Gardasil... Can I get it if I already have HPV?

Dear Seattle, WA,

Kudos to you for inquiring about inoculations (the formal term for vaccinations)! Human papillomavirus (HPV) is the most common sexually transmitted infection in the US. There are over 200 types (known as “strains”), over 40 of which are passed through sexual contact. Some of these strains don’t have symptoms and may go away on their own, while others can cause genital warts and several types of cancer. HPV vaccines protect against certain strains by teaching the immune system to produce antibodies against it — that way, the body knows how to protect those cells from infection in the future. Unfortunately, this means that HPV vaccines can’t treat any existing types of HPV. As far as age goes, it’s recommended that the vaccine be given to at age 11 or 12 years or up to 26 years old if they haven’t yet been vaccinated. While the vaccine is approved by the Food and Drug Administration (FDA) for use in people up to 45 years old, it’s typically not recommended for those over 26 since there’s likely been previous exposure to HPV strains. Given that there are so many variables at play, it’s a good idea to talk with a health care provider about whether the vaccine can protect you and your partner against any other strains you haven’t encountered.

It’s thought that the vaccine is most effective when it’s administered before someone becomes sexually active. That being said, someone who’s already been sexually active may reap some protection against strains to which they haven’t yet been exposed. A person’s prior exposure to HPV and age are some factors a health care provider will consider before administering the HPV vaccine. There are three approved vaccines for HPV (approved age ranges vary a bit between specific vaccines):

• Gardasil protects against HPV types 16 and 18, which cause about 70 percent of cervical cancer cases. It also protects against HPV types 6 and 11, which cause 90 percent of cases of genital warts.
• Gardasil-9 (a newer version of Gardasil) protects against five additional strains that cause approximately 15 percent of cervical cancers and aren’t covered by previously FDA-approved HPV vaccines. Gardasil-9 also has the potential to prevent 90 percent of cervical, vulvar, vaginal, and anal cancers caused by these HPV strains.
• Cervarix is another type of vaccine that protects only against HPV types 16 and 18.

So, what does all this mean for you? Among individuals assigned male at birth, some types of HPV can cause genital warts, while other types can cause penile, anal, or head and neck cancers. The types of HPV that can cause genital warts aren’t the same as the types that can cause cancer. While most individuals assigned male at birth don’t develop symptoms or health problems, it’s also good to keep in mind that for some, HPV may clear on its own within two years. Unfortunately, there aren’t blood tests available to diagnose a person for HPV prior to vaccination for men — generally, patients are diagnosed when visible genital warts appear. While you and your partner may be out of the recommended age range and may already be exposed to HPV, getting the vaccine could still help prevent infection from other types of HPV. Speaking with a health care provider is the best way to figure out which types of HPV you and your partner have been exposed to and if the vaccine may be appropriate for either of you.

If you do have another breakout of genital warts, it’s helpful to plan ahead so you can prevent transmission to other partners. The safest way to prevent transmission is to avoid sexual contact around the areas with warts. Using barrier methods such as condoms and dental dams can help reduce the risk of transmitting HPV but may not eliminate it entirely. This is because HPV can be present on parts of skin not covered by a condom or dental dam. Perhaps this is also an opportunity to talk with your partner and come to an agreement on the potential risks of HPV. Again, compliments to you for your concern about your own health and the health of your partner.