Is this true? I have seen a question like this:

Does vaccination protect the unexposed region from the same type of HPV if one has a genital exposure, but not oral, or vice versa?

I could not find info on this, now if I were knowledgeable on all the mechanisms behind HPV, this seems like it has an obvious answer, but I am not. I only know that oral HPV without the visible lesion is not easily transmittable, that HPV-16 is nearly all of oral HPVs. I wondered, HPV-16 is the most common, if I were to be exposed genitally, but not orally, would Gardasil or similar vaccine protect me orally? Or once the virus entered your system somewhere, at that moment, vaccination cannot help, so vaccinating will protect me from everything else that it covers, but not HPV-16, regardless the location.

Is question legitimate? If this was true, it might mean that if you are clear at the genital region, you are also clear in the mouth region if we are talking about HPV-16 for example, for one particular type.

Respectfully, you are asking about things here that you have no control over, and will likely never impact your life. Remember that the data after many years shows that only about .9% of the American population will have a non resolving HPV infection that cascades into a cancer. That makes your risk in all this very low and not worthy of changing your sexual life.

I will answer one of your questions tonight. Condoms do provide good but not perfect protection. As a male there is always an area around the base of the penis that is not covered. This will come in contact with your partner. That area is not at risk for cancer but genital warts caused by HPV. As to the types of testing you are referring to, those are generally not available to the public, used mostly by researchers, and are wildly expensive.

Each day I get between 15-25 emails from oral cancer patients, most who are in difficult situations or needing information about immunotherapy’s that are still in clinical trials. I need to devote my time to actual patients and care givers, so I won’t right now be able to get into the minutiae of your questions, which the answers to will not impact your life. I hope you do not find this rude, but in the next few weeks if time permits I will try to answer you a bit more.

Your can set your account to email you when anyone posts a reply to your thread. Please do that and in the hopefully near future I will reply further. If it makes you feel more secure there is no harm in getting vaccinated, millions have without issue. But in general I do not advise it to most people that have had a few sex partners. HPV is without question the most common sexually transmitted infection and pretty much every sexually active person will be infected at some point. You probably already have been and your immune system has taken care of it without any signs or symptoms of the event.

Welcome to the support group. OCF has been involved in the research of the oral aspects of HPV infections since 1999 when a research collaborator of ours Dr. Maura Gillison first laid out the evidence that HPV was driving the rapid growth in oral cancers, specifically oropharyngeal cancers. So from a science perspective, this has been historically one of the foundations strengths. There is a ton of information on our main web site about all this both our writings and also lots if links to the solid information the CDC and others have put out. That section of our site is at this link

https://oralcancerfoundation.org/understanding/hpv/

There are also the full science articles as published in respected peer reviewed science journals for those that want to get every detail in the research section of our web site in chronological order as they were funded, understood, and published if someone really wants to understand things at that level.

https://oralcancerfoundation.org/research/

So to your specific question. HPV is not a systemic infection. It does not travel from the cervical area for instance to the oral environment through some pathway or mechanism in your body. Each site that is known to be vulnerable to infection requires it’s own exposure.

Testing positive for HPV in a cervical exam is not a predictor that you will get oral or oropharynx HPV etiology cancer. But it is possible to pass the virus to a sexual partner while that infection is active. The important thing to remember is that the vast majority of men and women that get an active infection DO NOT subsequently get a cancer from it. The virus is ubiquitous in our world. Pretty much everyone that is sexually active will get an infection early in their sexual lives mostly in their teens and twenties. But 99% of those that get infected will have an immune system that will recognize this threat and destroy the infection. Only about 1% of individuals have an immune system that will fail to recognize it and then it will ultimately over many years, decades even in oropharynx cancer, prosper into an actual malignancy.

With the changing of sexual behaviors that occurred starting in the 1960s, this became an increasing problem particularly in oropharynx cancers. The increasing trend line of higher incidence rates continued and for several decades went unabated. That was until the introduction of a safe an effective vaccine that prevented the main versions of the virus particularly hpv16 from ever getting a foothold in vaccinated children. That was 2006. Several years later the vaccine was improved to cover even more oncogenic versions of the virus. Studies today particularly in cervical, show its effectiveness as the incidence rate of cervical cancers has declined. That has not been seen in head and neck cancers yet, though they will ultimately decline as well, because if the many decades long latency period of oropharynx cancers. The vaccines impact is systemic and protects all areas . Essentially if you cannot get the infection, you cannot get any of the hpv cancers.

So your second question. Remember that most people who get the infection have an immune system that will clear it. No matter how many times they are infected. Most do not even know they have been infected, as there are no outward symptoms, so you will get it, clear it, and never know that you had the infection. Women who get tested for hpv during cervical exams can test positive on and off during their lives depending on the timing of infection and testing. That does not mean that they will get cancer. The ones that test positive and continue to weeks and months later, have persistent infections and are the ones at risk.

There is no good HPV testing mechanism for men. For us that is a problem as it can exist for decades in us asymptomatically until the cancer develops if we do not clear it naturally.

Getting vaccinated after a number of sexual partners that may have infected you unknowingly has decreasing value as you age and have more partners. For sure the versions that you have not been infected with, and also are lesser threats, you will be protected from. This is why it is so important to vaccinate our kids before their sexual debut. Parents don’t like to hear this, but that is usually before the age of 13 when experimentation related to sex occurs, so between 10 and 12 years old is the recommended age. There doesn’t appear, now with many years of data, that the vaccine wanes in effectiveness so there are no boosters required.

One more point - there are no visible HPV lesions, only visible early cancers. So testing is your only course of discovery. If you have ever tested positive for the most dangerous one version 16, and you have had since that positive test no development of pre cancers changes to your cervix it would be safe to assume that you have a robust immune system that has protected you, and has left immune B cells behind to rapidly detect any new infection so that it will be dealt with.

I’ve lectured on this at universities and medical dental professional society meetings for many years. Most of those presentations were four hours long. There a lot of little details about all this that are interesting. Doctors, not average people, need to know all that. If between what I am posting today and the website pages that are vetted information did not cover what you want to know please ask more and I and others will try to get you the right information.

I do not know the answer to your question about the Covid vaccine. What I know about it is only like most people, what I learn from the news stations. I went and got all three of the Moderna shots as soon as I was eligible. I think that your priority should be to get vaccinated and when ready booster shots for Covid without delay. That is more of an immediate and present day danger to you. Asking your medical professionals about when after that they felt hpv vaccination was ok would be better information than I can offer you.

I too am scientifically curious, and I think that makes you and I more alike than different. I read science journals all the time, or other books and items that inform me about something, less novels for entertainment. Your questions are not a bad thing, I just have to put some patients ahead as I am sure you understand. Be well.

First to reiterate, there are no visible HPV lesions. There are cascade lesions like precancerous tissue changes, those are something more now than HPV. So there is nothing to see to tell you it’s there. Testing is a blind superficial swab or a more effective brush cytology cell collection commonly used in cervical. Bush cytology works very well in cervical, and since its introduction in the early 1950s is responsible for the dramatic drop in the death rate from cervical cancer. It is also a blind collection of cells, and as it is an abrasive collection of cells, it is nothing like swab collection. The idea works in cervical because it’s a relatively small area, unlike the oropharynx which is a huge amount of territory to scrape cells from, especially for a cancer that is not on the superficial tissues.,.

Abrasive brush collection of cells and then the following pathology to look at them under a microscope has many positives. It’s inexpensive, it collects a large number of cells from a specific area, so the pathologist has a decent sampling for a screening exam, but not as much information as from a real incisional or punch biopsy. A company tried to market brush cytology to the dental community for several years as an alternative to conventional biopsy, but failed. Part of their logic was that since general dentists are disinclined to do biopsies (ugh blood, eek), they might do this instead on visible lesions and catch early precancers that were visible but undefined as to what they actually were. But pathologists found the samples too small, and worse there was no cellular architecture, the layers of cells in proper positions from the outer epithelium down to the basal layer. Instead of nicely structured layers of cells like a punch or incisional biopsy, you got scrabbled eggs. Cells from all strata of tissue out of relationship to each other. Not as useful or definitive.

So other collection ideas were tried like gargling in the back of your throat with saline, but again while it dislodged some cells, who knows from where any suspicious cell came from. Add to that oropharynx cancers in the tonsil for instance, are within the tonsil not on the surface, so not visible, or collectible,or in the tonsilar crypts which are folds of tissues and again nothing early in there is easily accessible or visible.

From all this you can see that not being visible, and not being sampled easily is the problem with early discovery outside the cervix.

The vaccine is systemic. Non vaccinated people need to get the infection in each individual site, and can get them at different times in their lives depending on exposure. But they are seldom synchronous cancers. If you had and cleared a cervical hpv infection, the odds are very much in your favor that exposed elsewhere you would also clear those as well.

In oropharynx cancers version 16 is almost always the culprit. In determining oropharynx etiology (viral or something else) there, the p16 test is often used because it’s the most likely to cause those cancers. In the cervical areas it is a major player but so are a few other versions, most never found in oral. As stated earlier, no visible lesions means no easy detection. Oropharynx cancers are usually found late as a neck node metastasis, which Is hard to miss.

Thank you Brian. Yes, I agree with that statement, all my books are non-fiction and all my podcasts, blogs, forums all focused on the techincalities of stuff. I am reading scientific journals much more in recent time, but I am also having a fear that I am broadening, diverging to say - a bit too much, that instead of focusing on one or few of the stuff that truly interests me the most, this is why I am saying I won't go into this rabbit hole of this one and trying to just get a shortcut answer, I did not expect someone like you to come honestly, but kinda perfect!

Thank you again though, kudos to you!