[Question #2999] Later age HPV vaccination question

40 months ago
I'm recently motivated to receive the Gardasil vaccination series (heterosexual male, older than 26) as I have had only one previous partner and want to minimize future risk where possible. I have not yet had sexual contact with my new potential partner, but am wondering if I should broach delay of sexual activity for a time while following the vaccine schedule. I have not yet started the vaccine series and obviously wish I had completed it at a younger age for it to be a non-issue.  Would you recommend that someone in my position waits as long as possible after starting the series before new exposure to virus? 
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Welcome to the Forum.  Let me start this reply by applauding your decision to get the HPV vaccine.  In your situation it is good both for you and for your future partners.  The age cut offs for HPV vaccination are based on insurance-related calculations that most people will have acquired HPV by age 26 and do not account for persons who accrue sexual partners more slowly.  Further, newer HPV vaccines will cover more HPV types than earlier versions (9 rather than 4).

As far as considering sexual activity with a new partner, there are a number of variables to consider, all of which suggest that if the relationship can accommodate it, discussion with your new potential partner might be a good way forward.  Importantly, has your partner been vaccinated?  Further what about condoms early in the relationship if you decide to have sex- while not perfect, condoms do reduce the risk for acquisition of HPV substantially (50-60%).

Finally, I should point out that if the you decide to delay unprotected sex until the vaccine is effective, nearly everyone has substantial vaccine effect soon after receipt of their 2nd vaccination at 6 months and are protected from acquisition of infection.  The 3rd injection only has slight additional impact and is given in part o assure prolonged protection.

Perhaps some of this information is helpful- I hope so.  If my responses raise new questions or are unclear, please use your up to two follow-up questions to seek clarification.  EWH
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40 months ago
Dr. Hook, 

Thank you for your reply and information. To clarify your comment,  "nearly everyone has substantial vaccine effect soon after receipt of their 2nd vaccination at 6 months and are protected from acquisition of infection" - should the bolded be 2nd vaccination at 2 months? 

Following up to close out my inquiry, I was able to start the vaccine series (older than 26) at a local Planned Parenthood. My PCP and other outpatient clinics that I checked with were not willing to go outside the CDC recommended age ranges. So I've started the series even with possibly minimal benefit at my later age. Better late than never, to my view.

Thank you again.
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Sorry for the typo.  You are correct, it is after the 2nd vaccination at two months that nearly everyone is well protected from infection by the HPV types contained in the vaccine.

I'm sorry your PCP would not work with you on vaccination and am glad the at you are able to overcome this.  EWH
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