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HPV Vaccine Expanded to Include Ages 27-45

October 09, 2018 by Dr. Evan Goldstein

Client’s Tale

Dude, my life sucked for a full year. It started after I was rimmed and from then on, I started developing some bumps on my asshole. The rimming felt fucking awesome, but when I found out the bumps were actually anal warts from the Human Papilloma Virus (HPV), my viewpoint quickly changed. My primary care physician started some external treatments in the office with limited success and then added some external creams. That was when it fucking bloomed and my hole suddenly resembled a cauliflower. I was then sent to a dermatologist to freeze off the lesions. These in-office procedures did start to make some dent, but at the end of the day it’s still f-r-e-e-z-i-n-g your fucking ass off. It hurt like a bitch and you have to go back and back and back until it takes over your entire life. Finally, after 6 months, my doctor and I noticed some obvious improvement, but the warts were still evident. I was so frustrated and decided to Google around for a better approach.

In all the months of this saga, no one mentioned to have a full internal evaluation. I found Dr. Goldstein at Bespoke Surgical, who did a comprehensive internal and external examination and ended up finding significant internal lesions. From what he told me, without complete eradication, one can have recurrence month after month with no end in sight. I was also told that getting the HPV vaccine would not apply to me, since I was older than the required 26 years of age or younger, and because I was already exposed to it. But through Dr. Goldstein, not only did he eradicate both internal and external anal warts in one go in an operating room (sleepy and comfortable without pain, until after the local anesthetic wears off, that’s for sure), but also he was a huge proponent of getting the Gardasil vaccine, despite my age. I did have to pay out of pocket at the time, but it totally made sense for its beneficial effects. Another important tip was to get my partner(s) fully checked, in and out. My primary partner did have internal warts as well and seems as if we were playing the back and forth ping pong game. Finally, after many months, and now full evaluation and treatment with all the appropriate management being laid out, I can say that I am clear of anal warts. I still pop into the office every 3-6 months for a full check up. I do not want these fucking things again!

My Discussion

I told you so. Finally, after years of me sounding like a broken record and being a huge advocate for receiving the Gardasil vaccine (whether you’re under or over the age of 26 and whether or not one has previously had anal warts), CNN reported that the FDA approved a supplemental application for Gardasil 9 expanding the approved use of the vaccine to include women and men aged 27 through 45 years. Why is this monumental? Well, according to the CDC, every year about 14 million Americans become infected with HPV and Gardasil 9 prevents certain cancers and diseases caused by the nine HPV types covered by the vaccine.

The Centers for Disease Control and Prevention has stated that HPV vaccination prior to becoming infected with the HPV types covered by the vaccine has the potential to prevent more than 90 percent of these cancers from ever developing. Simply put: Gardasil is a game changer.

Although most of the substantiating data is from female centered studies, the effectiveness of Gardasil 9 in men 27 through 45 years of age is inferred from that and immunogenicity data from a clinical trial in which 150 men, 27 through 45 years of age, received a 3-dose regimen of Gardasil over 6 months. Anecdotally, as well, after one receives the full vaccination series, it has been documented to not only have protective effects on contracting any future subtypes, but also can indeed decrease the sequelae of the HPV subtypes one already possesses decreasing anal wart recurrence and/or the development of cancerous changes.

The Gardasil vaccine is beyond safe with limited reported adverse reactions, such as injection site pain, swelling, redness, and headaches.

With the FDA granting approval, it’s a landmark event for our community (and beyond). Clearly, analyzing our community with appropriate studies to evaluate anal warts and HPV ramifications has been and will continue to be limited. Though with several key players, institutions, and organizations, like Bespoke Surgical, we can now spearhead appropriate data acquisition to help improve the quality of life for our community. Intuitively, one would think that the vaccine would protect those who don’t have it already and the random age of 26 as the determining factor to acquiring the vaccine wound up being bullshit. Somehow, I do think that number was more spearheaded by the insurance world to limit the financial burden. Regardless, this new FDA approval and requirement will align with where European nations have been for quite some time already.

So if you have not gotten your vaccine and are under the age of 46, please call on your primary care physicians or us at Bespoke Surgical to start your three shot series. It is within 1, 3, and 6 months from the initial injection. I do caution that since this a new ruling, it may take some time for all insurances to adopt this new policy. That said, before you make an appointment, I strongly urge you to call your insurance for approval. But in a few months time, I am sure this will be a standard part of everyone’s vaccine routine. It has been part of mine for years and now I am happy to see it’s official and mainstream. Now onto approval for all men, specifically in the gay and bottoming world, who are the most afflicted by its consequences.

Stay in touch on Instagram: me and Bespoke Surgical.

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About the Author

Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical. Dr. Goldstein has extensive experience educating and shedding light on health care issues relating to the gay community, and has been published in several national publications including The Advocate, OUT Magazine, Vice, Refinery 29, NY Mag and more.

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