You raise an interesting question and I'm glad to clarify this for you and others who might read this. The quick answer is that the HPV vaccines prevent HPV infection; and because they are nearly 100% effective for prevention of 9 HPV types, they also are nearly 100% effective in preventing disease caused by those types.

Most vaccines are designed primarily to prevent infection, not disease. COVID-19 vaccines were designed to do both. FDA approval was based on disease (severity of illness, hospitalization, death), but from the start they were also intended to prevent infection itself. Media attention has been more on disease prevention rather than infection, and it is natural that this may raise questions about other immunizations, including the HPV vaccines.

The HPV vaccine was designed primiarly to prevent infection. In fact, the HPV vaccine is among the most effective vaccines ever developed in preventing infection:  it is believed to be truly 100% effective in preventing infection with the 9 HPV types covered by the vaccine. And because infection itself is prevented, the vaccine is also believed to be 100% effective against the diseases caused by those HPV types, i.e. genital and anal warts and cancers of the cervix, anus, rectum, penis and pharynx (throat). Together, these 9 types cause around 90% of all HPV disease. But there are over 100 more HPV types that commonly infect the genital and anal areas and are sexually transmitted. There is little or no protection against them, and warts, pre-cancer, and cancer itself still may develop in vaccinated persons. This isn't common, but it happens -- which is why Pap smears still are recommended in vaccinated women.

Another possible aspect of prevention is whether the vaccine protects against transmission to the vaccinated person's sex partners. If vaccinated before becoming infected, the answer is yes:  if someone cannot be infected with a partiuclar vaccine type (say HPV 6, 11, 16 or 18), then his or her partners are also protected. However, the vaccine does not cure established HPV. Someone infected with, say, HPV16 before being immunized might be able to transmit the virus to his or her partners.

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

HHH, MD

1- Just to confirm my understanding....I was infected with genital warts previously and was thinking of getting vaccinated prior to getting married to my GF (We have not had sexual relations yet) for a chance that it would make it less likely to transmit to her.  My understanding from below is that it won't REDUCE  the likelihood of transmission because the virus is already in me.  Is my understanding correct?

2- Last time we spoke....you mentioned that there are studies indicating that the Gardasil-9 (or HPV vaccines in general) may have an unintended therapeutic side in preventing the resurgence of the virus in previously infected individuals.  Has there been anything new on this topic or is it still grey? 

Thanks for your help

Regards,

Your second question partly answers the first. That vaccination may reduce the potential for reactivation of an existing HPV infection (question 2) suggests that it might also reduce the chance of transmission to sex partners (question 1). However, to my knowledge there are no published or reported data on this. So all we can say is that having been vaccinated might help protect your prospective partner from being infected with the HPV strain that caused your past genital warts. The best way for her to be protected is for her to be vaccinated against HPV herself. Since all people should be vaccinated, this is something she should be considering regardless of her past, current, or future sexual lifestyle. But even if she isn't vaccinated, the chance you still have active HPV and would infect her probably is very low, regardless of your vaccination status. If I were in your shoes, I wouldn't worry about this (although I recognize that there may be cultural issues or expectations that differ widely).

Just a final follow-up on this thread.....I did notice a wart on the shaft of the penis recently (previously was in the pubic region) and I just wanted to see if you think this was a case of ''recurring'' wart or if it could be from the original infection.  (Feb 2020 : 4 warts then December 2020 : 1 wart then November 2021 1 wart)

I would always advise professonal in-person care for a suspected genital warts. If your previous diagnosis (February) was definite and the present one looks typical, then presumably your self-diagnosis is correct. That said, genital warts usually do not involve the pubic area, and there are many other kinds of skin bumps. So if that episode wasn't professionally diagnosed, I would advise you see a doctor about the current penlie lesion and follow his or her advice. The chance it's malignant is very low, if it looks like a typical wart.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.