not to have known that HPV vaccine could be beneficial at my age (45)?

[hpvandme]

I’m 45 and have just had an abnormal smear result, showing high risk HPV and low grade dyskyasosis/ CIN 1. I’ve never had an abnormal smear before. I didn’t know that there is a peri/menopause ‘spike’ in HPV, and that this can come from either reactivation of an old infection or a new infection/reinfection.

In my case, it feels very likely that it’s the latter (married for 20 years, now divorced, one new sexual partner post-divorce). One study I read said that while it is very difficult to establish whether HPV is a new infection or reactivation, when it appears in older women there is a strong link with new partners. pmc.ncbi.nlm.nih.gov/articles/PMC4068337/#S9

The HPV vaccine protects against 9 of the most serious strains of HPV. It can’t protect against a reactivation of a strain but it can protect against reinfection and against infection from strains that you have not encountered previously.

If I’d known all of this a year ago I would 100% have got the HPV vaccine privately before having sex with new partners again. I expect some replies will say that HPV is very common and nothing to worry about – but in a minority of cases it can be very serious indeed and if I’d been making an informed choice, I would have chosen to take the vaccine for the added protection it provides. I just didn’t know how it worked or that I could benefit from it!

I'm posting this in the hope that it might help someone else. (Also, very happy for any experts to correct my explanation above and provide more accurate knowledge)

AIBU not to have known that the HPV vaccine could be beneficial at my age (45)?
Yes you are unreasonable not to have known. Everyone knows this.
No you are not unreasonable. It's news to me too.

@hpvandme I'm not sure why I looked into it. This was before DC were old enough to get the vaccine so I hadn't received any 'prompts'.

I'd lost DH and on reading about the HPV vaccine and if it was 'worth having' before, and in case I met someone else, most of the literature I read was from the USA. I know then have a different criteria for to health insurance etc.

Anyway it boils down to yes I understand most people would have acquired HPV at some point as they age, but as we all know there are many strains of HPV, so it doesn't make sense to say we would have encountered all strains. I think the cut of age of 45 is wrong too. Yes I guess if you're with the one partner for life, it's unlikely to get HPV but not everyone is. I do think it's ageist. They just look at risk and apply it to everyone.

When I went privately, I could have given any date of birth, they have nothing to check it against. They gave me the record of the vaccine if I wanted to send that to my GP.

Oh at that stage it was 3 vaccines as well. At school now they only have one as that's just as effective as three doses. Not sure if that's for all ages.

@Theboymolefoxandhorse thanks for such a detailed reply. I’m not suggesting the NHS vaccination scheme should routinely vaccinate older women.

I also recognise that the study above is not claiming to or able to conclusively state that HPV rates in older women are due to reinfection. I understand that the evidence of whether it is reactivation or new infection is unclear. But that is my point. If there is uncertainty, then there is a clear possibility that new partners create new HPV risk and new cervical cancer risk. And therefore women who have been monogamous for many years but then have new partners should have this information to decide whether or not they want to take the vaccine privately.

As someone else said, women in their 40s will have encountered HPV but presumably they have not encountered all 9 strains covered by the vaccine. So why not protect where you can? I’m shocked that cervical cancer is the fourth most common cancer in women in the UK but actually one where there is action that we can take that might (and yes I recognise it is uncertain) reduce that risk.

The message we are given is that the vaccine is not beneficial after you are sexually active and have been exposed to HPV. But that can’t be true. It’s not AS beneficial but there is at least a possibility that it will still offer some protection. And until there is more conclusive evidence to explain when HPV incidence is a new infection and when it is activation of a dormant infection (and how those might interact) for £360 I would definitely have chosen to take the vaccine.

I just think that more information about the scope of the HPV vaccine could be useful for many older women. If nothing else if more women of that age took the vaccine it would start to generate stronger evidence about its value. Maybe even useful to do a pilot study?

@hpvandmeI just wanted to thank you again for this thread. I've booked in now for the first vaccine (I think I'll need two doses).

I asked my private GP about having it privately, and she said no evidence it is effective in over 35s so no point! Was I misled?!

Thanks for posting this, Op. I also found out a few weeks ago that HPV can be introduced via masturbation (from your hands) and that is one reason why smears are recommended until age 65 even if you are no longer sexually active (the other reason being reactivation of a dormant virus).

Interesting, I asked my gynecologist about it a few years ago (I'm not in the UK) and she said there was no benefit for me.

My younger sister who is early 30s was the first cohort offered this so women aged 35-45 are likely to have been too old to have it the first time around.

Jst bumping this thread, as I am about to book the HPV vaccine (a little over age 45) and found the thread during a search. I am just waiting on a private clinic locally to come back to me to say they will give it to me off licence (I think they will).

I don't have HPV according to last smear, but I only just realised this vaccine is open to adults and so I am bloody well having it. Even if I have to fib about my age to get it.

Anyway, bumping so more eyes see 👀

Thank you for starting this thread. I’ve only just come across it and have ended up down an HPV rabbit hole.

I’ve attended sexual health clinics regularly for years, always had routine STI screening before new partners, and not once was I told that private HPV vaccination is available beyond the school programme. I was even told by the nurse who does my smears that the vaccine isn’t suitable for people over 26. Had I known it was an option, I would absolutely have paid for it years ago.

This feels particularly frustrating given that I had two LLETZ procedures in my early 20s for CIN 2. I cleared that HPV infection long ago, but that doesn’t protect me from reinfection or from other high-risk strains. Having a hot loop of wire taken to my cervix is not an experience I’m keen to repeat.

Condoms don’t reliably prevent HPV, oral transmission is common, and HPV isn’t routinely tested for outside cervical screening. Withholding information about the only form of primary prevention from sexually active adults isn’t informed choice. It’s a systemic failure.

I agree. Before calling a private clinic - who have now booked me in despite being over the age of 45 for £175 - I called my local NHS sexual health clinic. They said they would only give it to women up to age 25. After that age, they only administer it to men who have sex with men.