[Question #196] Gardasil Advice

112 months ago

I’m old (late sixty-something). I’ve been in a relationship with only one lady involving uncovered vaginal intercourse and oral sex. She had several partners before me. The relationship is over and now I want to see other women. I may be a rare bird, but I would like to ask how useful it would be to get vaccinated with Gardasil 9 at my age. I wouldn’t want cancer-causing HPV myself or to give it to partners.

How likely is it that I have the dangerous strains of HPV considering my limited conservative history? I assume my immune system would react in a helpful way to the vaccine at my age, is that true? Bottom line, how advisable is it to be vaccinated with Gardasil 9 now? Is it worth it?

BTW, big thanks to all the people who make this web site possible. You educate way more people than just the people who post here and the site is one of the best things on the web.

H. Hunter Handsfield, MD

112 months ago

Welcome to the forum. Thanks for your question. Thanks also for your vote of confidence about our services.

I would not recommend HPV vaccination for you. First, assuming you've had other sex partners in your life, you've undoubtedly already been infected with HPV types, probably more than once -- and you would not be further protected against those virus strains. That your recent partner had "several" other partners does not significantly increase your risk. Second, the effectiveness of the vaccine has not been studied at your age. While I agree it is likely that your immune system would respond to the vaccine, it's not a guarantee. The response to the vaccine -- i.e. the amount of anti-HPV antibody produced by the immune system -- is strongest at age 9-11, somewhat less so in teens, and still lower at age 20-26. It's hard to say what the response would be at your age. But even if highly effective, the chance you will get a new HPV infection at your age -- even if you have several new sex partners going forward -- is quite low.

Finally, vaccination now would do nothing against HPV if you are already infected, i.e. would not protect against any HPV that your recent partner might have had. It's too late for that; you would have had to be immunized before that relationship started, or at least while it was underway. Afterward is useless.

Having said all that, the vaccine certainly would be harmless, and if you can convince your doctor to immunize you, feel free. But I honestly don't think it's worth the cost, probably around $500 for the three doses, and probably not covered by health insurance, since the recommended cut-off is age 26.

I hope this has helped. Best wishes-- HHH, MD

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112 months ago

Thank you for the reply. However, my partner was the only one I’ve ever had intercourse with. (told you I was an rare bird) She did have several partners before we began our monogamous relationship though. Does that change your opinion?

H. Hunter Handsfield, MD

112 months ago

No, it doesn't change my opinion. If you happen to have been infected with HPV from your recent relationship, vaccination now will make no difference. It doesn't help established infections, only prevents future ones. Given your admittedly unusual sexual history, if you are likely to have several sex partners going forward, Gardasil might protect you from future HPV infections. But still the benefit to you, or to future partenrs, would be quite minor. I still don't recommend immunization.---

112 months ago

Dr. Handsfield,
Thank you very much for your response and your expertise!

H. Hunter Handsfield, MD

112 months ago

You're welcome. I'm glad we could help.---