I have a question regarding inoculation. For context, I have genital warts, presumably a low risk strain. I have tested negative for all HPV types via Pap smear. Nonetheless, I took all three gardisil 9 shots following my diagnosis. I have read a great deal of anecdotal information regarding shaving and the risk of spreading the infection via micro cuts in the skin. I’m struggling with this concept. If I am vaccinated, wouldn’t my body then recognize and eradicate any infection newly introduced to any area, either via shaving, sexual inter course, or any other means of inoculation? 

First, I'm glad the inflammatory reaction (infection?) to your treatment apparently is no longer an issue. It's also good to be reminded you have been vaccinated. Your question about spread of your existing (probably resolving) infection -- probably HPV type 6 or 11, which cause almost 90% of genital warts -- is insightful and sophisticated. Both the question and some aspects of your writing suggest you might have some health care training (?).

You are correct that the vaccine, and probably equally or more more important, the immune response to your existing infection, should prevent new infection with the same HPV types. And that in turn implies that auto-inoculation (self spread of a current infection to a new body area) should be uncommon or not occur at all. And probably it doesn't. For example, even though the oral cavity is susceptible to HPV, and even though all human beings often contact their mouths with their fingers after touching their genitals (usually unconsciously), it is believed to be uncommon for someone genital HPV to infect their mouth and throat.

The same reasoning suggests that local spread of HPV, like by scratching or shaving, also should be rare. And probably it is. Despite the "anecdotal information" you cite, I am unaware of any data that this actually happens. (It is crucial to not rely on "Dr. Google" and on websites by and for people with a particular problem, like Reddit for example.) Certainly new warts can appear in the general area in the first weeks or months after appearance of genital warts, but that probably is mostly due to the initial inoculation and early spread along the skin, before immunity is maximal. To the extent auto-inoculation sometimes may occur, it seems likely to also be limited to early infection before immunity is fully developed. That's not to say later auto-inoculation is impossible -- we simply have no good data -- and so it's reasonable to warn patients with genital warts to try to remember to not scratch and to hold off a few months on shaving the area. But I doubt it makes any difference.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Thank you, Doctor. I was instinctively inclined to agree with your assertion regarding this matter.

I also appreciate your support concerning my inflammatory infection. Indeed, the symptoms subsided upon discontinuing the Veregen; however, the warts persist, and I have encountered significant difficulty in locating a knowledgeable physician experienced in treating HPV. Consequently, my path forward remains uncertain at this time.

Lastly, I have no formal medical training. I am merely an enthusiast with a viral infection, who enjoys delving into medical literature, journals, research papers, etc. to gain a better understanding of this virus.

Thank you once again for the invaluable service you provide.