Pfizer decides to publish only the one study that shows that the drug is effective while the other 10 studies that show no statistical effectiveness go unpublished.

    If we're going to use an approach to public heath that is so penetratingly utilitarian that we take away personal choice I suggest sterilization. To me, the way to get dumb people, or whomever the target is, to stop having children, or whatever the undesired action is, is to convince them that it is in their best interests to not have more kids. Then, they make the choice to have more kids or not to have more kids based on information they're armed with. Similarly, in 2007, abortion should have long since gone the way of the Apple IIe. It should be a non-issue because birth control and safe sex should be well promoted.

    The end result will be that Americans that are paying attention should be pissed that they are REQUIRED to get their daughters vaccinated but realize that there appears to be good data supporting the vaccination.


    side note:
    The problem with calling other people's reasons illogical is that logic regarding beliefs is almost entirely subjective. Religous extremists think that everyone else's beliefs are illogical. Who is right? Me. Prove that my religious beliefs are wrong and yours are right. Or, since we're all scientists, prove the theory that my religion is wrong, right (H null).

    Didn't jesus walk on water? Well, that is physically impossible.
     
  36. lilnoelle

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    I would have to agree, however, I would still try to convince the parent to use medical resources in addition to religious resources.

    My grandma (45 at the time) died from breast cancer and left 9 children because she refused to recieve medical attention for religious reasons.

    It would be very sad for a child to die from something preventable simply because the parent decided not to intervene, however, these decisions are complicated, and perhaps it is the person who is most intimate with the decision (the parent) who should make the decision.
     
  37. Law2Doc

    Law2Doc 5K+ Member
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    Not all jurisdictions allow you to opt out of the vaccine if your kids want to attend public school, so there's a lot of the country that doesn't get that sign a form option.

    As for the notion that the occaisional parent's refusal not putting the population at risk, you have to realize that vaccines work by having a sizeable percentage of the "herd" vaccinated. The more people that opt out, the more the herd is jeopardized. The people that opt out are "using" the rest of us. And maybe next year more of the rest of us will opt out too. And so on. Pretty soon we are all screwed. (This has apparently already happened in some states, resulting in various outbreaks of childhood illnesses for which there are vaccines).
     
  38. lilnoelle

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    As mentioned before, my children are vaccinated, but I seriously hope that my school's district allows for that option because my daughters medical records are nowhere to be found because my daughters first pediatrician went AWOL. (even the state health department can't find her)

    It would be ridiculous to vaccinate my daughter again (believe it or not, I've had people advise me to do just that) and it will be very costly for me to have blood titer's done on her to prove her previous vaccinations.

    Though I may still have problems getting my daughter's vaccinated down the road because it is likely that her pediatrician will require her previous records in order to give her further vaccinations. What a mess.

    I know this thread has gone a little off topic. I haven't decided what I think about the HPV vaccination yet (I am one of those parents who wants to believe her children will wait till marriage as I did) but I imagine when it comes to that point, she'll probably get the vaccination.
     
  39. Tired

    Tired Fading away

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    Think recent outbreaks of whooping cough in Colorado, among other places.

    The difference with HPV, of course, is the mode of transmission. Historically our "mandatory" vaccines have been against pathogens that are spread through casual contact, and so the state interest in preventing these diseases in school settings is obviously compelling. To date, I am unaware of any "epidemics" of HPV in school-age children. And although there are undoubtedly "silent" epidemics in many populations, they lack the immediate shock value of other public health emergencies.

    I feel nervous when people start talking about making HPV vaccination mandatory. Those of my political persuassion frequently seem very comfortable in substituting their own judgement for that of children's parents. Personally, I need a little more than "they just don't want to accept that their kids will have sex anyway".
     
  40. 45408

    45408 aw buddy

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    whoa, I didn't think you posted anything over 3-4 sentences. :D
     
  41. Critical Mass

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    Just to throw this out there for the sake of completeness, a condom is not effective in preventing the spread of HPV. A young lady can give her companion a hand job and then touch her lady parts for instance. I think that the rate of transmission for HPV's is not significantly decreased with a latex barrier. Sign me up for some latex boxer briefs!

    Also, I don't think that there is a movement to make an vaccine HPV for men.

    HPV is a marker for sexual activity. I don't consider it to be a disease (or an STD for that matter) unless symptoms present. Therein lies society's problem with understanding the issue.
     
  42. angel03

    angel03 Member

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    Isn't Hep B transmitted as an STD? In Florida that is a vaccination that is requird, so i don't really understand the uproar with the HPV vaccine when the Hep B one is the same idea.

    Although I could be completely wrong about this.
     
  43. Law2Doc

    Law2Doc 5K+ Member
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    There are many people walking around with STD's (or a whole host of diseases, for that matter) who are asymptomatic. A lack of symptoms does not mean you are not carrying a disease that may ultimately cause symptoms in you or others. HPV is a virus (hence the name) not a marker, and is not something you ignore because of its connection with cancer.
     
  44. Critical Mass

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    If I am carrying chlamydia that never hurts me, then I wouldn't consider that a disease either.

    True, HPV is a virus, but how many other viruses do we carry that never cause disease in an immunocompetent host?
     
  45. Tired

    Tired Fading away

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    You're essentially correct, although remember that HBV vaccine was added to the childhood series because of mother-to-child transmission. Neonatal HBV is devastating, and easily prevented with a vaccine series, the first dose given at day 1 of life. There is also theoretical transmission of HBV through any exposure of body fluid on broken skin, and the virus is carried in the blood and saliva. This at least raises the possibility of transmission in sports, which HPV does not have.

    Is Hep B required for school attendence? If it is, that's new, because I didn't get the series until I was going to college, and I went to a public school.
     
  46. Tired

    Tired Fading away

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    The viruses you are talking about (chlamydia and HPV) do cause pathology, although they are clinically silent. HPV results in dysplasia/metaplasia (although admittedly this reverses in most people spontaneously). Chlamydia, at least in some people, will result in low grade chronic inflammation that can cause fallopian tube scarring, eventual FHC/PID, chronic urethritis, etc.

    I'm a little suspicious of the "no symptoms = no disease" since early cancer also seems to fit this bill.
     
  47. Critical Mass

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    I am willing to agree with Tired and L2D, but I am also in favor of changing the way we name these things to pull the stigma away from them given their prevalence.

    I have grown tired of fighting with people over the issue of encountering HPV's nearly every time you have sexual contact with a non-virgin. That's why I want to stop calling it a disease--sexually-associated infection I'm okay with, but people need to realize that they have probably come into contact with the virus whether or not they will ever be aware of it.
     
  48. Law2Doc

    Law2Doc 5K+ Member
    Physician Moderator Emeritus

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    Your dates probably would tend to disagree.

    As Tired hinted at, the early stage of many diseases is asymptomatic. Doesn't mean it isn't yet a disease.
     
  49. Critical Mass

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    Where I live, they are making it a moral issue, and I don't really think that it is one. This is why I am in favor of calling it a marker since in most cases nothing ever happens when you become infected with HPV.

    To me, genital warts is a "disease." Cervical cancer is a "disease." HPV infection in general? To me that's just like saying I had sex with a non-virgin.

    Just out of curiosity, how often does chlamydia hurt men? (Just wondering about the strength of my analogy.)
     
  50. lord_jeebus

    lord_jeebus 和魂洋才
    Moderator Physician

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    Of course there is; Merck would love to double their sales
     
  51. Critical Mass

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    You got me there. I guess what I meant to say is that I don't think that the current vaccine has yet been shown to be effective in men.

    Sign me up when efficacy has been established. :thumbup:
     
  52. indo

    indo Feed me a stray cat

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    hah. New medication.

    Actually I've been sleeping like a normal person for the last week and the fog is starting to lift.
     

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