Is 20-Something Too Late For A Guy To Get The HPV Vaccine?

A generation of young men missed out on the HPV vaccine. Now, Side Effects Public Media's 29-year-old correspondent wonders if that’s putting him at risk.

Sex with someone new has always made me nervous. And now, TV is making is making it even worse.

I keep seeing scary ads featuring young people asking their parents why they didn’t get the vaccine to protect against the human papillomavirus, or HPV.  If you’re unfamiliar with HPV, it’s a sexually transmitted infection and it has been linked to various cancers, including cervical cancer.

I didn’t get vaccinated. So lately I’ve been wondering, now that I’m 29 and single again: Is it too late for me to get the vaccine?

I found out about HPV in 2008 from a college girlfriend. Back then, the Centers for Disease Control and Prevention only recommended the vaccine for girls and young women between the ages 11 and 26. The earlier the better, they said, to try to reach girls before they became sexually active. The vaccine is also more effective at a younger age.

At the time, I remember thinking that limiting it to females was strange — after all, men still spread HPV, right? But I didn’t worry that much. My understanding was that, since I didn’t have a cervix, HPV couldn’t hurt me.  

Wrong. HPV absolutely affects men. It causes genital warts and is pulling past tobacco and alcohol as a leading cause of cancers in the back of the mouth and throat, the area called the oropharynx. The CDC now estimates about 70 percent of all oropharyngeal cancers may be caused by HPV, including roughly 12,600 cases in men each year.

“There are now more oropharynx cancers in men in the United States each year than there are cervical cancers in women,” says Erich Sturgis, a surgeon and researcher at the MD Anderson Cancer Center in Houston.

And there’s no way to screen for oropharyngeal cancer, so Sturgis says most people catch it late.

“Typically it’s a man, while he’s shaving he notices a lump in his neck,” says Sturgis. “That means it’s already a cancer that has spread.”

HPV also puts men at a risk for cancers of the anus and penis. Those are rare, but still...

So, for men like me who missed the vaccine, is it still worth it?

The answer is complicated. In 2011, the CDC began recommending the vaccine for males ages 11 through 21 (26 for some high-risk groups).

I was too old for the vaccine by the time the CDC began recommending it for men. But researchers I talked to said the vaccine could still help, if I haven’t already been exposed.

An estimated 80 percent of sexually active people will be exposed to HPV by the age of 45. For men, there’s no commercially available test to find out if you have been exposed. (Women can be checked for HPV exposure as part of a Pap test.)

Eighty percent of the population sounds bleak, but there’s a caveat: “There are several dozen types of HPV that infect the genital region,” says Greg Zimet, co-director of the Center for HPV Research in Indianapolis. Just a fraction of those cause cancer or warts, and the latest version of the vaccine Gardasil protects against nine of those HPV types, the ones responsible for vast majority of HPV-related problems.

So let’s say — hypothetically — you’re kind of shy around women and haven’t had that many partners. Is it possible you’ve been spared?

“The chances you’ve been exposed to all nine types are actually vanishingly small,” says John Schiller, a researcher with the National Cancer Institute.

Schiller says the vaccine might not be a bad idea for someone outside the CDC’s recommended age range, but it’s not cheap. “You’re past the age where your health insurance is going to pay for it,” says Schiller, so he says it’s a personal decision. “Peace of mind for you may be worth more than it is for some other people.”

The CDC currently recommends three doses. At $130 a dose out-of-pocket, getting vaccinated against HPV is going to cost me more than a few very nice dinners out.

Even though I’m past the CDC’s recommended age, and even though the price is steep, I asked my doctor to give me the vaccine. It could help me, even if it just calms my anxious inner voice. And it might keep me from spreading the virus to someone else.

Side Effects Public Media is a health reporting collaborative based at WFYI in Indianapolis. Jake Harper can be reached at 317-614-0482 or jharper@wfyi.org. Follow him on Twitter: @jkhrpr.