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Health

Should People Over 26 Get the HPV Vaccine?

If you’re over the recommended age, it might be a difficult and expensive process, but it also might be worth it.

Sometimes you have a sex question that's not just, you know, an idle passing thought. And in those times you need a real answer—one that's based on deep research and scientific rigor. In those times you need Hard Data. The human papillomavirus (HPV) is one of the most common sexually transmitted infections in the world. It's also one of the most feared, due to mounting evidence showing links between HPV and cancers of the cervix, throat, anus, and penis. Fortunately, scientists have developed a vaccine that protects both men and women against some of the most dangerous strains of HPV. For maximum protection, you should get the vaccine before becoming sexually active—ideally, around age 11 or 12. However, vaccination is still recommended by the FDA (and typically covered by insurance) for anyone up to age 26.

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But what if—like me—you're older than 26? Can you—and should you—still consider getting it?

I've been pondering this myself ever since the HPV vaccine was made available to men in 2009. I wasn't within the recommend age guidelines then, and I'm certainly not now. However, over-26ers can still get it—in fact, I got it myself earlier this year. I found the process to be somewhat difficult and expensive and, unfortunately, there was no way to know how much protection the vaccine was actually going to give me; however, I think it was worthwhile. Here's why, along with everything else you need to know about getting this vaccine past age 26.

Regardless of age, you'll probably still get at least a little protection.
The current version of the HPV vaccine covers nine different strains of the virus. The odds of having been exposed to every single one of these strains is low, even among people who have had several sexual partners. Obviously, the fewer partners you've had, the more you stand to gain in terms of protection; however, the average person is likely to experience at least a small protective benefit.

Sadly, it's impossible to know precisely how much benefit you'll get because we don't currently have an HPV test for men and, while there is a test for women, it's pretty limited because it can only diagnose HPV infections of the cervix.

It's worth considering, even if you're in a monogamous relationship.
You and your current partner might be monogamous, but this doesn't necessarily mean that you should forego the HPV vaccine. Monogamy doesn't guarantee sexual health because we know that a lot of people end up cheating and, further, that cheaters aren't very good about practicing safe sex. Not only that, but if your relationship doesn't last forever, getting vaccinated could protect you if you ever end up back on the dating market.

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It's safe to get, regardless of age.
When getting any vaccine, there's always a risk of side effects; however, most of them are mild and temporary. This is true of the HPV vaccine, too—it doesn't pose greater risk than other vaccines, and it certainly doesn't cause mental retardation, as US Congresswoman Michele Bachmann erroneously claimed in 2011. Also, even if you've already been infected with HPV, the vaccine won't hurt you.

The reason this vaccine is only recommended for people under 26 has nothing to do with safety. In fact, we know it's safe for older folks because, in some countries—including Australia—this vaccine is recommended up to age 45, at least for women.

It's not cheap.
Most insurance companies won't cover the cost of the HPV vaccine if you're over the recommended age. Unfortunately, this means a significant out-of-pocket expense, as in a series of threes shots that cost $150-200 each. In total, I spent just over $600 for mine. That hurt more than the shots themselves.

The price tag of this vaccine is why it's only covered by insurance for people under 26. Because it's not economically feasible to give a $600 vaccine to everyone, federal regulators established guidelines that prioritized protecting those at the highest risk of infection. This is the same reason behind why the expensive HIV-preventative drug regimen PrEP is only recommended for a few narrow subgroups of the population—it's just not cost-effective otherwise.

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Remember that these recommendations are designed to maximize public health at minimal cost. They aren't necessarily in the best interest of each individual.

You might need to shop around.
When I went to get my vaccine, I found it to be a complicated process because if you're over the recommended age and, therefore, receiving the shots "off label," not every medical provider will administer it.

For example, I called three different Planned Parenthood locations only to hear that their policy was not to provide this vaccine to anyone over 26. A different STI clinic told me the same thing.

The way I ultimately got the vaccine was by going to a clinic at a local drugstore. Although they gave me the first two injections without hesitation, the nurse who administered the third and final shot exclaimed the following when I told her why I was there: "But you're so old!" That made me feel great.

She eventually agreed to give me the shot after I told her what I had written for this article. Incidentally, while I was receiving my injection, we had a conversation about a class she was thinking about taking on how to become a dominatrix (these are the kinds of conversations people strike up when they find out I'm a sex researcher).

Despite the hassle, expense, and insult I endured in the process of getting the HPV vaccine, I'm glad to have done it. Again, I'll probably never know how much protection I got from it—if any—but at the very least, I hope that by sharing this information, others who are over 26 will at least recognize that vaccination is still possible and consider whether it's right for them. A lot of over-26ers would benefit—if only they realized they could give it a shot.